So obi wɔ w’abusua mu, titiriw wɔ ne mmofraase, anya kokoram wɔ akyi berɛmo mu? Anaasɛ so oduruyɛfo bi aka akyerɛ wo sɛ wowɔ polyps pii wɔ wo dwensɔtwaa mu? Ebia eyi fi awosu mu tebea bi a ɛkɔ so wɔ mmusua mu. Ɛnnɛ yɛrebɛka tebea biako a ɛte saa a ɛntaa nsi nanso ɛho hia yiye ho asɛm. Ɛyɛ FAP, anaa Abusua mu Adenomatous Polyposis. Ɛwom sɛ edin no yɛ den kakra de, nanso momma yɛnte ase kɛkɛ.
Sɛ yɛbɛka no tiawa a, dɛn ne FAP?
FAP yɛ awosu mu tebea a wotumi de fi awo ntoatoaso so kɔ awo ntoatoaso so. Nnipa a wɔwɔ saa tebea yi nya akisikuru pii a wɔfrɛ no adenomas , a ebetumi abɛyɛ kokoram, wɔ wɔn akyi berɛmo ne wɔn akyi berɛmo mu.
Seesei ebia woresusuw sɛ, "So ɛyɛ ade a ɛfata sɛ wubenya cyst wɔ wo dwonku mu?" Yiw, ɛyɛ ade a ɛfata sɛ nnipa binom benya saa akisikuru yi biako anaa abien bere a wɔrenyin no. Nanso obi a ɔwɔ FAP betumi anya saa akisikuru yi ɔhaha pii, ebia mpempem pii mpo . Na efi ase wɔ mmofraase pɛɛ , ebia bere a wɔadi mfe 15 anaa 16 pɛ.
Saa polyps yi nyɛ kokoram mfiase no. Nanso wɔfrɛ wɔn ‘precancerous’. Eyi kyerɛ sɛ sɛ wɔansa a, asiane kɛse wɔ hɔ sɛ awiei koraa no, saa polyps yi mu biako anaa nea ɛboro saa bɛdan kokoram a ɛwɔ akyi berɛmo mu .
Susuw sɛnea ɛbɛyɛ den sɛ wobeyi akisikuru yi ɔhaha pii afi hɔ mmiako mmiako no ho hwɛ. Ɛkame ayɛ sɛ ɛrentumi nyɛ yiye. Ɛno nti na sɛnea ɛbɛyɛ na wɔadi asiane kɛse yi ho dwuma no, nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ oprehyɛn yi dwensɔtwaa kɛse no nyinaa, a ɛyɛ colectomy nyinaa . Ɛtɔ da bi a, woyi akyi berɛmo no nso (proctocolectomy).
Sɛ wɔanyɛ oprehyɛn yi a, ɛda adi sɛ nnipa dodow no ara a wɔwɔ FAP no benya kokoram wɔ wɔn mfinimfini mfe mu. Afei nso, ɛnyɛ dwensɔtwaa mu nko na nnipa a wɔwɔ FAP no benya akisikuru, na mmom nipadua no afã afoforo nso (sɛ nhwɛso no, yafunu, dwensɔtwaa ketewaa, honam ani, ne nnompe). Enti, sɛ woyi akyi berɛmo no mpo a, ebehia sɛ wɔyɛ wɔn aduruyɛ mu nhwehwɛmu daa wɔ wɔn nkwa nna nyinaa mu.
Asiane bɛn na ɛwɔ kokoram mu wɔ FAP mu?
Sɛ wɔansa a, ɛkame ayɛ sɛ FAP betumi anya kokoram wɔ akyi berɛmo mu 100% . Eyi yɛ tebea a emu yɛ den yiye. Nnipa a wɔwɔ FAP no nya kokoram wɔ wɔn mfe a edi kan koraa mu na ɛyɛ ntɛmntɛm sen onipa a wɔtaa yɛ no. Enti, sɛ wunim sɛ abusua abakɔsɛm bi wɔ FAP ho a, ɛsɛ sɛ wo ba no yɛ colonoscopy afe biara fi bere a wadi mfe 10.
Wɔ kokoram a ɛwɔ akyi berɛmo mu akyi no, nnipa a wɔwɔ FAP nso wɔ asiane mu sɛ wobenya kokoram ahorow afoforo.
| Kokoram su | Asiane a ɛwɔ hɔ sɛ ɛbɛba (ɛnyɛ nea ɛbae ara kwa ) . |
|---|---|
| Duodenal kokoram | ~8% . |
| Papillary thyroid kokoram | ~2% |
| Kokoram a ɛwɔ dwensɔtwaa mu | ~2% |
| mmerɛbo mu kokoram (Hepatoblastoma) - titiriw wɔ mmofra mu | ~1.5% na ɛwɔ hɔ. |
| Yafunu mu kokoram | ~1% |
| Amemene ne akyi berɛmo mu akisikuru | Ennu 1% . |
So FAP ahorow ahorow wɔ hɔ?
