So woate yafunu mu kokoram bi a wonya fi awo mu ho asɛm? (Hereditary Diffuse Gastric Cancer - HDGC) Momma yɛnka eyi ho asɛm!

Ɛnnɛ yɛrebɛka tebea bi a emu yɛ den a nnipa pii nnim ho asɛm. Eyi yɛ yafunu mu kokoram bi a wonya fi awo mu. Nnuruyɛfo frɛ no `(Hereditary Diffuse Gastric Cancer)` anaa `(HDGC)` tiawa. Sɛ obi a ɔwɔ w’abusua mu anya saa tebea yi, anaasɛ wopɛ sɛ wuhu ho nsɛm pii a, asɛm yi bɛyɛ nea ɛho hia wo paa. Mma ɛnhaw wo, momma yɛnka ho asɛm tiawa.

Dɛn ne `(HDGC)` yi?

Sɛ yɛbɛka no tiawa a, HDGC yɛ kokoram ho asiane a efi awosu mu. Wei kyerɛ sɛ asiane a ɛwɔ wo nkwa nna nyinaa mu sɛ wobɛnya yafunu mu kokoram (Gastric cancer) no kɔ soro bɛyɛ 70%. Ɛnyɛ ɛno nko, mmea a wonya saa tebea yi fi awo mu no nso wɔ asiane a ɛkɔ soro 42% sɛ wobenya nufu mu kokoram pɔtee bi , Lobular Breast Cancer (LBC) .

Nnipa a wɔwɔ saa `(HDGC)` tebea yi nya awosu mu abɔde a wɔayɛ no foforo (`(mutated gene)`) fi wɔn awofo no mu biako hɔ. Mpɛn pii no, eyi yɛ awosu mu abɔde a wɔfrɛ no `(CDH1)` . Nanso ɛtɔ mmere bi a awosu mu nkwaadɔm afoforo betumi aka ho. `(CDH1)` yɛ awosu mu abɔde a ɛma akisikuru siw ano (`(akisikuru a esiw akisikuru ano)`). Sɛ wɔsakra eyi a, ɛnyɛ adwuma yiye mfa nni kokoram so. Susuw ho hwɛ, saa awosu mu abɔde yi te sɛ polisini bi a ɔwɔ yɛn nipadua mu a ɔma kokoram nkwammoaa nnyin. Enti sɛ saa polisini no yɛ mmerɛw a, dɛn na ɛba? Saa na ɛkɔ so wɔ ha nso.

Dɛn ne "diffuse" yafunu mu kokoram?

Afei ma yɛnhwɛ nea saa `(Diffuse Gastric Cancer)` yi yɛ. Eyi yɛ yafunu mu kokoram bi. Nanso sɛ́ anka eyi benyin wɔ baabi te sɛ kokoram afoforo no, ɛtrɛw kɔ yafunu no fasu no nyinaa mu wɔ nkwammoaa akuwakuw nketewa mu. Ɛte sɛ nsu a ɛretu a ɛtrɛw fa ɔfasu bi so. Esiane eyi nti, yafunu no fasu no yɛ den na ɛyɛ den. Nkakrankakra, ɛtrɛw kɔ yafunu no fasu a emu dɔ no mu.

Ɛyɛ den kakra sɛ wobehu yafunu mu kokoram yi efisɛ wontumi nhu no pefee wɔ mfoninitwa nhwehwɛmu a wɔtaa yɛ mu. Afei nso, mpɛn pii no, yare no atrɛw akyi nkutoo na sɛnkyerɛnne ahorow no da adi, wɔ akyiri yi. Saa bere no, ebia na kokoram no atrɛw (atrɛw) afa yafunu no fasu no mu akɔ ntini ahorow a ɛbɛn hɔ te sɛ mmerɛbo anaa nnompe mu.

Saa tebea yi abu so dɛn?

