So woate kokoram bi a wɔntaa nhu a wɔfrɛ no Chordoma ho asɛm? Momma yɛnka ho asɛm!

Ebia wontee saa din "chordoma" yi ho asɛm da. Ɛno nyɛ nwonwa, efisɛ eyi yɛ kokoram a wɔntaa nhu. Nanso, ɛwom mpo sɛ ɛntaa nsi de, nanso ɛho hia paa sɛ yehu eyi. Efisɛ, saa akisikuru yi betumi aba yɛn akyi berɛmo mu anaasɛ wɔ ti nhwi no ase. Enti ɛnnɛ, momma yɛnka nea saa chordoma yi yɛ, sɛnea ɛkɔ so, nea ɛyɛ sɛnkyerɛnne ahorow, ne ayaresa ahorow no ho asɛm nkɔ akyiri na ɛnyɛ den koraa.

Dɛn ne Chordoma? Momma yɛnhwehwɛ mu kɛkɛ!

Sɛ yɛbɛka no tiawa a, chordoma yɛ kokoram a ɛba nnompe mu . Ɛtaa ba w’akyi berɛmo anaa wo ti nhwi ase, nnompe a ɛwɔ wo kɔn atifi ne w’amemene ase. Nnuruyɛfo bu no sɛ kokoram bi a wɔfrɛ no sarcoma. Sarcoma yɛ asɛmfua a wɔde frɛ kokoram a ɛba nnompe ne ntini a ɛyɛ mmerɛw (ntini a ɛka bom) mu.

Mpɛn pii no, chordomas nyin nkakrankakra . Nanso, ɔhaw no ne sɛ ebetumi ayɛ den kakra sɛ wɔbɛsa efisɛ ɛbɛn yɛn ntini ahorow, kyerɛ sɛ, amemene ne akyi berɛmo no yiye, na ɛkɔhyɛn ntini a ɛyɛ mmerɛw a atwa wɔn ho ahyia no mu.

Ade foforo ne sɛ, sɛ wɔsa saa akisikuru yi mpo a, hokwan kɛse sɛ ɛbɛsan aba bio . Mpɛn pii no, eyi si wɔ beae koro no ara a na mfitiase akisikuru no wɔ no. Afei nso, wɔ 30% kosi 40% mu no, chordoma kokoram nkwammoaa tumi trɛw kɔ nipadua no afã afoforo. Nnuruyɛfo frɛ eyi ``metastasizing''.

Ɛhe na Chordoma betumi atrɛw akɔ nipadua no afã afoforo?

Sɛ chordoma bi kɔ mmeae afoforo, kyerɛ sɛ, ɛtrɛw kɔ nipadua no afã afoforo a, mmeae a ɛtaa betumi atrɛw ne:

• W’ahurututu
• Lymph nodes a ɛbɛn akisikuru no
• Nnompe afoforo
• Brɛboɔ
• Wedeɛ

Ɛhe na chordoma betumi aba?

Chordoma betumi aba w’akyi berɛmo ho baabiara, nanso mmeae abiɛsa na ɛtaa ba:

1. Sacrum: Eyi ne dompe a ɛyɛ ahinanan a ɛda w’asen ntam. Chordomas bɛyɛ 35% na ɛba wɔ ha.

2. Ti nhwi ase: Ne titiriw no, wɔ wo ti nhwi ase, wɔ nnompe a ɛboa w’amemene no mu. Wɔsan frɛ eyinom ``Clival chordomas'' efisɛ ɛtaa ba wɔ ``Clivus'' dompe a ɛwɔ ha no mu. Saa ɔkwan yi nso yɛ bɛyɛ 35% wɔ chordomas nyinaa mu.

3. Wɔ akyi berɛmo no akyi berɛmo a ɛretu (`vertebrae`): Ɛne sɛ, akyi berɛmo a ɛwɔ wo kɔn, wo moma so, ne w’akyi. Chordomas ba wɔ eyinom mu bɛyɛ 30% mu. Wɔtaa ba awotwaa mu akyi berɛmo a ɛto so abien no mu. Ebetumi aba nso wɔ akyi berɛmo a ɛwɔ akyi (akyi akyi berɛmo) ne moma so (akyi berɛmo) mu.

Dɛn ne chordoma ahorow atitiriw?