Yiw, FAP titiriw bi wɔ hɔ ne nketewa pii a ɛsono kakra na ɛnyɛ den pii. Ma yɛnhwɛ nea wɔyɛ.
| FAP type | Nkyerɛmu |
|---|---|
| Classic FAP (FAP a Wɔde Di Dwuma) . | Eyi ne ɔkwan a wɔtaa de di dwuma. Polyp bɛboro 100, ebia mpempem pii, na ɛba wɔ akyi berɛmo no mu. |
| FAP a wɔayɛ no mmerɛw (AFAP) . | Eyi nyɛ aniberesɛm kakra. Ntini dodow a ɛba dwensɔtwaa no mu no yɛ 20 kosi 100. |
| Gardner yare a ɛma obi nya ɔyare no | Eyi te sɛ Classic FAP, a ɛkyerɛ sɛ akisikuru bɛboro 100 na ɛba. Nea ɛka ho no, akisikuru ahorow afoforo nso ba nipadua no afã afoforo, sɛ nhwɛso no, honam ani, ntini a ɛyɛ mmerɛw, ne nnompe mu. |
| Turcot yare a ɛma obi nya ɔyare no | Eyi ma akisikuru pii ba dwensɔtwaa no mu, na ɛma kokoram akisikuru bi nso ba amemene no mu. |
Nsonsonoe bɛn na ɛda FAP ne Lynch Syndrome ntam?
Lynch syndrome yɛ awosu mu tebea foforo a wobetumi de akɔ awo ntoatoaso ahorow mu na ama asiane a ɛwɔ hɔ sɛ obi benya kokoram wɔ akyi berɛmo mu no yɛ kɛse. Nanso nsonsonoe titiriw bi wɔ abien no ntam. Nnipa a wɔwɔ Lynch syndrome no nnya polyps ɔhaha pii, sɛnea wɔyɛ wɔ FAP mu no. Ɛtɔ mmere bi a, polyp biako anaa abien ba, na ebetumi abɛyɛ kokoram ntɛmntɛm. Ɛno nti na ɛtɔ da bi a wɔfrɛ Lynch syndrome sɛ "nonpolyposis" tebea no. Tebea abien no nyinaa fi sintɔ ahorow a ɛwɔ awosu mu nkwaadɔm ahorow mu.
Dɛn ne FAP ho sɛnkyerɛnne ahorow?
Wɔ FAP mu no, akyi berɛmo mu akisikuru fi ase nyin ntɛm sen nnipa dodow no ara, mpɛn pii no wɔ mmofraase. Mpɛn pii no, saa akisikuru yi mfa sɛnkyerɛnne biara mma kosi sɛ ɛbɛyɛ kɛse a asiane wom. Ɛno nti na nhwehwɛmu ho hia kɛse no.
Nanso, esiane sɛ akisikuru no dodow dɔɔso na enyin ntɛmntɛm nti, ɛtɔ mmere bi a, yare no ho sɛnkyerɛnne betumi ada adi. Nsɛnkyerɛnne a ɛtete saa no bi ne:
- Mogya a ɛba akyi berɛmo mu
- Atiridiinini a ɛkɔ so daa
- Yafunu mu yaw a enni sabea
Nea ɛka eyi ho no, ebia nnipa a wɔwɔ FAP nso benya abɔnten so sɛnkyerɛnne ahorow a ɛnyɛ den sɛ oduruyɛfo betumi ahu.
- Dermatofibromas: Nkuruwankuruwa a ɛyɛ den a ɛte sɛ akuru a ɛba honam ani.
- Epidermal cysts: Nkuruwankuruwa a ɛyɛ kurukuruwa a keratin ahyɛ mu ma a ɛba honam ani.
- Nnompe mu yare:Akuru a ɛnyɛ kokoram a ɛba nnompe no mu. Wɔtaa hu eyinom wɔ ti nhwi anaa akyi berɛmo mu.
- Nsõ a ɛboro so anaa sẽ a abɔ: Wobetumi de nsensan X-ray ahu eyinom.
- Pigmented retinal spots (CHRPE): Wobetumi ahu eyinom bere a wɔreyɛ aniwa mu nhwehwɛmu no. Nanso, mpɛn pii no ennya anisoadehu so nkɛntɛnso.
Dɛn ne ade titiriw a ɛde FAP ba?
Sɛnea yɛadi kan aka no, awosu mu nkwaadɔm mu nsakrae na ɛde FAP ba. Wɔfrɛ awosu mu abɔde a ɛka eyi no APC (Adenomatous Polyposis Coli) awosu mu abɔde.