Sɛ yɛreka tebea `(HDGC)` ho asɛm a, wobu akontaa sɛ nnipa mpem du biara mu bɛyɛ baanum kosi du betumi anya saa tebea yi wɔ awo mu. Yafunu mu kokoram nyinaa mu bɛyɛ 20% yɛ `(diffuse)` su. Saa kokoram a ɛtrɛw no mu bɛyɛ 2% yɛ awosu mu `(HDGC).` Ɛwom sɛ mpɛn pii no yafunu mu kokoram abu so wɔ Asia aman mu sen Atɔe Fam aman mu de, nanso wɔbɔ saa `(HDGC)` tebea yi ho amanneɛ mpɛn pii wɔ Atɔe Fam aman mu.

Dɛn ne `(HDGC)` tebea no ho sɛnkyerɛnne?

Sɛnea yɛadi kan aka no, ebia yafunu mu kokoram a ɛtrɛw yi ho sɛnkyerɛnne renna adi kosi sɛ yare no bɛtrɛw (a akɔ mmeae afoforo). Ɛno nti na ɛho hia sɛ wohu asiane a ɛwɔ hɔ sɛ saa tebea yi betumi akɔ mmusua mu no. Wɔ HDGC mu no, kokoram no ba bere a obi sua kakra sen kokoram afoforo. Wohu nnipa dodow no ara ansa na wɔadi mfe 40.

Nsɛnkyerɛnne titiriw no betumi ayɛ:

• Yafunu mu yaw (titiriw wɔ yafunu no benkum atifi) .
• Yafunu a ɛho ayɛ kurukuruwa, yafunu a ɛyɛ mmerɛw
• Akisikuru ne ɔfe
• Akɔnnɔ
• Mu duru a ɛso tew
• Ɔbrɛ a ɛtra so, ɔbrɛ
• Ɛyɛ den sɛ wobɛmene aduan
• Mogya a ɛwɔ poop mu (`(Mogya a ɛwɔ poop mu)`)
• Mogya a wɔfe (`(Mogya a wɔfe)`) .
• Jaundice (ani ne honam ani a ɛyɛ kɔkɔɔ) .

Ɛtɔ mmere bi a, awo mu dɛmdi a wɔfrɛ no anofafa a ɛpaapae anaa anom a apaapae nso betumi ayɛ saa yare yi ho sɛnkyerɛnne a edi kan. Nea enti a ɛte saa ne sɛ saa awosu mu nsakrae yi betumi ama awo mu dɛmdi yi aba. Nanso, mpɛn pii no, anofafa a apaapae no ne HDGC nni abusuabɔ. Nanso, sɛ wɔwoo wo a wowɔ awo mu dɛmdi a ɛte saa na obi a ɔwɔ w’abusua mu anya kokoram ahorow yi a, ebia w’adwene mu yɛ wo naa kakra.

Dɛn ne nea enti a wɔhyehyɛɛ saa `(HDGC)` yi?

HDGC yɛ awosu mu yare . Ɛba bere a nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm a esiw akisikuru ano a yɛadi kan aka ho asɛm no biako mu sesa nhyehyɛe a ɛwɔ wo DNA mu no. Awosu mu nkwaadɔm a esiw akisikuru ano ka kyerɛ nkwammoaa sɛ wonni nkwammoaa mu mpaapaemu ne wɔn nyin so. Enti sɛ saa awosu mu nkwaadɔm yi ntumi nyɛ adwuma yiye a, kokoram betumi anya.

Wunya saa awosu mu abɔde a wɔayɛ no foforo yi fi wo maame anaa wo papa hɔ. Wɔfrɛ nkwaadɔm mu nsakrae a wonya fi awo mu wɔ saa kwan yi so no sɛ mmoawa mu nkwaadɔm mu nsakrae . Ɛka w’awo nkwammoaa no awosu mu nkwaadɔm.

Ɔkwan bɛn so na saa `(HDGC)` yi nya agyapade?