Wiase Nyinaa Akwahosan Ahyehyɛde (WHO) akyekyɛ chordoma mu ayɛ no atitiriw abiɛsa. Saa nkyekyɛmu yi gyina sɛnea kokoram nkwammoaa no hwɛ wɔ microscope (`histology`) ase so.

1. Classic/conventional chordoma: Eyi ne ɔkwan a ɛtaa ba (80% kosi 90% wɔ chordoma nyinaa mu). Nkwammoaa a ɛwɔ saa su yi mu no yɛ nkwammoaa soronko bi a ɛwɔ "bubble" kakra. Chondroid chordoma yɛ ɔkwan foforo a wɔfa so yɛ saa. Ɛyɛ chordoma nyinaa mu 5% kosi 15%. Chondroid chordoma taa ba wɔ ti nhwi no ase.

2. Dedifferentiated chordoma: Eyi yɛ ɔkwan a ɛntaa nsi koraa (ennu 5%). Nkwammoaa a wɔadi afra wɔ ɔkwan a ɛnteɛ so na ɛda adi. Saa ɔkwan yi nyin ntɛmntɛm, ɛyɛ basabasa, na ɛda adi sɛ ɛbɛkɔ nipadua no afã afoforo sen ahorow afoforo.

3. Chordoma a ɛnyɛ nea ɛda nsow yiye: Eyi nso ho yɛ na koraa . Wɔakyerɛw ayarefo a ennu 60 din wɔ aduruyɛ ho kyerɛwtohɔ mu de besi nnɛ. Ade titiriw a ɛwɔ saa ɔkwan yi so ne sɛ wɔama awosu mu abɔde bi a wɔfrɛ no `(SMARCB1)` anaa `(INI1)` ayɛ adwuma (deletion). Wɔtaa hu saa chordoma yi wɔ mmofra ne mmerante ne mmabaa mu.

Hena na ɛda adi kɛse sɛ obenya chordoma?

Chordoma betumi aba wɔ mfe biara mu, wɔ obiara mu. Nanso, ɛtaa ba mpanyimfo a wɔadi fi mfe 50 kosi 80. Mmofra nya nsɛm kakraa bi pɛ na ɛka wɔn, bɛyɛ nsɛm no nyinaa mu 5%.

Wɔahu nso sɛ mmarima taa nya chordoma bɛyɛ mpɛn 1.5 sen mmea.

Eyi abu so dɛn?

Chordoma yɛ kokoram a ɛntaa nsi koraa . Ɛka nnipa bɛyɛ ɔpepem biako biara mu biako afe biara. Ɛno kyerɛ sɛ, sɛ nhwɛso no, wɔ United States no, afe biara nnipa foforo bɛyɛ 300 pɛ na wohu.

Chordomas yɛ nnompe mu akisikuru titiriw nyinaa mu 1% kosi 4%.

Dɛn ne chordoma ho sɛnkyerɛnne ahorow?

Bere a chordoma nyin no, ebetumi de nhyɛso aba akyi berɛmo anaa amemene a atwa ho ahyia no so. Saa nhyɛso yi de yare no ho sɛnkyerɛnne ahorow ba . Nsɛnkyerɛnne nso betumi ayɛ soronko a egyina baabi a akisikuru no wɔ wɔ akyi berɛmo no mu so.

Chordoma ho sɛnkyerɛnne a ɛtaa ba ne ɛyaw, mmerɛwyɛ, ne/anaasɛ akyi, nsa, anaa nan a ɛyɛ mmerɛw .

Su ahorow a ɛwɔ ti nhwi ase chordoma mu:

Sɛ wowɔ chordoma wɔ wo ti nhwi ase, a ɛwɔ w’amemene ase a, wubetumi anya sɛnkyerɛnne ahorow te sɛ:

• Anisoadehu abien (Diplopia) .
• Anisoadehu a ɛyɛ kusuu
• Tipaeɛ
• Anim a ɛyɛ mmerɛw anaa ɛyaw

Su ahorow a ɛwɔ chordoma a ɛwɔ dua dompe/sacrum mu:

Sɛ wowɔ chordoma wɔ w’akyi berɛmo no fã a ɛba fam koraa, a ɛbɛn sacrum no a, wubetumi anya sɛnkyerɛnne ahorow te sɛ:

• Akuru anaa akuru a ɛpuepue fa honam ani
• Ɛyɛ den sɛ wobɛtow nsu anaasɛ wobɛtow nsu (akisikuru anaa dwensɔtwaa a ɛnyɛ adwuma yiye) .
• Ɛyaw wɔ akyi anaa akyi berɛmo mu

Ma ɛntra w’adwenem sɛ, ɛtɔ mmere bi a wobetumi de saa sɛnkyerɛnne ahorow yi afrafra aduruyɛ mu tebea afoforo a ɛtaa ba. Ɛno nti na ɛho hia sɛ wohwehwɛ aduruyɛfo afotu sɛ wowɔ sɛnkyerɛnne bi a ɛkɔ so daa, a ɛyɛ soronko a.