Awosu mu nneɛma na ɛhwɛ biribiara a ɛwɔ yɛn nipadua mu so, te sɛ kɔmputa so dwumadi. Saa APC awosu mu abɔde yi yɛ ‘tumor suppressor gene’. Ɛne sɛ, adwuma titiriw a saa awosu mu abɔde yi yɛ ne sɛ ebesiw nkwammoaa mu mpaapaemu a wontumi nni so na ɛnyɛ akisikuru. Ɛte sɛ breki a ɛwɔ kar mu.
Obi a ɔwɔ FAP no wɔ APC awosu mu abɔde a wɔayɛ no foforo, a ɛkyerɛ sɛ ɛyɛ sintɔ. Afei, te sɛ kar a ne breki abubu no, nkwammoaa mu paapae a wontumi nni so na ɛyɛ akisikuru ɔhaha pii.
Saa awosu mu sintɔ yi fi awo mu. Sɛ awofo no mu biako wɔ saa APC awosu mu nkwaadɔm mu nsakrae yi a, abofra no wɔ hokwan 50% sɛ obenya bi . Eyi kyerɛ sɛ ebia abofra biara benya bi anaasɛ ɔrennya bi. Nanso, nnipa a wɔahu sɛ wɔwɔ FAP no mu bɛyɛ 30% nni abusua abakɔsɛm biara. Eyi kyerɛ sɛ saa awosu mu sintɔ yi aba wɔn nipadua mu nnansa yi (mfitiase mutation).
Dɛn ne nsɛnnennen a ebetumi afi FAP mu aba?
Ɔhaw a ɛho hia na asiane wom sen biara a ɛsɛ sɛ wɔde FAP di ho dwuma ne kokoram a ɛwɔ akyi berɛmo mu . Asiane yi so tew kɛse bere a wɔyɛ oprehyɛn yi akyi berɛmo no. Nanso, nsɛnnennen bi wɔ asetra a wonni akyi berɛmo mu. Wɔsakra ɔkwan a wɔfa so tu dwensɔtwaa no. Eyi nti, wobetumi de ileostomy kotoku anaa ileal kotoku adi dwuma.
Esiane sɛ APC awosu mu abɔde mu sintɔ no wɔ nkwammoaa biara a ɛwɔ nipadua no mu nti, akisikuru nso betumi ayɛ wɔ dwensɔtwaa no akyi. Eyinom bi wɔ asiane mu sɛ wobenya kokoram.
- Duodenal polyps: Ɛkame ayɛ sɛ eyinom nyin wɔ obiara a ɔwɔ FAP mu. Eyinom mu kakraa bi betumi abɛyɛ kokoram a ɛwɔ duodenum, bile duct, anaa pancreatic duct mu.
- Yafunu mu polyps: Ɛba nnipa bɛyɛ 90% mu, nanso ɔha biara mu kakraa bi pɛ, bɛyɛ 1%, na ɛkɔ kokoram.
- Desmoid tumors: Eyinom nyɛ kokoram. Nanso wotumi yɛ basabasa paa na wotumi trɛw kɔ akwaa ne mogya ntini a ɛbɛn hɔ mu, na ɛsɛe wɔn. Ɛyɛ den sɛ wobeyi afi hɔ na ebetumi asan aba.
- Thyroid kokoram: Eyi betumi aba wɔ nnipa a wɔwɔ FAP no mu bɛyɛ 2% mu. Mpɛn pii no, wotumi sa eyinom koraa.
- Mmɛn mu kokoram: hepatoblastoma, titiriw wɔ mmofra a wɔwɔ FAP muAsiane ketewaa bi wɔ hɔ sɛ obi benya mmerɛbo mu kokoram bi a ɛntaa nsi a wɔfrɛ no.
Ɔkwan bɛn so na wɔsa na wodi ho dwuma?
Wobetumi akyekyɛ FAP ayaresa nhyehyɛe no mu abien: oprehyɛn ne nkwa nna nyinaa mu sɔhwɛ.
1. Oprehyɛn a wɔyɛ
Ɛho behia sɛ nnipa dodow no ara a wɔwɔ FAP a wɔtaa yɛ no yɛ colectomy a ɛyɛ ne nyinaa, a nea ɛka ho ne sɛ wobeyi wɔn akyi berɛmo no nyinaa, wɔ wɔn mfe 20 anaa 30 mfiase mu hɔ. Wo duruyɛfo begyina wo tebea so asi bere ne ɔkwan a wobɛfa so ayɛ oprehyɛn yi ho gyinae.