HDGC yɛ tebea a ɛyɛ autosomal titiriw . Eyi kyerɛ sɛ ɛsɛ sɛ wunya awosu mu abɔde a wɔayɛ no foforo no biako pɛ na ama woanya yare no. Wobetumi anya afi wo maame anaa wo papa hɔ. Sɛ w’awofo no mu biako wɔ mutation no a, wo anaa wo nuanom wɔ hokwan 50% sɛ wobenya bi. Fa no sɛ hokwan a ɛwɔ hɔ sɛ sika bi bɛba ti anaa dua so.

So obiara a onya awosu mu nkwaadɔm mu nsakrae no nya kokoram?

Dabi, awosu mu nsakrae a wunya fi w’awofo hɔ no ka awosu mu nkwaadɔm a esiw kokoram ano a ɛwɔ nkwammoaa biara mu no biako pɛ. Nanso nkwammoaa biara wɔ saa awosu mu abɔde yi abien, biako fi wo maame hɔ na biako nso fi wo papa hɔ. Enti sɛ woannya nkwaadɔm mu nsakrae koro no ara amfi awofo baanu no nyinaa hɔ mpo a, woda so ara wɔ awosu mu abɔde a ɛyɛ adwuma sɛnea ɛsɛ no bi.

Sɛ kokoram benya a, nkwaadɔm mu nsakrae a ɛto so abien (`(somatic mutation)`) .Ɛsɛ sɛ ɛba ntini a kokoram no ba (i.e., yafunu no mu ntini anaa nufu no mu ntini) mu wɔ wo nkwa nna mu. Saa nkwaadɔm mu nsakrae a ɛto so abien yi nso ma awosu mu nkwaadɔm no mfonini foforo no yɛ adwuma. Ɛno na kokoram no fi ase nyin.

Dɛn na ɛde nkwaadɔm mu nsakrae a ɛto so abien yi ba?

Sɛ yɛbɛka nokware a, yennim nea enti a ɛte saa ankasa. Nanso nneɛma ahorow betumi adi dwuma. Nneɛma a atwa yɛn ho ahyia a wɔde wɔn ho hyɛ mu no taa di dwuma wɔ awosu mu nyarewa "a ɛkanyan" no mu. Ebia awosu mu nkwaadɔm afoforo nso ka ho. Mmusua bi a wokura HDGC awosu mu abɔde no mu kokoram dɔɔso sen afoforo.

Nneɛma a atwa yɛn ho ahyia a ɛde asiane ba a ɛma yafunu mu kokoram nya no bi ne:

• Sigaretnom
• Nsã a wɔnom boro so
• Nam kɔkɔɔ a wodi dodo (te sɛ nantwinam, oguammaa) .
• (H. pylori) yare mmoawa (eyi yɛ ɔyare mmoawa a wɔde yafunu mu akisikuru ba) .

Ɔkwan bɛn so na sɔhwɛ nhyehyɛe no te ma `(HDGC)`?

Sɛ mpo wunnya nnyaa sɛnkyerɛnne biara a, sɛ ntease bi wɔ hɔ a enti ɛsɛ sɛ wususuw sɛ wowɔ asiane mu (sɛ nhwɛso no, sɛ obi a ɔwɔ w’abusua mu anya kokoram ahorow yi, anaasɛ woayɛ awosu mu nhwehwɛmu a ɛkyerɛ sɛ nsakrae bi aba `(CDH1)` awosu mu nkwaadɔm mu a), oduruyɛfo betumi de wo akɔma sɛ wɔnkɔyɛ `(HDGC)` ho nhwehwɛmu.

Wo duruyɛfo no begyina w’abusua abakɔsɛm ne/anaasɛ awosu mu nhwehwɛmu aba so abu asiane a ɛwɔ hɔ no ho akontaa. Ebia wɔbɛhwehwɛ nneɛma a edi kokoram anim nso wɔ wo ntini ahorow mu. Sɛ nhwɛso no, ebia wɔbɛhwehwɛ tebea bi a wɔfrɛ no Lobular Carcinoma In Situ (LCIS) wɔ nufu no mu anaasɛ nkwammoaa a ɛte sɛ signet-ring wɔ yafunu no mu. Eyinom yɛ nsakrae a ɛba ntɛm a ebetumi abɛyɛ kokoram.

