{"id":3873,"date":"2020-04-14T17:23:42","date_gmt":"2020-04-14T14:23:42","guid":{"rendered":"https:\/\/rugute.lt\/?page_id=3873"},"modified":"2022-01-12T09:54:09","modified_gmt":"2022-01-12T07:54:09","slug":"kepenu-navikai","status":"publish","type":"page","link":"https:\/\/rugute.lt\/en\/informacija\/piktybiniai-navikai\/kepenu-navikai\/","title":{"rendered":"Kepen\u0173 navikai"},"content":{"rendered":"
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Piktybiniai navikai<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Kepen\u0173 navikai<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Kepen\u0173 piktybiniai navikai sudaro ma\u017eiau nei 5 % vis\u0173 piktybini\u0173 navik\u0173 vaikyst\u0117je. Da\u017eniausi i\u0161 j\u0173 \u2013 hepatoblastoma (40-50 %) ir hepatoceliulin\u0117 karcinoma (20-25 %).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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Berniukai serga da\u017eniau nei mergait\u0117s. Hepatoblastoma \u2013 gana retas kepen\u0173 piktybinis navikas, da\u017eniausiai diagnozuojamas ma\u017eiems vaikams. 95 % ligos atvej\u0173 nustatoma iki 4 m. am\u017eiaus. 10% atvej\u0173 i\u0161 karto randamos metastaz\u0117s plau\u010diuose. Re\u010diau navikas metastazuoja i kitus pilvo organus ar centrin\u0119 nerv\u0173 sistem\u0105. Hepatoceliuline karcinoma da\u017eniausiai serga vyresni nei 10 m. vaikai. \u0160i karcinoma da\u017eniausiai metastazuoja \u012f plau\u010dius, kaul\u0173 \u010diulpus ir limfmazgius.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t

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Pasteb\u0117ta, jog nei\u0161ne\u0161ioti naujagimiai hepatoblastoma serga da\u017eniau. Nustatytas ligos ry\u0161ys su kitais susirgimais: Beckwith-Wiedemann sindromu, \u0161eimine adenomatozine polipoze, Aicardi sindromu. Hepatoceliulin\u0117s karcinomos i\u0161sivystymui turi \u012ftakos \u012fvair\u016bs veiksniai, sukeliantys kepen\u0173 ciroz\u0119. Da\u017eniausiai \u0161is navikas susidaro vaikams, sergantiems l\u0117tiniu hepatitu B arba C, tul\u017eies latak\u0173 atrezija, von Gierke liga, ataksija-telangiektazija, esant alfa-1 antitripsino tr\u016bkumui.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t

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Hepatoblastoma paprastai randama t\u0117vams ap\u010diuopus darin\u012f po de\u0161iniuoju \u0161onkauli\u0173 lanku ar pilvo viduryje. Pilvas gali b\u016bti pap\u016bstas, skausmingas. Kartais atsiranda kar\u0161\u010diavimas, bendras silpnumas, pykinimas ir v\u0117mimas, odos nie\u017eulys, i\u0161ry\u0161k\u0117ja gelta (odos ir aki\u0173 baltym\u0173 pageltimas), suma\u017e\u0117ja apetitas, krenta svoris. Hepatoceliulin\u0117 karcinoma pasirei\u0161kia pana\u0161iai, ta\u010diau simptomai da\u017enai ry\u0161kesni, vaikas atrodo labiau palieg\u0119s. Retais atvejais kepen\u0173 navikai i\u0161skiria hormonus, d\u0117l kuri\u0173 vaikas anks\u010diau subr\u0119sta.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t

