Malignant melanoma - Melanoma Malignant
☆ I te 2022 Stiftung Warentest hua mai i Tiamana, he iti noa iho te pai o nga kaihoko ki a ModelDerm i nga korero mo te waea rongoa utu.
He melanoma tata ki te 2.5cm (1 inihi) ma te 1.5cm (0.6 inihi)
References
Ko te melanoma he momo pukupuku ka puta i te wa e kino ana nga melanocytes. Ko nga melanocytes i ahu mai i te kohanga neural. Ko te tikanga ka tupu te melanomas ehara i te kiri anake engari ki etahi atu waahi e haere ana nga pūtau neural crest, penei i te kopa me te roro. Ko te hunga mate ki te wahanga 0 melanoma e rima tau te roa o te oranga o te 97%, engari ko te hunga e mate ana i te wahanga IV he 10% noa iho.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
Ko te Cutaneous melanoma (CM) he momo tumo kiri tino kino, he kawenga mo te 90% o nga mate pukupuku kiri. Hei whakatika i tenei, i mahi tahi nga tohunga o the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) .
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Ko te Melanoma, he momo mate pukupuku kiri, e tu ana mo tona hononga tata ki te punaha mate. Ka kitea tenei mai i te nui haere o te mate ki nga tangata kua ngoikore te punaha mate, te noho mai o nga pūtau aukati i roto i nga pukupuku taketake e rua me to ratou horapa atu ki etahi atu wahanga o te tinana, me te mea ka taea e te punaha mate te mohio ki etahi pūmua kei roto i nga pūtau melanoma. Ko te mea nui, ko nga maimoatanga e whakanui ana i te punaha raupatu kua whakaatuhia he oati mo te whawhai ki te mate pukupuku. Ahakoa he whanaketanga tata tonu te whakamahinga o nga rongoa whakakaha i te mate pukupuku ki te rongoa i te melanoma matatau, ko nga rangahau tata nei e tohu ana ko te whakakotahi i enei rongoa me te chemotherapy, te whakamaarama irirangi, me nga maimoatanga rapoi e whaaia ana ka tino pai ake nga hua. Heoi, ka taea e taua whakamaarama mate mate te whakaputa i te whānuitanga o nga paanga o te mate-a-mate e pa ana ki nga momo whekau, ka iti pea te whakamahi. Ma te titiro whakamua, ko nga huarahi e whai ake nei mo te rongoa i te melanoma matatau ka uru pea ki nga rongoa e aro ana ki nga waahi arowhai mate motuhake penei i te PD1, nga raau taero ranei e whakararu ana i nga huarahi ngota ngota penei i te BRAF me te MEK.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Ko te take tuatahi o te melanoma ko te whakamaaramatanga o te rama ultraviolet ki te hunga he iti te taumata o te kiri melanin (taupori ma). Ko te rama UV pea mai i te ra, i nga taputapu tanning ranei. Ko te hunga he maha nga nevus, he hitori melanoma o nga mema o te whanau, me te ngoikore o te mahi aukati ka nui ake te mate ki te melanoma.
Ma te whakamahi whakamarumaru ra me te karo i te rama UV ka taea te aukati i te melanoma. Ko te tikanga ka tangohia te maimoatanga ma te pokanga. Ki te hunga he mate pukupuku paku te rahi ake, ka whakamatauria nga kopuku lymph tata mo te horapa (metastasis). Ko te nuinga o nga tangata ka ora mena karekau he metastasis. Mo te hunga kua horapahia te melanoma, ka pai ake te oranga o te rongoa mate mate, te rongoa koiora, te whakamaarama iraruke, te chemotherapy ranei. Ma te maimoatanga, ko nga reeti oranga e rima tau i te United States ko te 99% i waenga i te hunga e mate ana i te rohe, 65% i te wa kua horapa te mate ki nga ngongo lymph, me te 25% i waenga i te hunga kua horapa tawhiti.
Ko te Melanoma te momo tino kino o te mate pukupuku kiri. Ko Ahitereiria me Aotearoa te reiti teitei o te mate pukupuku o te ao. Ko nga reiti teitei o te mate pukupuku ka puta ano ki te Raki o Uropi me Amerika Te Tai Tokerau. He iti ake te ahua o te Melanoma ki Ahia, Awherika, me Amerika Latina. I te United States, 1.6 nga wa ka nui ake te mate melanoma ki nga tane i nga wahine.
○ Nga tohu me nga tohu
Ko nga tohu tuatahi o te melanoma ko nga huringa ki te ahua me te tae o te nevus o naianei. I roto i te take o te melanoma nodular, ko te ahua o te putunga hou i runga i te kiri. I nga wahanga o muri mai o te melanoma, ka patito te nevi, ka pupuhi, ka whakaheke toto ranei.
[A-Asymmetry] Hangarite te ahua
[B-Borders] Taitapa (he koretake me nga tapa me nga kokonga)
[C-Color] Tae (he rerekee me te korikori)
[D-Diameter] Diamita (nui ake i te 6 mm = 0.24 inihi = rite te rahi o te komuru pene)
[E-Evolving] Te whanake i roto i te waa
cf) Ka tutuki pea te keratosis Seborrheic ki etahi, ki te katoa ranei o nga paearu ABCD, ka puta he whakaoho teka.
Ka taea te metastasis o te melanoma wawe, engari he onge; iti iho i te haurima o nga melanomas ka kitea moata ka huri hei metastatic. Ka kitea te mate metastases o te roro ki nga turoro melanoma metastatic. Ka horapa hoki te melanoma metastatic ki te ate, ki nga wheua, ki te puku, ki nga ngongo lymph tawhiti ranei.
○ Taatari
Ko te titiro ki te waahi e paataihia ana ko te tikanga tino noa mo te whakapae he mate pukupuku. Ko nga nevus he rereke te tae, te ahua ranei ka kiia he tohu mate pukupuku.
Ka tirohia e nga rata nga kiore katoa, tae atu ki era iti iho i te 6 mm te whanui. Ina whakamahia e nga tohunga kua whakangungua, he pai ake te mahi a dermoscopy ki te tautuhi i nga mate kino atu i te whakamahi i te kanohi tahanga anake. Ko te tātaritanga ma te koiora o tetahi reanga kiri he tohu kei te mate pukupuku pea.
○ Maimoatanga
#Mohs surgery
Ka tohuhia pea e to taakuta te whakamaarama mate mate mena kei a koe te wahanga 3, te wahanga 4 melanoma e kore e taea te tango ma te pokanga.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]