Ɔkwan bɛn so na wohu HDGC?

Sɛ wowɔ yafunu mu kokoram a ɛkɔ mmeae afoforo ho sɛnkyerɛnne a, wo duruyɛfo bɛhwehwɛ adanse a ɛkyerɛ sɛ kokoram wɔ wo yafunu fasu mu. Wɔbɛfa ntini mu nhwɛsode na wɔde afiri a wɔde hwɛ nneɛma nketenkete ahwɛ mu. Sɛ wohu sɛ yafunu mu kokoram atrɛw, na sɛ obi a ɔwɔ w’abusua mu anya kokoram a ɛte sɛɛ a, ebia wo duruyɛfo bɛkyerɛ sɛ wɔnyɛ awosu mu nhwehwɛmu .

Mprempren, wɔahu sɛ ayarefo a wɔwɔ HDGC no mu bɛyɛ 40% wɔ saa CDH1 mu nsakrae yi. Ebia nkwaadɔm mu nsakrae afoforo ka ho, nanso CDH1 ne nea yenim titiriw na yebetumi ahu. Sɛ wowɔ bi a, ɛyɛ ɔkwan a ɛyɛ nokware a wobɛfa so ahu HDGC. Nanso, sɛ wowɔ abusua abakɔsɛm a ɛfa yafunu mu kokoram a ɛtrɛw yi ho a, ebia wobehu sɛ wowɔ HDGC sɛ wunni CDH1 mutation no mpo a.

Sɔhwɛ bɛn na wɔde hwehwɛ `(HDGC)`?

Wobetumi ayɛ nhwehwɛmu ahorow yi de ahu yare no:

• Awosu mu nhwehwɛmu:Eyi yɛ mogya mu nhwehwɛmu. Wɔfa wo mogya bi na wɔyɛ mu nhwehwɛmu hwɛ sɛ awosu mu nsakrae bi wɔ hɔ a ɛne awosu mu nyarewa wɔ abusuabɔ anaa. Nnipa binom yɛ nhwehwɛmu yi efisɛ wɔwɔ abusua abakɔsɛm a ɛkyerɛ sɛ wɔanya awosu mu nyarewa. Afoforo nso yɛ awosu mu nhwehwɛmu a ɛte sɛɛ esiane sɛ wonnim wɔn abusua akwahosan ho abakɔsɛm nti, wɔn ankasa nsɛm nti, anaasɛ wɔreyɛ nhyehyɛe awo mma nti.
• Upper endoscopy (EGD test): Eyi yɛ sɔhwɛ a wode hwɛ wo yafunu a ɛwɔ soro no mu (i.e., esophagus, yafunu) na wofa ntini ahorow. Eyi ho hia na ama wɔahu yafunu mu kokoram, titiriw kokoram a atrɛw yi. Yafunu mu ɔyaresafo (oduruyɛfo a ne ho akokwaw wɔ yafunu mu nyarewa ho) yɛ eyi. Ɔde afiri tenten bi (endoscope) a mfoninitwa afiri ketewaa bi wom fa w’anom na ɔde sian wo menewam kɔ ​​wo yafunu mu. Wobetumi nso afa tube no mu afa ntini mu nhwɛsode ahorow. Nanso, sɛ wɔfa akwan yi so mpo a, ebetumi ayɛ den sɛ wobenya yafunu mu kokoram a ɛtrɛw kɔ mmeae afoforo. Esiane sɛ ɛtrɛw kɛse nti, ebia oduruyɛfo no rentumi nhu anaasɛ onnya bi wɔ ntini a wɔde ayɛ nhwɛsode no mu. Enti, ɛsɛ sɛ oduruyɛfo a ɔhwehwɛ kokoram a ɛte sɛɛ no ​​nya ntetee ne osuahu soronko.
• Nufu mu MRI: Esiane sɛ wɔmfa mammogram a wɔyɛ no daa nhu nufu mu kokoram a ɛwɔ lobular mu nti, nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ MRI. Sɛ MRI no da biribi a ɛyɛ soronko adi a, wɔhyɛ no agyirae na oduruyɛfo foforo fa ntini bi.
• Biopsy: Oduruyɛfo no fa ntini bi na ɔde kɔ lab ma wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu. Saa biopsy yi betumi asi so dua sɛ ebia kokoram nkwammoaa wɔ ntini a wɔde yɛɛ nhwɛso no mu anaa.

