Mesothelium wani membrane ne wanda ke layin yawancin gabobin ciki don rufe su da kare su. Ya ƙunshi yadudduka biyu na ɗanyen sel, ɗaya daga cikinsu, na ciki, yana lulluɓe gabobi daban -daban kamar huhu, zuciya da ciki, na biyun, na waje, yana yin wani irin jakar da ke kewaye da rufin ciki. . Ruwa yana samuwa a tsakanin waɗannan yadudduka biyu na sel, wanda ke sauƙaƙe motsi na gabobi.

A wasu lokutan mesothelium na iya shafar ciwace -ciwacen da ba su da kyau, kuma da wuya, kansar da ake kira mesotheliomas. Daga nan ne a cikin roƙon cewa ya fi yawa, wato a ce mesothelium wanda ke rufe huhu; a mafi yawan lokuta, yana faruwa ne sakamakon kamuwa da cutar asbestos. Amma wannan yanayin har yanzu yana da wuya, akwai, a cewar alkalumma daga Babban Hukumar Kula da Lafiya, sabbin cututtukan 600 zuwa 900 da aka gano kowace shekara a Faransa.

A mesothelium ya ƙunshi yadudduka biyu na fannonin sel da ake kira mesothelial cells. Tsakanin waɗannan yadudduka biyu akwai ruwa. Mesothelium yana layika saman ciki na santsi mai laushi na ramin jikin mutum (da ake kira serous membranes). Don haka, waɗannan layukan salula guda biyu suna kare kirji, ciki ko zuciya.

Mesothelium yana da sunaye daban -daban dangane da inda yake a cikin jiki: game da huhu shine pleura, murfin da ke rufe ciki, ƙashin ƙugu ko viscera ana kiransa peritoneum, kuma a ƙarshe mesothelium wanda ke kare zuciya ana kiranta pericardium (pericardium kuma yana rufe asalin manyan tasoshin).

Ruwan da ke tsakanin yadudduka biyu na mesothelium yana taimakawa sauƙaƙe motsi na gabobi. A zahiri, murfin ciki yana lulluɓe waɗannan gabobin ciki kai tsaye, yayin da mayafin waje ya zama jakar da ke kewaye da murfin ciki.

Babban aikin epithelium shine kare gabobin ciki da ya rufe:

• mesothelium da ke kewaye da huhu ana kiranta pleura: don haka yana nuna halaye na sel na rufin epithelial. Amma kuma yana da yuwuwar ɓoye sel: a zahiri, yana ɓoyewa, musamman, cytokines da abubuwan haɓaka. Bugu da ƙari, zagayawar ƙwayar lymph gami da motsi na ruwan pleural suna da alaƙa da takamaiman tsarin pleura. Wannan ya ƙunshi, musamman, pores a matakin parietal pleura, wanda ke ba da izinin juzu'in lymphatic don haɗa kai tsaye tare da sararin pleural;
• peritoneum shine takamaiman mesothelium na ciki. Wannan peritoneum dole ne, a zahiri, a ɗauki kansa a matsayin gabobi. Sassan jikinsa yayi bayani musamman zagayawar ruwan peritoneal, babban abin hawan sa shine madaidaicin diaphragm. Bugu da kari, murfin mahaifa shima wuri ne mai mahimmanci na musaya. A ƙarshe, ya juya cewa wannan membrane shima yana da keɓaɓɓun keɓancewar rigakafi;
• Pericardium, wanda shine mesothelium da ke kewaye da zuciya, yana da aikin ilimin motsa jiki na kula da myocardium, amma kuma na ba shi damar zamewa yayin ƙulli.