Dɛn nti na Chordoma nya nkɔso? Dɛn na ɛde ba?

Nhwehwɛmufo da so ara nnim nea ɛde chordoma ba ankasa , nanso wogye di sɛ nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm bi a wɔfrɛ no TBXT mu no ka ho.

Wɔabɔ amanneɛ sɛ mmusua pii na wɔwɔ chordoma. Bere a wɔsɔɔ wɔn hwɛe no, wohui sɛ wɔanya `(TBXT)` awosu mu abɔde a ɛyɛ abien no fi awo mu. Afei nso, wɔahu nsakrae a ɛba `(TBXT)` awosu mu abɔde mu wɔ nnipa a wɔwɔ chordoma nanso obiara nni abusua no mu a ɔwɔ yare no mu.

Chordoma fi nkwammoaa a ɛwɔ nhyehyɛe bi a wɔfrɛ no ``notochord.`` Saa ``notochord`` yi yɛ bere tiaa mu nhyehyɛe a ɛho hia yiye ma awotwaa akyi berɛmo mu nkɔso bere a ɛrenyin no. Mpɛn pii no, saa ``notochord`` yi yera bɛyɛ adapɛn awotwe wɔ nyinsɛn no mu. Nanso, wɔ nnipa kakraa bi pɛ mu no, saa ``notochord`` nkwammoaa yi bi betumi akɔ so atra akyi berɛmo no nnompe anaa ti nhwi no ase.

Enti, mprempren adwene ne sɛ, sɛ nsakrae bi ba `(TBXT)` awosu mu abɔde a yɛadi kan aka ho asɛm no mu a, saa `(notochord)` nkwammoaa a aka yi betumi afi ase anyin wɔ ɔkwan a ɛnteɛ so na ayɛ chordoma.

Afei nso, nnipa a wɔwɔ awosu mu tebea bi a wɔfrɛ no ``Tuberous sclerosis`` no wɔ asiane kɛse mu sɛ wobenya chordoma. Saa ``Tuberous sclerosis`` tebea yi betumi ama obi anya akisikuru, nkɔso a ɛkyɛ, ne akisikuru wɔ nipadua no afã horow. Eyi fi nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm abien a wɔfrɛ no ``TSC1`` ne ``TSC2`` mu.

Ɔkwan bɛn so na wobehu chordoma?

Sɛ wowɔ chordoma ho sɛnkyerɛnne ahorow a, oduruyɛfo bi bedi kan abisa wo sɛnkyerɛnne ne w’ayaresa ho abakɔsɛm. Afei wɔbɛyɛ nipadua mu nhwehwɛmu ne ntini mu nhwehwɛmu.

Sɛ oduruyɛfo no susuw sɛ akisikuru bi wɔ hɔ a, ɔbɛhyɛ sɛ wɔnyɛ mfoninitwa nhwehwɛmu te sɛ X-ray, kɔmputa so mfoninitwa (CT) mfonini, anaa MRI mfonini. Saa MRI mfonini yi taa boa ma wohu sɛ obi anya chordoma.

Afei, ɛda adi sɛ wo duruyɛfo de wo bɛkɔ nnompe mu kokoram ho ɔbenfo nkyɛn ma wahu sɛ woahu na wanya adwene a ɛto so abien. Ebia wɔbɛyɛ mfoninitwa nhwehwɛmu foforo nso de ahu beae pɔtee a chordoma no wɔ, ahwɛ sɛ atrɛw akɔ nipadua no afã afoforo anaa, na wɔayɛ nhwehwɛmu afoforo.

Nanso, ɔkwan biako pɛ a wobetumi afa so ahu chordoma no yiye ne sɛ wɔbɛyɛ wɔn nipadua mu nhwehwɛmu . Nea ɛka eyi ho ne sɛ wɔbɛfa akisikuru no ketewaa bi, a mpɛn pii no wɔde ade a wɔde twa nipadua no mu nhwehwɛmu di dwuma, na wɔde afiri a wɔde hwɛ nneɛma nketenkete ahwɛ mu. Ɛno ansa na oduruyɛfo titiriw bi betumi ahu no yiye sɛ ebia ɛyɛ chordoma anaa.

