{"id":552,"date":"2021-07-05T15:07:37","date_gmt":"2021-07-05T12:07:37","guid":{"rendered":"https:\/\/www.silmasaatio.fi\/pienet-suonikalvon-melanoomat\/"},"modified":"2024-11-22T11:41:55","modified_gmt":"2024-11-22T09:41:55","slug":"sma-melanom-i-aderhinnan","status":"publish","type":"post","link":"https:\/\/www.silmasaatio.fi\/sv\/sma-melanom-i-aderhinnan\/","title":{"rendered":"Sm\u00e5 melanom i \u00e5derhinnan"},"content":{"rendered":"

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Uvealt melanom<\/a>\u00a0\u00e4r den vanligaste typen av elakartad tum\u00f6r i \u00f6gat hos vuxna. Incidensen f\u00f6r denna typ av \u00f6goncancer i norra Europa \u00e4r en av de h\u00f6gsta i v\u00e4rlden. \u00c5lder \u00e4r en av de st\u00f6rsta riskfaktorerna och antalet patienter blir fler i takt med att befolkningen \u00e5ldras.<\/p>\n

Storleken p\u00e5 tum\u00f6ren \u00e4r den viktigaste faktorn som f\u00f6rutsp\u00e5r om sjukdomen sprids till andra delar av kroppen \u2013 fr\u00e4mst levern. Med tanke p\u00e5 de insjuknade patienternas prognos \u00e4r det viktigt med en s\u00e5 tidig diagnos som m\u00f6jligt och en effektiv lokal behandling som minskar risken f\u00f6r metastasering.<\/p>\n

Godartade pigmentfl\u00e4ckar i \u00e5derhinnan f\u00f6rekommer hos ungef\u00e4r tio procent av befolkningen. Det \u00e4r sv\u00e5rt att skilja mellan sm\u00e5 melanom och godartade pigmentfl\u00e4ckar i \u00e5derhinnan. Bed\u00f6mningen grundar sig enbart p\u00e5 tum\u00f6rens utseende och tillv\u00e4xttendens, eftersom det \u00e4r tekniskt komplicerat att ta v\u00e4vnadsprov fr\u00e5n de minsta tum\u00f6rerna. En liten del av de godartade pigmentfl\u00e4ckarna kan med tiden utvecklas till maligna melanom. F\u00f6r att skilja mellan pigmentfl\u00e4ckar och melanom har man identifierat typiska drag f\u00f6r utseendet p\u00e5 f\u00f6r\u00e4ndringar, men oftast har dessa \u00e4nnu inte utvecklats hos de allra minsta tum\u00f6rerna. D\u00e5 baseras diagnosen mellan f\u00f6r\u00e4ndringarna p\u00e5 den dokumenterade tillv\u00e4xten. \u00c5 andra sidan kan ocks\u00e5 godartade pigmentfl\u00e4ckar v\u00e4xa, men mycket l\u00e5ngsammare \u00e4n melanom.<\/p>\n

I os\u00e4kra fall har man f\u00f6ljt upp f\u00f6r\u00e4ndringar i \u00e5derhinnan just f\u00f6r att uppt\u00e4cka eventuell tillv\u00e4xt och s\u00e4kerst\u00e4lla diagnosen. Under uppf\u00f6ljningstiden f\u00f6religger det dock risk f\u00f6r metastaser om det \u00e4r fr\u00e5ga om en elakartad sjukdom. Sm\u00e5 melanom i \u00e5derhinnan finns vanligtvis i bakre delen av \u00f6gat n\u00e4ra makula och synnervspapillen, och behandling av dem kan f\u00f6rs\u00e4mra synen avsev\u00e4rt. Innan behandling inleds m\u00e5ste man d\u00e4rf\u00f6r f\u00f6rs\u00e4kra sig om att det faktiskt r\u00f6r sig om en elakartad tum\u00f6r och inte en godartad pigmentfl\u00e4ck, som \u00e4r mycket vanligare.<\/p>\n<\/div>\n<\/div>\n

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Behandling av sm\u00e5 melanom i \u00e5derhinnan<\/h2>\n

I Finland behandlas de flesta melanom i \u00e5derhinnan med en str\u00e5lplatta som placeras p\u00e5 \u00f6gats yta. Med hj\u00e4lp av den f\u00f6rs\u00f6ker man eliminera tum\u00f6ren i \u00f6gat och samtidigt bevara s\u00e5 god syn som m\u00f6jligt, bland annat genom att minimera omr\u00e5det som str\u00e5las. Det viktigaste m\u00e5let med behandlingen \u00e4r dock att minimera d\u00f6dligheten som tum\u00f6ren orsakar genom att s\u00e5 snart som m\u00f6jligt ta bort tum\u00f6ren, m\u00e5h\u00e4nda redan innan den har spridit sig. F\u00f6r att tum\u00f6ren ska f\u00f6rsvinna genom behandling med str\u00e5lplatta m\u00e5ste omr\u00e5det som str\u00e5las t\u00e4cka hela tum\u00f6ren. Str\u00e5lplattan orsakar \u00e4ven spridd str\u00e5lning, som har betydelse f\u00f6r elimineringen av elakartade celler i utkanten av tum\u00f6ren, men ocks\u00e5 bidrar till synneds\u00e4ttning och andra komplikationer. Behandlingen m\u00e5ste vara tillr\u00e4ckligt effektiv f\u00f6r att d\u00f6da tum\u00f6ren, men samtidigt s\u00e5 pass skonsam att patienten beh\u00e5ller sin syn.<\/p>\n