Kwayoyin mesothelium na iya fuskantar wasu canje -canje a wasu lokuta waɗanda ke yin yadda suke girma ko nuna hali mara kyau:

• wannan wani lokacin yana haifar da samuwar abin da ake kira ciwon kansa, saboda haka begnins: alal misali, ƙwayar fibrous na pleura, ko ma abin da ake kira mesothelioma multcystic;
• Hakanan akwai cututtukan daji na mesothelium, amma hakika cutar kansa ce da ba a saba ganin irinta ba: ana samun adadi guda 600 zuwa 900 kowace shekara a Faransa. Yana cikin pleura cewa yana faruwa akai -akai, tunda kashi 90% na mastotiomas masu cutarwa suna shafar wannan pleura, suna ɗaukar mesothelioma pleural. Wannan mummunan mesothelioma mara kyau shine, a mafi yawan lokuta, yana haifar da bayyanar asbestos. Kusan 70% na lokuta na mesothelioma pleural na faruwa a cikin mutane. A zahiri, an ƙaddara rabon mesotheliomas ga irin wannan bayyanar ga asbestos a 83% a cikin maza da 38% a cikin mata, a cewar alkalumma daga Haute Autorité de Santé (HAS). Bugu da ƙari, an nuna alaƙar sakamako-sakamako;
• a lokuta da ba a saba gani ba, kusan kashi 10%, wannan kansar na iya shafar peritoneum, kuma ana kiranta mesothelioma peritoneal;
• A ƙarshe, lokuta na musamman sun shafi pericardium, wannan ciwon daji da ake kira mesothelioma pericardial, har ma fiye da haka, yana iya shafar farjin ƙwayayen.

Gudanar da warkarwa, a yayin mesothelioma, wannan cutar sankara mai ƙarancin gaske, ƙwararre ce: dole ne a tattauna ta a cikin taron tuntuba da yawa. Akwai cibiyoyin kwararru da aka sadaukar don wannan cutar kansa a Faransa, waɗanda ke cikin hanyar sadarwar da ake kira MESOCLIN. Magungunan da kanta ƙungiya ce ke kula da ita. Chemotherapy tare da pemetrexed da gishiri platinum shine daidaitaccen magani.

Yin tiyata don dalilai na warkewa ya ƙunshi fa'idar pleuropneumonectomy amma ya kasance na musamman: hakika, yana iya damuwa da farkon matakan mesothelioma. A halin yanzu ana gudanar da shi a gwajin asibiti.

Dole ne a ba da wuri mai mahimmanci don kulawa mai goyan baya har ma da kulawar jinya, don mafi kyawun kiyaye lafiyar rayuwa ga mai haƙuri. Taimako da mukarraban sune muhimman abubuwa, haka nan sauraro, rakiya, halarta. Amma dole ne mu tuna da gaske cewa irin wannan mummunan ƙwayar cuta yana da wuya sosai kuma ya kasance banda. Dangane da hanyoyin bincike na yanzu, suna masu alƙawarin kuma masu ɗaukar bege:

• don haka, akwai karatuttuka da yawa waɗanda ke duban interferons, da nufin toshe hanyar zuwa ci gaban wannan cutar kansa ta hanyar haɓaka hanyoyin rigakafi na asali;
• haka kuma, har yanzu a matakin bincike a halin yanzu, dabarun yin amfani da maganin antitumor virotherapy ya ƙunshi kamuwa da ƙwayoyin cutar kansa tare da ƙwayar cuta da nufin kaiwa ga kawar da su. Koyaya, yana nuna cewa ƙwayoyin mesothelioma suna da hankali musamman ga wannan magani. Wata ƙungiyar Nantes da Jean-François Fonteneau ke jagoranta ta gano dalilin da yasa waɗannan ƙwayoyin kansar mesothelial ke da matukar damuwa da wannan magani ta hanyar virotherapy: wannan yana da alaƙa da cewa, a yawancin su, sun lura da ɓacewar ƙwayoyin halittar da ke rikodin nau'in. 1 interferons, kwayoyin da ke da kaddarorin rigakafi. Don haka wannan binciken ya buɗe hanyar zuwa gwajin tsinkaya, musamman, wanda zai ba da damar yin hasashen martanin magani ta hanyar virotherapy, da dabaru don haɓaka tasirin sa.

Binciken mesothelioma na huhu yana da rikitarwa don ganewa da farko, kuma ya haɗa da matakai da yawa a jere.

Nazarin jiki

Alamun farko galibi ba na musamman ba ne:

• alamun sa hannu a ciki: ciwon kirji, bushewar tari, dyspnea (wahalar numfashi ta ƙaru da aiki);
• lalacewar yanayin gaba ɗaya, tare da asarar nauyi;
• alamun mamayewar gida: ciwon kirji ko kafada.