Dɛn ne ayaresa ahorow a wɔde sa Chordoma?

Ayaresa titiriw a eye sen biara a wɔde sa chordoma ne sɛ wobeyi akisikuru no nyinaa afi hɔ denam oprehyɛn so . Nnuruyɛfo frɛ eyi ``En bloc resection.`` Sɛ woyi akisikuru no fi hɔ koraa wɔ saa kwan yi so a, ɔyarefo no wɔ hokwan a eye sen biara sɛ ɔbɛtra ase akyɛ.

Nanso, egyina baabi a akisikuru no wɔ so no, eyi betumi ayɛ den yiye. Titiriw no, mpɛn pii no ɛrentumi nyɛ yiye sɛ wobeyi chordomas a ɛwɔ ti nhwi no ase no afi hɔ koraa.

Efisɛ chordoma a ɛwɔ akyi berɛmo mu no betumi asɛe w’akyi berɛmo ne ntini ne mogya ntini a ɛho hia a atwa ho ahyia no. Sɛ eyi sɛe bere a wɔreyɛ oprehyɛn no a, ebetumi ama obi adi dɛm bere tenten anaa owu mpo. Afei nso, ɛyɛ den sɛ wobeyi chordoma bi a ɛwɔ ti nhwi no ase no afi hɔ koraa efisɛ ɛbɛn amemene no dua, ti nhwi ntini, ne akyi berɛmo no yiye. Ntini mu oprehyɛn ho animdefo bɔ mmɔden sɛ wobeyi akisikuru no pii sɛnea wobetumi, bere a ahobammɔ wom sɛnea wobetumi no.

Mpɛn pii no, chordomas ntumi nyɛ wɔn ade yiye wɔ mframa a wɔde sa yare anaa nnuru a wɔde sa yare sɛ ayaresa titiriw ho. Nanso, wɔ oprehyɛn akyi no, ebia w’aduruyɛfo kuw no bɛkamfo mframa a wɔde sa yare akyerɛ sɛnea ɛbɛyɛ a akisikuru no nsan mma bio.

Mprempren nhwehwɛmufo reyɛ nhwehwɛmu wɔ ayaresa foforo a wɔde sa chordoma te sɛ ayaresa a wɔde wɔn ani asi so ne nnuru a ɛko tia nyarewa ho. Ebia nnuruyɛ mu sɔhwɛ ahorow mpo wɔ hɔ a wubetumi de wo ho ahyɛ mu.

So wobetumi asiw chordoma ano?

Nokwarem no, biribiara nni hɔ a wubetumi ayɛ de asiw chordomas ano. Mpɛn pii no, wonya nkɔso kwa.

Nanso, sɛ obi wɔ w'abusua mu anya Chordoma, anaasɛ wowɔ tebea bi a wɔfrɛ no ``Tuberous sclerosis,'' a ɛho hia sɛ wokɔ oduruyɛfo nkyɛn daa kɔhwɛ wo. Afei wobetumi ahwɛ wo so sɛ ebia Chordoma ho sɛnkyerɛnne bi wɔ hɔ anaa. Dodow a wohu eyi ntɛm no, dodow no ara na ɛda adi sɛ ayaresa no bedi nkonim.

Hokwan ahorow bɛn na ɛwɔ hɔ sɛ obi bɛsan anya ahoɔden afi chordoma mu? (Nkɔmhyɛ) .

Nkɔmhyɛ, anaa nsusuwii a ɛfa chordoma ho no gyina nneɛma pii so:

• Beae a akisikuru no wɔ ne dodow a wobetumi ayi afi hɔ wɔ oprehyɛn mu: Sɛ wotumi yi akisikuru no koraa a, hokwan a ɛwɔ hɔ sɛ ne ho bɛtɔ no no yɛ kɛse. Sɛ wɔde ayaresa afoforo nkutoo di dwuma a wɔnyɛ oprehyɛn a, hokwan a ɛwɔ hɔ no sua.
• Sɛ́ ebia kokoram no atrɛw akɔ nipadua no afã afoforo (a ɛtrɛw): Sɛ atrɛw akɔ mmeae a ɛwɔ akyirikyiri a, ebia nkwa a wonya no so bɛtew.
• Mfe a woadi bere a wɔahu sɛ wowɔ yare no: Mpɛn pii no, nnipa a wɔadi boro mfe 60 no nkwa a wonya no sua kakra.
• Sɛ́ ebia akisikuru no nni nsonsonoe anaasɛ ɛnte saa: Ahorow te sɛ ``Poorly differentiated chordoma`` wɔ nkɔmhyɛ a enye koraa sen ``conventional chordoma``.

