Umdlavuza womthondo

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Umdlavuza womthondo kuwumdlavuza owakheka esikhumbeni noma izicubu zomthondo.Izimpawu zingafaka ukukhula okungajwayelekile, isilonda noma isilonda esikhunjeni sowesilisa, kanye nokopha noma ukukhipha okunuka kabi.

Penile_Edema_02

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[hlela | Hlela umthombo]

Umdlavuza 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[hlela | Hlela umthombo]

Izifo[hlela | Hlela umthombo]

  • 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[hlela | Hlela umthombo]

Kuphakama umdlavuza Penile kusuka eyandulela izilonda, okuyinto ngokuvamile bathuthuke kusukela ephansi kulibanga ephezulu grade izilonda.Kumdlavuza we-penile ohlobene ne-HPV lokhu kulandelana kanje: [1]

  1. I-squplus hyperplasia ;
  2. I-penile intraepithelial neoplasia esezingeni eliphansi (i-PIN);
  3. I-PIN esezingeni eliphakeme (i-carcinoma in situ— Isifo sikaBowen, i- Erythroplasia yaseQueyrat ne- bowenoid papulosis (BP));
  4. 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[hlela | Hlela umthombo]

I-International Society of Urological Pathology (ISUP) incoma ukusetshenziswa kwe- p16 INK4A immunostain for the diagnostic and classification of HPV-related penile cancer. [5]

Ukuhlukaniswa[hlela | Hlela umthombo]

Cishe 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[hlela | Hlela umthombo]

Njengamakhemikhali 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[hlela | Hlela umthombo]

Ukudlanga 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 | Hlela umthombo]

  • 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[hlela | Hlela umthombo]

Ukwelashwa 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[hlela | Hlela umthombo]

Isibikezelo 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[hlela | Hlela umthombo]

Umdlavuza 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 | Hlela umthombo]

  1. 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 Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content Cite error: Invalid <ref> tag; name "Bleeker2009" defined multiple times with different content
  2. 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. 
  3. Empty citation (help)
  4. 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 Cite error: Invalid <ref> tag; name "pow-sang-2010" defined multiple times with different content
  5. 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. 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. 
  7. "[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. 
  8. . September 2018. 
  9. The American Cancer Society: Penile Cancer: What is penile cancer? American Cancer Society, Last revised: January 8, 2012
  10. The Official Website of the Royal Australasian College of Physicians, Published September 2010
  11. "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. 
  12. The American Cancer Society: Penile Cancer: What are the key statistics about penile cancer American Cancer Society, Last revised: January 18, 2012
  13. Carcinoma in situ of the penis in a 76-year-old circumcised man.