Dɛn na ɛba bere a wɔahu sɛ ɛwɔ `(HDGC)` akyi?

Sɛ wowɔ kokoram dedaw a, wo duruyɛfo no ne wo bɛkasa afa ayaresa a wubetumi apaw ho. Sɛ wunnya nnyaa kokoram mpo a, sɛ wowɔ saa yare yi a, ɛda adi sɛ wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ kokoram nhwehwɛmu daa, sɛnea yɛaka wɔ atifi hɔ no. Oprehyɛn a wɔde siw ano yɛ ɔkwan foforo a wubetumi ne wo duruyɛfo akasa afa ho.

Ɔkwan bɛn so na wɔsa yafunu mu kokoram a ɛtrɛw kɔ mmeae afoforo?

Mpɛn pii no, oprehyɛn ne kokoram a wobetumi de oprehyɛn ayi afi hɔ no ho ayaresa a edi kan. Sɛ wowɔ HDGC a, wo duruyɛfo bɛtaa akamfo akyerɛ sɛ wontwa yafunu no nyinaa . Eyi te saa efisɛ asiane kɛse wɔ HDGC mu sɛ ɛbɛtrɛw akɔ akyirikyiri ansa na wɔahu.

Wɔ yafunu a wotwa koraa mu no, oduruyɛfo a ɔyɛ oprehyɛn no yi wo yafunu nyinaa na ɔde wo yafunu no awiei bata wo dwensɔtwaa ketewa no ho tẽẽ. Ebetumi aba sɛ obi bɛtra ase a wunni yafunu, nanso nneɛma bɔne bi wɔ hɔ. Sɛ woyɛ oprehyɛn wie a, ebia wobenya ayaresa foforo (ayaresa a ɛboa) te sɛ mframa a wɔde sa yare anaa nnuru a wɔde sa yare.

Esiane sɛ mmea a wɔwɔ `(HDGC)` nso wɔ asiane mu sɛ wobenya nufu mu kokoram a ɛwɔ lobular (`(LBC)`) nti, ɛsɛ sɛ wohu `(LBC)` ho sɛnkyerɛnne bere nyinaa bere a wɔreyɛ ayaresa no. Sɛ wowɔ `(LBC)` a, mpɛn pii no, wɔde nufu mu kokoram oprehyɛn na efi ayaresa ase. Afei wɔde ayaresa afoforo ma.

Dɛn ne nkwa nna a wɔhwɛ kwan wɔ `(HDGC)` tebea no mu?

Nkwa nna gyina kokoram no a wobehu ntɛm na wɔasa so. Sɛ wɔyɛ nhwehwɛmu daa mpo a, eyi betumi ayɛ den. Sɛ wɔkyere yafunu mu kokoram a ɛtrɛw kɔ mmeae afoforo na wɔsa no ntɛm a, mfe anum a wɔde tra ase no boro 90%. Nanso, sɛ wohu no akyiri a, bere a akɔhyɛ yafunu no fasu mu akyi no, dodow no so tew kodu nea ennu 30%.

Ɛno nti na yɛka sɛ ɛho hia paa sɛ wobɛhunu abusua abakɔsɛm na sɛ wowɔ asiane mu a, wobɛhwehwɛ aduruyɛ mu afotuo.

So ɔkwan bi wɔ hɔ a wɔfa so siw `(HDGC)` ano?