Wo nnuruyɛfo kuw no betumi ama wo nsɛm a ɛyɛ nokware sen biara a ɛfa nea wobɛhwɛ kwan ho a egyina wo tebea no so, enti nsuro sɛ wubebisa wɔn nsɛm.

So eyi betumi akum obi?

Yiw, chordoma betumi akum obi. Mpɛn pii no, owu ba bere a akisikuru no asan aba bio akyi, na ɛsɛe ntini a ɛwɔ w’akyi berɛmo, w’amemene, anaa w’amemene ntini mu no.

Nhwehwɛmu bi a wɔyɛe wɔ ayarefo 357 a wɔwɔ chordoma mu no daa no adi sɛ nnipa dodow a wonyaa nkwa no te sɛ nea edidi so yi:

• Mfeɛ mmiɛnsa akyi: 80.5% .
• Mfeɛ anum akyi: 68.4% .
• Mfeɛ du akyi: 39.2% .

Nanso kae sɛ eyinom yɛ sɛ wɔkyekyem pɛpɛɛpɛ a. W’aduruyɛfo kuw no betumi de nsɛm a ɛkɔ akyiri a ɛfa nkwa dodow a wonya ho a egyina wo tebea pɔtee so ama.

So Chordoma Yɛ Kokoram Anaasɛ Ɛyɛ Akisikuru a Ɛteɛ?

Akyinnye biara nni ho sɛ chordoma yɛ ɔyare bɔne (kokoram). Wommu ne subtypes no mu biara sɛ ɛnyɛ kokoram.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Chordoma betumi asan aba bio bere a wɔasa no yare akyi mpo, wɔ mfe pii akyi mpo. Enti, bere tenten a wo ne w’aduruyɛfo kuw no bedi akyi no ho hia yiye.

Sɛ wunya sɛnkyerɛnne foforo biara, anaasɛ wo sɛnkyerɛnne a ɛwɔ hɔ dedaw no mu yɛ den a , hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa.

Awiei koraa no, nneɛma kakraa bi a ɛsɛ sɛ wokae (Take-Home Message) .

Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne adwennwen nka bere a wuhu sɛ wowɔ nnompe mu kokoram a wɔntaa nhu no. Chordoma yɛ kokoram a ɛyɛ den sɛ wɔbɛsa esiane beae a ɛwɔ nti.

Nanso, nya ahotoso sɛ w’aduruyɛfo kuw no bɛyɛ ayaresa nhyehyɛe a ɛkɔ akyiri a wɔayɛ ama wo na ɛbɛboa wo ma woasa wo chordoma no na w’asetra atu mpɔn .

• Ɛho hia sɛ wuhu sɛnkyerɛnne ahorow no ntɛm: hwehwɛ nnuruyɛfo afotu sɛ wote ɛyaw a ɛkɔ so, wo ho yɛ wo yaw, anaasɛ wosakra w’ani so a.
• Hwehwɛ aduruyɛfo a wɔn ho akokwaw afotu: Esiane sɛ chordoma yɛ yare a ɛntaa nsi nti, ɛho hia yiye sɛ wohwehwɛ ayaresa fi nnuruyɛfo kuw a wɔn ho akokwaw hɔ.
• Ɛho hia sɛ wɔyɛ nhwehwɛmu daa wɔ ayaresa akyi mpo: Esiane sɛ asiane wɔ hɔ sɛ yare no bɛsan aba bio nti, kɔ nhwehwɛmu no sɛnea nnuruyɛfo no kyerɛ no.

Mewɔ anidaso sɛ wubehu sɛ saa nsɛm yi bɛboa. Sɛ wowɔ nsɛmmisa bi a, ntwentwɛn wo nan ase sɛ wubebisa wo duruyɛfo.

---

` Chordoma, kokoram, nnompe mu kokoram, akyi berɛmo, ti nhwi, sacrum, clivus