Det finns flera olika plattor och isotoper som kan anv\u00e4ndas f\u00f6r behandling med str\u00e5lplatta. Vid behandling av sm\u00e5 uveala melanom f\u00f6redrar man mindre plattor med en diameter p\u00e5 10\u00a0mm och 15\u00a0mm. Anv\u00e4ndningen av en st\u00f6rre platta \u00e4r mer utbredd i v\u00e4rlden. Den har ungef\u00e4r dubbelt s\u00e5 stor yta och spridd str\u00e5lning \u00e4n 10\u00a0mm-plattan, som anv\u00e4nds fr\u00e4mst i Finland. Vid behandling av sm\u00e5 melanom med str\u00e5lplatta kan valet av platta p\u00e5verka b\u00e5de synprognosen och elimineringen av tum\u00f6ren. En mindre platta ger upphov till f\u00e4rre komplikationer, men tidigare var det os\u00e4kert om den eliminerar tum\u00f6ren lika effektivt som en st\u00f6rre str\u00e5lplatta. Vid anv\u00e4ndning av en st\u00f6rre platta bestr\u00e5las ett st\u00f6rre omr\u00e5de, men plattans f\u00f6rdelar i fr\u00e5ga om sm\u00e5 melanom \u00e4r oklar.<\/p>\n

Tidig diagnos p\u00e5 melanom i \u00e5derhinnan och effektiv behandling<\/h2>\n

Min doktorsavhandling behandlade sm\u00e5 melanom i \u00e5derhinnan.\u00a0 Vi unders\u00f6kte hur sm\u00e5 melanom i \u00e5derhinnan som kunde bilda metastaser. Tidigare forskning har p\u00e5visat m\u00e5nga drag som tyder p\u00e5 att sm\u00e5 melanom i \u00e5derhinnan \u00e4r elakartade. D\u00e4remot visste man inte tidigare hur sm\u00e5 tum\u00f6rer som bildar metastaser och hur stor en tum\u00f6r kan vara utan att den riskerar att spridas.<\/p>\n

V\u00e5r forskning beskrev f\u00f6r f\u00f6rsta g\u00e5ngen de kliniska dragen f\u00f6r dessa tum\u00f6rer. Resultaten bekr\u00e4ftar v\u00e5r hypotes att sm\u00e5 tum\u00f6rer blir spridningsben\u00e4gna n\u00e4r tum\u00f6rens diameter \u00f6verskrider 3\u00a0mm. Forskning<\/p>\n

sresultaten har betydelse f\u00f6r uppf\u00f6ljningen av pigmentfl\u00e4ckar och sm\u00e5 tum\u00f6rer. F\u00f6r att underl\u00e4tta diagnostiken fastst\u00e4llde vi hur snabbt melanom i \u00e5derhinnan f\u00f6rdubblas och v\u00e4xer och med hj\u00e4lp av dessa uppgifter kan man st\u00e4lla diagnoser tidigare \u00e4n f\u00f6rut.<\/p>\n

Vi analyserade behandlingsresultaten efter det att sm\u00e5 melanom i \u00e5derhinnan hade behandlats med de mindre str\u00e5lplattorna med en diameter p\u00e5 10\u00a0mm och 15\u00a0mm. Vi uppt\u00e4ckte att b\u00e5da plattorna eliminerar tum\u00f6rer lika effektivt, men att man lyckades beh\u00e5lla patientens syn b\u00e4ttre med den mindre 10\u00a0mm-plattan.<\/p>\n

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Artikelf\u00f6rfattaren \u00e4r medicine doktor\u00a0Susanna Jouhi<\/strong>, som blir f\u00e4rdig specialistl\u00e4kare i \u00f6gonsjukdomar h\u00f6sten 2021.\u00a0 Silm\u00e4s\u00e4\u00e4ti\u00f6 har genom\u00a0<\/em>stipendier<\/em><\/a>\u00a0st\u00f6tt doktor Jouhis avhandling \u201dPienten suonikalvoston melanoomien diagnostiikka, hoito ja ennuste\u201d (Diagnostik, behandling och prognos f\u00f6r sm\u00e5 uveala melanom)<\/em><\/p>\n

Den engelskspr\u00e5kiga avhandlingen kan l\u00e4sas i sin helhet\u00a0h\u00e4r<\/a>.<\/p>\n

Doktor\u00a0Jouhi ar<\/em>betar f\u00f6r n\u00e4rvarande vid\u00a0<\/em>HUS klinik f\u00f6r \u00f6gonsjukdomar<\/em><\/a>.\u00a0\u00a0<\/em><\/p>\n

Artikelns bild: Blue Macro eye close up, Edgar Martirosyan\/Shutterstock.com<\/em><\/p>\n<\/section>\n","protected":false},"excerpt":{"rendered":"

Uvealt melanom\u00a0\u00e4r den vanligaste typen av elakartad tum\u00f6r i \u00f6gat hos vuxna. Incidensen f\u00f6r denna typ av \u00f6goncancer i norra Europa \u00e4r en av de…<\/p>\n","protected":false},"author":1,"featured_media":372,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-552","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aktuell"],"yoast_head":"\nSm\u00e5 melanom i \u00e5derhinnan - Silm\u00e4s\u00e4\u00e4ti\u00f6<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.silmasaatio.fi\/sv\/sma-melanom-i-aderhinnan\/\" \/>\n<meta property=\"og:locale\" content=\"sv_SE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sm\u00e5 melanom i \u00e5derhinnan - Silm\u00e4s\u00e4\u00e4ti\u00f6\" \/>\n<meta property=\"og:description\" content=\"Uvealt melanom\u00a0\u00e4r den vanligaste typen av elakartad tum\u00f6r i \u00f6gat hos vuxna. 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