2. Nhwehwɛmu a wɔyɛ no daa
Ɛho behia sɛ woyɛ nhwehwɛmu ahorow ansa na wɔayɛ wo oprehyɛn ne bere a wɔayɛ wo oprehyɛn akyi, ne w’asetra nyinaa. Eyi ne ɔkwan a eye sen biara a wobɛfa so abɔ wo nkwa ho ban.
| Sɔhwɛ su | Botaeɛ | Bere a wɔkamfo kyerɛ mpɛn pii |
|---|---|---|
| Colonoscopy a wɔde hwɛ nipadua no mu | Sɛnea ɛbɛyɛ a wɔbɛhwɛ sɛ akisikuru wɔ akyi berɛmo ne akyi berɛmo mu. | Wɔ wɔn a wɔwɔ asiane mu fam no, afe biara fi bere a wɔadi mfe 10 kosi sɛ wɔbɛyɛ wɔn oprehyɛn. |
| Sigmoidoscopy a wɔde hwɛ ade | Sɛnea ɛbɛyɛ a wɔbɛhwehwɛ rectum anaa ileal kotoku a aka no mu wɔ oprehyɛn akyi. | Wɔ oprehyɛn akyi no, asram 6-12 biara anaa mfe 1-4 biara. |
| Endoscopy a ɛwɔ soro | Sɛnea ɛbɛyɛ a wobɛhwɛ sɛ akisikuru wɔ yafunu ne dwensɔtwaa ketewa (colon) mu. | Wɔ bere ne bere mu sɛnea oduruyɛfo kamfo kyerɛ no. |
| Ultrasound a wɔde yɛ nhwehwɛmu | Wɔ thyroid anaa mmerɛbo mu kokoram ho. | Wɔ aduruyɛ mu afotu so. |
| CT anaa MRI mfoninitwa | Sɛnea ɛbɛyɛ a wobɛhwɛ sɛ desmoid tumors. | Wɔ aduruyɛ mu afotu so. |
Asetra te dɛn wɔ FAP ho?
Ɛyɛ ade a ɛfata sɛ wubedi awerɛhow na wo ho adwiriw wo bere a wuhu sɛ wowɔ awosu mu tebea bi te sɛ eyi no. Nanso, tebea yi a wubehu ntɛm no ne ɔkwan a eye sen biara a wobɛfa so adi wo kokoram ho asiane ho dwuma.
Sɛ obi a ɔwɔ FAP no hwɛ no yiye na ɔhwɛ no daa a, obetumi atra ase sɛnea ɛsɛ, akyɛ, na ɔwɔ apɔwmuden . Sɛ woyi akyi berɛmo no fi hɔ wie a, asiane kɛse no fi kokoram afoforo a ɛwɔ yafunu mu anaa desmoid akisikuru mu. Nanso eyinom ho yɛ na koraa sen kokoram a ɛwɔ akyi berɛmo mu.
Ɛwom sɛ oprehyɛn yɛ asetra mu nsakrae kɛse de, nanso esiane nnɛyi mfiridwuma mu nimdeɛ a ɛkɔ anim nti, oprehyɛn a wɔde afiri a wɔde hwɛ nipadua mu no betumi aboa wo ma wo ho atɔ wo ntɛmntɛm.
Nea ehia paa ne sɛ wubehu sɛ ɛnyɛ wo nkutoo na wowɔ hɔ. Nnuruyɛfo, abusuafo, ne nnamfonom wɔ hɔ a wobetumi akyerɛ wo kwan na wɔaboa wo wɔ akwantu yi mu. Enti, sɛ wowɔ nsɛmmisa anaa nsɛm bi a ɛhaw wo a, wo ne wo duruyɛfo nka ho asɛm pefee.
Nkrasɛm a Wɔde Kɔ Fie
- FAP yɛ awosu mu yare a emu yɛ den a ɛkɔ so wɔ awo ntoatoaso ahorow mu na ɛma akisikuru ɔhaha pii ba wɔ akyi berɛmo no mu.
- Sɛ wɔansa a, asiane a ɛwɔ hɔ sɛ obi benya kokoram wɔ akyi berɛmo mu no bɛn 100%.
- Sɛ obi a ɔwɔ w’abusua mu anya kokoram anaa akisikuru pii wɔ ne mmofraase a, wo ne wo duruyɛfo nkasa mfa awosu mu nhwehwɛmu a wɔbɛyɛ ho.
- Ɛho hia sɛ wohu ntɛm na wɔyɛ nhwehwɛmu daa na ama wɔagye nkwa. Ɛsɛ sɛ mmofra a wɔwɔ asiane mu fi ase yɛ nhwehwɛmu bere a wɔadi mfe 10 no.
- Ayaresa titiriw a wɔde siw kokoram ho asiane ano ne oprehyɛn a wɔde yi dwensɔtwaa kɛse no (colectomy).
- Sɛ wonya ayaresa ne hwɛ a ɛfata a, wubetumi atra ase a edi mũ na ahoɔden wom wɔ FAP mpo mu.
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