Umdlavuza womthondo
Umdlavuza womthondo kuwumdlavuza owakheka esikhumbeni noma izicubu zomthondo.Izimpawu zingafaka ukukhula okungajwayelekile, isilonda noma isilonda esikhunjeni sowesilisa, kanye nokopha noma ukukhipha okunuka kabi.
Izici zobungozi zibandakanya i-phimosis (ukungakwazi ukuhoxisa ijwabu lobudoda), ukuvuvukala okungapheli, ukubhema, ukutheleleka nge-HPV, i- condylomata acuminate, ukuba nabalingani abaningi bezocansi, kanye nokuya ocansini usemncane.
Cishe ama-95% omdlavuza we-penile angama- squamous cell carcinomas .Ezinye izinhlobo zomdlavuza we-penile njenge- Merkel cell carcinoma, i- cell cell carcinoma, ne- melanoma ngokuvamile azivamile. [1]Ku-2018, kwenzeka emadodeni angama-34,000 futhi kwabangela ukufa kwabantu abayi-15,000.
Izimpawu
hlelaUmdlavuza wePenile ungabonakala njengokubomvu nokucasula epeni ngesikhumba esijiyile ku-glans noma ijwabu langaphakathi noma isilonda, ukukhula kwangaphandle ( exophytic ) noma ukukhula okufana "nomunwe" (papillary). [2]Umdlavuza wePenile ungahambisana nokukhishwa kwe-penile noma ngaphandle kobunzima noma ukushisa noma ukuhayiza ngenkathi uchama (i- dysuria ) nokuphuma kwegazi endodeni. [2] [3]
Izici zobungozi
hlelaIzifo
hlela- Ukutheleleka nge-HIV —amadoda ane-HIV anengozi ephindwe kasishiyagalombili yokuthola umdlavuza we-penile kunamadoda angenayo i-HIV.
- I-human papillomavirus -HPV iyingozi ekuthuthukiseni umdlavuza we-penile. [4] Ngokusho kweCentre for Disease Control and Prevention (CDC), i-HPV ibhekele cishe i-800 (cishe i-40%) yamacala we-1,570 womdlavuza we-penile otholakala minyaka yonke e-United States.Kunezinhlobo ezingaphezu kuka-120 ze-HPV.
- Ama-genital warts -Izinsumpa zangasese noma ze-perianal zandisa ubungozi besifo somdlavuza we-penile ongahlaseli cishe izikhathi ezingama-3.7 uma kwenzeka ngaphezulu kweminyaka emibili ngaphambi kosuku lokubhekiswa. [4]Cishe uhhafu wamadoda anomdlavuza we-penile nawo anezinsumpa zangasese, ezibangelwa i-HPV.
I-Pathogenesis
hlelaKuphakama umdlavuza Penile kusuka eyandulela izilonda, okuyinto ngokuvamile bathuthuke kusukela ephansi kulibanga ephezulu grade izilonda.Kumdlavuza we-penile ohlobene ne-HPV lokhu kulandelana kanje: [1]
- I-squplus hyperplasia ;
- I-penile intraepithelial neoplasia esezingeni eliphansi (i-PIN);
- I-PIN esezingeni eliphakeme (i-carcinoma in situ— Isifo sikaBowen, i- Erythroplasia yaseQueyrat ne- bowenoid papulosis (BP));
- I-carcinoma ehlaselayo yomthondo.
Kodwa-ke, kwezinye izimo izilonda ezingezona eze-dysplastic noma ezinesizungu ezingadlulela ngqo zingaba nomdlavuza.Izibonelo zifaka izilonda ze-penile flat (FPL) ne- condylomata acuminata . [1]
Ku- HPV umdlavuza ongemuhle isilonda esandulele kakhulu yi- lichen sclerosus (LS). [1]
Ukuxilongwa
hlelaI-International Society of Urological Pathology (ISUP) incoma ukusetshenziswa kwe- p16 INK4A immunostain for the diagnostic and classification of HPV-related penile cancer. [5]
Ukuhlukaniswa
hlelaCishe ama-95% omdlavuza we-penile angama- squamous cell carcinomas .Zihlukaniswe ngezinhlobo ezilandelayo:
- i-basaloid (4%)
- insumpa (6%)
- i-warty-basaloid exubile (17%)
- i-verrucous (8%)
- i-papillary (7%)
- enye i-SCC ixubile (7%)
- i-sarcomatoid carcinomas (1%)
- akuchaziwe ngenye indlela (49%)
Ezinye izinhlobo ze-carcinomas azivamile futhi zingafaka iseli elincane, i- Merkel cell, i- cell ecacile, i-sebaceous cell noma i- basal cell tumors.Izilonda ezingekho epithelial ezifana nama- melanomas nama- sarcomas zivame kakhulu. [1]
Isiteji
hlelaNjengamakhemikhali amaningi amabi, umdlavuza we-penile ungasakazekela kwezinye izitho zomzimba.Ngokuvamile kuyisifo esiyinhloko, indawo yokuqala lapho umdlavuza usakazeka khona emzimbeni.Kancane kancane kuyisifo esibuhlungu sesibili, lapho umdlavuza usabalalele khona endondeni kusuka kwenye indawo.Ukufakwa komdlavuza we-penile kunqunywa ubukhulu bokuhlasela kwesimila, i-nodal metastasis, kanye ne-metastasis ekude.