Dole ne jarrabawar asibiti ta haɗa da, a cikin tsari, tambayar da za ta nemi shafar asbestos na baya, ko a cikin ƙwararrun ƙwararru ko in ba haka ba, kuma za ta kimanta yiwuwar dogaro da taba. Za a ƙarfafa shan taba.

POSTERS

Aikin hoto na tsari ya haɗa da:

• x-ray na kirji. Don haka duk wani hoton da ake tuhuma yakamata ya haifar da saurin aiwatar da aikin sikelin thoracic;
• na'urar daukar hoto ta kirji, tare da allurar samfurin sabanin iodinated (in babu contraindication). Idan tuhuma tana da ƙarfi, shawarwarin suna nuna a lokaci guda yin yankan ciki na sama.

Biology

A halin yanzu, babu wata alama don gwajin alamun ƙwayar ƙwayar cuta don dalilai na bincike.

Anatomopathology

A ƙarshe, za a tabbatar da ganewar ta samfuran biopsy. Karatun sau biyu daga masanin ilimin cuta wanda ya ƙware a mesothelioma yana da mahimmanci (likitoci na cibiyar sadarwa ta MESOPATH).

Ka'idar tantanin halitta tana ɗaya daga cikin manyan ka'idodin ilmin halitta na zamani. Manufofinsa guda uku sune kamar haka: a gefe guda, dukkan rayayyun halittu sun kasance daga sel (sel guda ɗaya ga kwayoyin halittar da ba a rayayye ba, sel da yawa ga duk sauran halittu masu rai, ko dabbobi ne, tsirrai ko namomin kaza). Don haka, tantanin halitta shine sashin asali na tsari da tsari a cikin kwayoyin halitta. A ƙarshe, duk sel suna fitowa ne daga sel waɗanda suka riga sun wanzu.

Wannan ka'idar tantanin halitta tana ɗaukar tushe daga XVI^e karni a cikin Netherlands, godiya ga kera farkon microscope na fili wanda aka sanye shi da ruwan tabarau biyu, ta Zacharais Janssen. Masanin kimiyyar Holland Antoine Van Leuwenhoek shi ma zai yi microscope na farko, wanda a cikinsa ne zai gano ƙwayoyin cuta ta hanyar lura da gutsuttsarin tartar daga haƙoransa. Abokin Leuwenhoek, masanin kimiyyar Ingilishi Robert Hooke ne zai gano ƙwayoyin farko.

Ka'idojin kimiyya koyaushe 'ya'yan itacen dogon bayani ne, galibi gama -gari: hakika, galibi sun haɗa da aikin gini wanda ya fara daga binciken wasu mutane. Don dawowa kaɗan musamman ga ƙwayoyin mesothelial, ga masanin kimiyya ne daga farkon karni na 1865 cewa muna bin diddigin mahimmancin. Wannan masanin ilimin halitta na farko da sunan Edmund B. Wilson (1939-XNUMX) hakika ya lura kuma ya bayyana yadda kwai da aka haƙa ya raba zuwa ɗaruruwan sel don ƙirƙirar tayi, kuma waɗanne ɓangarori na jiki ke haɓaka daga waɗanne sel. Bugu da ƙari, don rikodin, daga baya ɗalibinsa Walter Sutton ne ya gano rawar chromosomes a matsayin raka'a na gado.

A ƙarshe, duk waɗannan abubuwan da suka biyo baya musamman sun kawo takamaiman ilimi game da batun ƙwayoyin mesothelial: ya bayyana cewa waɗannan, a zahiri, sun samo asali ne daga mesoblast, matsakaiciyar salon salula na amfrayo (amfrayo ta ƙunshi yadudduka uku waɗanda suke a asali na dukkan sel na jiki: endoderm, mesoderm da ectoderm). Daga qarshe, ya kamata a lura cewa duk sel da aka samo daga mesoderm suna yin dukkan ko sashi na gabobin ciki daban -daban, ban da tsarin juyayi wanda da kansa yake samu daga ectoderm.