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Diagnozuojant piktybinius kepen\u0173 navikus, atliekami sekantys tyrimai:<\/div>
– klinikinis kraujo tyrimas;<\/div>
– biocheminis kraujo tyrimas (kepen\u0173 fermentai, bilirubinas, alfa fetoproteinas);<\/div>
– hepatito B ar C virus\u0173 \u017eymenys;<\/div>
– ultragarsinis pilvo tyrimas (kitaip, echoskopija, sonoskopija);<\/div>
– pilvo kompiuterin\u0117 ar magnetinio rezonanso tomografija;<\/div>
– kepen\u0173 biopsija (audinio pa\u0117mimas tolesniam i\u0161tyrimui mikroskopu);<\/div>
– kaul\u0173 skenavimas, kiti tyrimai, padedantys aptikti metastazes.<\/div>
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Alfa fetoproteino padid\u0117jimas b\u016bdingas net 90-95 % vaik\u0173, sergan\u010di\u0173 hepatoblastoma ir \u017eymiai re\u010diau, sergant hepatoceliuline karcinoma. \u0160is \u017eymuo naudojamas vertinant naviko atsak\u0105 \u012f gydym\u0105. Gydymo metu nuolat stebima kepen\u0173 funkcija, kuri\u0105 atspindi kepen\u0173 fermentai (AST, ALT, LDH, \u0161armin\u0117 fosfataz\u0117).<\/div>
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Priklausomai nuo galimyb\u0117s navik\u0105 pa\u0161alinti chirurgi\u0161kai, jo i\u0161plitimo \u012f aplinkinius ir atokius organus, nustatoma ligos stadija.<\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t
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Jei tik \u012fmanoma, stengiamasi pa\u0161alinti kiek galima daugiau naviko, v\u0117liau taikoma chemoterapija. Kartais prireikia kepen\u0173 transplantacijos. Gydymo intensyvumas priklauso nuo naviko r\u016b\u0161ies, dyd\u017eio, ligos stadijos, vaiko am\u017eiaus bei bendros sveikatos b\u016bkl\u0117s.<\/div>
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Chirurginis gydymas<\/i><\/div>
Operacija \u2013 tai pagrindinis piktybini\u0173 kepen\u0173 navik\u0173 gydymo metodas. Visi\u0161kas naviko pa\u0161alinimas suteikia daugiau vil\u010di\u0173 pasveikti. D\u0117l kepen\u0173 savyb\u0117s regeneruoti (atsinaujinti), gali b\u016bti pa\u0161alinta nema\u017ea j\u0173 dalis. Chirurginiu b\u016bdu \u0161alinamos ir metastaz\u0117s plau\u010diuose. Kuomet naviko ne\u012fmanoma pa\u0161alinti, prie\u0161 operacij\u0105 skiriama chemoterapija, po kurios tumoras suma\u017e\u0117ja ir operacija tampa ma\u017eiau pavojinga. Nuo agresyvaus chirurginio gydymo susilaikoma, jei kepenys prie\u0161 i\u0161sivystant tumorui, jau buvo pa\u017eeistos pirmin\u0117s ligos, pvz., hepatito.<\/div>
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Chemoterapija<\/i><\/div>
Da\u017eniausiai hepatoblastomos gydymui naudojama cisplatina, vinkristinas, 5-fluoruracilas ir doksorubicinas. Pa\u017eengusios ligos atveju kartais naudojamas ifosfamidas, daktinomicinas ir etopozidas. Hepatoceliulin\u0117 karcinoma daug ma\u017eiau jautri chemoterapijai nei hepatoblastoma. Gydymui naudojama cisplatina, doksorubicinas, vinkristinas, 5-fluoruracilas.<\/div>
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Spindulinis gydymas<\/i><\/div>
Spindulinis gydymas netaikomas, nes normalios kepen\u0173 l\u0105stel\u0117s yra ypatingai jautrios jonizuojantiems spinduliams. Kepen\u0173 transplantacija Kepen\u0173 transplantacija, segant hepatoblastoma ar hepatoceliuline karcinoma rekomenduojama, kuomet tumoro negalima pa\u0161alinti chirurgi\u0161kai ar \u012fvykus ligos recidyvui. Operacijos metu pa\u0161alinamos visos kepenys, o \u012f j\u0173 viet\u0105 persodinamos donorin\u0117s. Gali b\u016bti persodinta tik dalis kepen\u0173, paimta i\u0161 t\u0117v\u0173, kuri v\u0117liau regeneruoja.<\/div>
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Kaul\u0173 \u010diulp\u0173 ir kamienini\u0173 l\u0105steli\u0173 transplantacija<\/i><\/div>
Kamienini\u0173 l\u0105steli\u0173 transplantacija \u2013 viena i\u0161 naujausi\u0173 hepatoblastomos gydymo alternatyv\u0173. Taikoma agresyvi chemoterapija didel\u0117mis doz\u0117mis, kurios metu sunaikinamos navikin\u0117s l\u0105stel\u0117s, ta\u010diau kartu \u017e\u016bsta ir kaul\u0173 \u010diulpai. Jiems i\u0161 naujo u\u017epildyti panaudojamos anks\u010diau i\u0161 kraujo surinktos periferin\u0117s kamienin\u0117s l\u0105stel\u0117s.<\/div>
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Kitos priemon\u0117s<\/i><\/div>
Vis pla\u010diau taikomi sekantys gydymo metodai:<\/div>
– krioterapija (navikini\u0173 l\u0105steli\u0173 sunaikinimas \u0161al\u010diu);<\/div>
– etanolio injekcijos (navikini\u0173 l\u0105steli\u0173 sunaikinimas koncentruotu etanolio tirpalu);<\/div>
– kepen\u0173 arterijos chemoembolizacija (vaist\u0173 suleidimas \u012f navik\u0105 maitinan\u010dias kraujagysles, tuo pa\u010diu siekiant jas u\u017ekim\u0161ti);<\/div>
– antiangiogenezini\u0173 vaist\u0173 panaudojimas (siekiant sustabdyti kraujagysli\u0173 susidarym\u0105 tumore).<\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t
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Bendras i\u0161gyvenamumas hepatoblastomos atveju \u2013 60-70 %. Lig\u0105 diagnozavus ankstyvoje stadijoje jis siekia 90 %. Sergant hepatoceliuline karcinoma prognoz\u0117 \u017eymiai blogesn\u0117, nes \u0161io naviko l\u0105stel\u0117s itin agresyvios, greitai apima visas kepenis, i\u0161plinta \u012f kitus organus. Po gydymo \u0117musi did\u0117ti alfa fetoproteino koncentracija rodo ligos atsinaujinim\u0105.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

Piktybiniai navikai Kepen\u0173 navikai Kepen\u0173 piktybiniai navikai sudaro ma\u017eiau nei 5 % vis\u0173 piktybini\u0173 navik\u0173 vaikyst\u0117je. Da\u017eniausi i\u0161 j\u0173 \u2013 hepatoblastoma (40-50 %) ir hepatoceliulin\u0117 karcinoma (20-25 %). Sergamumas Berniukai serga da\u017eniau nei mergait\u0117s. Hepatoblastoma \u2013 gana retas kepen\u0173 piktybinis navikas, da\u017eniausiai diagnozuojamas ma\u017eiems vaikams. 95 % ligos atvej\u0173 nustatoma iki 4 m. am\u017eiaus. 10% […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3842,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-3873","page","type-page","status-publish","hentry"],"yoast_head":"\nKepen\u0173 navikai - Labdaros ir paramos fondas \u201eRugut\u0117\u201c<\/title>\n<meta name=\"description\" content=\"Kepen\u0173 piktybiniai navikai sudaro ma\u017eiau nei 5 % vis\u0173 piktybini\u0173 navik\u0173 vaikyst\u0117je. 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