Ingxenye ye-T yemihlahlandlela yesiteji ye-AJCC TNM ingeyesimila sokuqala ngokulandelayo:
- I-TX: Isigaxa sokuqala asikwazi ukuhlolwa.
- I-T0: Akunabufakazi besimila esiyinhloko.
- I-Tis: I-Carcinoma in situ .
- I-Ta: I-carcinoma engabonakali ehlaselayo.
- I-T1a: Isimila sihlasela izicubu ezihlangene ezingaphansi kwe-lymph vascular invasion futhi asihlukaniswanga kahle (okungukuthi, ibanga lesi-3-4).
- I-T1b: Isimila sihlasela izicubu ezixhuma ngaphansi kwe-lymph ngokuhlasela kwe-lymph vascular noma sihlukaniswe kabi.
- I-T2: Isimila sihlasela i-corpus spongiosum noma i-cavernosum.
- I-T3: I-tumor ihlasela i-urethra noma i-prostate.
- I-T4: Isimila sihlasela ezinye izakhiwo eziseduze.
I-Anatomic Stage noma Amaqembu Okuqagela umdlavuza we-penile ami kanjena:
- Isigaba 0 — I-Carcinoma in situ .
- Isigaba I-Umdlavuza uhlukaniswe ngokulingene noma kahle futhi uthinta kuphela izicubu ezixhumene ne-subepithelial.
- Isigaba II — Umdlavuza wehlukaniswe kabi, uthinta ama-lymphatics, noma uhlasela i-corpora noma i-urethra.
- Isigaba IIIa — Kunokuhlasela okujulile ethweni lobudoda nakwe-metastasis ku-lymph node eyodwa.
- Isigaba IIIb — Kunokuhlasela okujulile ethweni lobudoda nakwe-metastasis kuma-lymph node amaningi we-inguinal.
- Isigaba IV — Umdlavuza uhlasele ezakhiweni ezincikene nepipi, kufakwa imastastas node ye-pelvic, noma i-metastasis ekude ikhona.
Izimila ezinhle ze-HPV
hlelaUkudlanga kwabantu i-papillomavirus kumdlavuza we-penile kuphakeme cishe ngama-40%. I-HPV16 yi-genotype ebaluleke kakhulu ebala cishe izicubu ezingama-63% zama-HPV-positive.Phakathi komdlavuza we-warty / basaloid ukwanda kwe-HPV kungama-70-100% kanti kwezinye izinhlobo kucishe kube ngu-30%. [1]
Ukuvimbela
hlela- Imishanguzo ye-HPV efana neGardasil noma iCervarix inganciphisa ubungozi be-HPV futhi, ngenxa yalokho, umdlavuza we-penile. [1] [6]
- Ukusetshenziswa kwamakhondomu kucatshangwa ukuthi kuyazivikela emdlavuzeni ophathelene ne-HPV penile. [1]
- Ukuhlanzeka okuhle kwezitho zobulili, okubandakanya ukugeza ipipi, isikhumba, nejwabu nsuku zonke ngamanzi, kungavimbela i-balanitis nomdlavuza we-penile. Noma kunjalo, insipho enezithako ezinzima kufanele igwenywe.Template:Ifsubst
- Ukuphela kokubhema kunganciphisa ingozi yomdlavuza we-penile. [4]
- Ukusoka ngesikhathi sobuntwana noma ebuntwaneni kungahlinzeka ngokuvikelwa okuyingxenye kumdlavuza we-penile. Ababhali abaningana baphakamise ukusoka njengecebo elingenzeka lokuvikela umdlavuza we-penile; [1] [6] [7] kodwa-ke, i-American Cancer Society ikhomba ukuthi lesi sifo siyivelakancane futhi iphawula ukuthi i-American Academy of Pediatrics noma iCanada Academy of Pediatrics ayikukhuthazi ukusoka okwenzeka njalo ngaphambi kokubeletha.
- I-Phimosis ingavinjelwa ngokwenza inhlanzeko efanele nokubuyisa ijwabu njalo.
- I-Paraphimosis ingavinjelwa ngokungashiyi ijwabu lihoxiswe isikhathi eside.
Ukwelashwa
hlelaUkwelashwa komdlavuza we-penile kuzohluka ngokuya ngesigaba somtholampilo sesimila ngesikhathi sokuxilongwa.Kunezinketho eziningi zokwelashwa komdlavuza we-penile, kuya ngesiteji.Kubandakanya ukuhlinzwa, ukwelashwa ngemisebe, ukwelashwa ngamakhemikhali kanye nokwelashwa kwezinto eziphilayo.Ukwelashwa okuvame kakhulu kungenye yezinhlobo ezinhlanu zokuhlinzwa:
- Ukusikwa kwendawo yonke — isisu nezinye izicubu ezinempilo ezizungezile ziyasuswa
- I- microsurgery —ukuhlinzwa okwenziwa ngesibonakhulu kusetshenziselwa ukususa isimila nezicubu ezincane ezinempilo ngangokunokwenzeka
- Ukuhlinzwa nge-Laser —isibani selaser sisetshenziselwa ukushisa noma ukusika amaseli anomdlavuza
- Ukusoka — ijwabu elinomdlavuza liyasuswa
- Ukunqunywa (i- penectomy) —ukususwa kwesitho sangasese ngokuphelele noma ngokuphelele, futhi mhlawumbe nama- lymph node ahambisanayo.
Indima yokwelashwa ngemisebe ifaka phakathi indlela yokulondolozwa komzimba yomdlavuza wepenile osezingeni lokuqala ezikhungweni ezikhethekile.Ngaphezu kwalokho, i-adjuvant therapy isetshenziselwa iziguli ezinesifo esithuthukile endaweni noma ukuphatha izimpawu. [8]
Isibikezelo
hlelaIsibikezelo singahluka kakhulu ezigulini, kuya ngokuthi sikalwe kuphi.Ngokuvamile, lapho umdlavuza utholakala ngokushesha, kungcono ukubikezelwa.Izinga lokusinda leminyaka emihlanu yonke yazo zonke izigaba zomdlavuza we-penile cishe liyi-50%.
I-Epidemiology
hlelaUmdlavuza wePenile wumdlavuza ongajwayelekile emazweni athuthukile okwenzeka minyaka yonke okuhluka kusuka ku-0.3 kuye ku-1 kwabangu-100,000 ngonyaka kubalwa cishe i-0.4-0.6% yazo zonke izifo ezimbi. [1]I-annual kwesifo cishe 1 ezingabantu 100,000 e-United States, [9] e-1 250,000 e-Australia, [10] kanye 0,82 ngamunye 100,000 eDenmark. [11]E-United Kingdom, abesilisa abangaphansi kwama-500 abatholakala benomdlavuza we-penile minyaka yonke. [12]
Kodwa-ke, emazweni asathuthuka umdlavuza we-penile uvame kakhulu.Isibonelo, eParaguay, e- Uruguay, e- Uganda naseBrazil izehlakalo eziyi-4.2, 4.4, 2.8 no-1.5-3.7 ku-100,000 ngamunye, ngokulandelana. [1] [4]Kwamanye amazwe aseNingizimu Melika, e-Afrika, nase-Asia, lolu hlobo lomdlavuza lwenza kufinyelela ku-10% wezifo ezibulalayo emadodeni. [1]
Ingozi yokuphila konke ilinganiselwa ku-1 kwabangu-1,437 e-United States naku-1 kwabangu-1,694 eDenmark. [13]
Izinkomba
hlela- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Penile cancer: epidemiology, pathogenesis and prevention. Cite error: Invalid
<ref>
tag; name "Bleeker2009" defined multiple times with different content - ↑ 2.0 2.1 (in en) Penile cancer: diagnosis, clinical features and management. 2013-03-20. http://rcnpublishing.com/doi/abs/10.7748/ns2013.03.27.29.50.e6135.
- ↑ Empty citation (help)
- ↑ 4.0 4.1 4.2 4.3 Epidemiology and natural history of penile cancer. August 2010. Cite error: Invalid
<ref>
tag; name "pow-sang-2010" defined multiple times with different content - ↑ Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers V: Recommendations on the Use of Immunohistochemical and Molecular Biomarkers in Penile Cancer. https://pubmed.ncbi.nlm.nih.gov/32235153.
- ↑ 6.0 6.1 "Penile cancer--prevention and premalignant conditions". Urology 76 (2 Suppl 1): S24-35. August 2010. doi:10.1016/j.urology.2010.04.007. PMID 20691883.
- ↑ "[Prevention strategies for testicular and penile cancer: an integrative review]". Revista da Escola de Enfermagem da USP 45 (1): 277–82. March 2011. doi:10.1590/s0080-62342011000100039. PMID 21445520.
- ↑ . September 2018.
- ↑ The American Cancer Society: Penile Cancer: What is penile cancer? Archived 2017-01-14 at the Wayback Machine. American Cancer Society, Last revised: January 8, 2012
- ↑ The Official Website of the Royal Australasian College of Physicians, Published September 2010
- ↑ "Falling incidence of penis cancer in an uncircumcised population (Denmark 1943-90)". BMJ (Clinical Research Ed.) 311 (7018): 1471. December 1995. doi:10.1136/bmj.311.7018.1471. PMID 8520335.
- ↑ The American Cancer Society: Penile Cancer: What are the key statistics about penile cancer Archived 2017-01-14 at the Wayback Machine. American Cancer Society, Last revised: January 18, 2012
- ↑ Carcinoma in situ of the penis in a 76-year-old circumcised man.