Sɛ wowɔ `(CDH1)` gene mutation (a ɛne asiane a ɛkɔ soro sɛ wobɛnya kokoram wɔ abusuabɔ) a, akwan pii wɔ hɔ a wobɛfa so asiw ano. Wɔ nnipa a wonni saa awosu mu nkwaadɔm mu nsakrae pɔtee yi fam no, wɔankyerɛkyerɛ asiane ahorow ne nneɛma a wɔbɛyɛ no mu pefee. Wubetumi ne wo duruyɛfo akasa afa w’ankasa asiane ahorow ne akwan horow a wubetumi apaw ho.

Oprehyɛn a wɔde siw yare ano

Sɛ anyɛ yiye koraa no, wɔahu sɛ wowɔ HDGC mfe 20 na wunni akwahosan ho haw atitiriw foforo biara a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ yafunu no nyinaa a wɔde siw ano . Ɛwom sɛ yafunu a ɛyera no betumi anya wo aduan mu nneɛma so nkɛntɛnso bi de, nanso ɛnyɛ den sɛ wubedi saa nsunsuanso bɔne yi ho dwuma sen sɛ wubedi yafunu mu kokoram a akɔ anim ho dwuma.

Wɔ wɔn a wonsiesiee wɔn ho sɛ wɔbɛyɛ saa anammɔn yi fam no, wobetumi afa "twɛn-na-hwɛ" kwan so, a ɛhwehwɛ sɛ wɔtaa yɛ dwensɔtwaa no atifi endoscopy ne random biopsy samples. Nanso, sɛ wɔhwɛ HDGC yiye saa mpo a, ebia ɛnyɛ bere nyinaa na wobehu HDGC ntɛm (bere a ayaresa no tu mpɔn kɛse no).

Nneɛma bɔne a efi yafunu a wotwa nyinaa mu ba:

• Dumping syndrome: Sɛ aduan fi aduan mu kɔ dwensɔtwaa ketewa no mu tẽẽ a, ɛfa dwensɔtwaa ketewa no mu ntɛmntɛm sen sɛnea ɛte daa. Eyi betumi ama nsakrae kɛse aba nkwaadɔm a ɛwɔ aduan mu no mu, na ɛde sɛnkyerɛnne ahorow te sɛ akisikuru, akisikuru, ne asikre a ɛba mogya mu aba. Wobetumi adi saa sɛnkyerɛnne ahorow yi so denam w’adidi su a wobɛsakra no so. Saa sɛnkyerɛnne ahorow yi bɛbrɛ ase bere a bere kɔ so no.
• Nnuan a wɔmfa nni dwuma yiye ne aduan pa a wonnya nni: Sɛ woyi yafunu no fi hɔ a, yafunu no fã a acid ne enzymes a ɛboa ma wɔyam aduan wom no yera. Eyi betumi asiw aduan a wɔansɛe no yiye na amma nipadua no annye aduannuru. Eyi betumi ama obi anya aduan pa a wonnya nni. Wobetumi aboa eyi denam w’aduan a wobɛsakra no ne aduannuru a wode ma a wobɛnom so.

Awosu mu afotu ne abusua nhyehyɛe

Wɔ nnipa a wɔwɔ CDH1 awosu mu nkwaadɔm mu nsakrae fam no, awosu mu afotu betumi aboa kɛse wɔ abusua nhyehyɛe ho nkɔmmɔbɔ mu. Eyi betumi aboa wo ma woate asiane a ɛwɔ hɔ sɛ wo ba benya HDGC tebea no afi awo mu no ase. Sɛ woreyɛ nhyehyɛe sɛ wobɛwo mma a, ɔkwan biako a wobɛfa so adi saa asiane no ho dwuma ne In Vitro Fertilization (IVF) a wobɛpaw .

Wɔ IVF mu no, wogye nkesua ne mmadwoa fi ɛna ne agya hɔ na wɔde ma wɔ aduruyɛdan mu. Sɛ nkwaboaa no nyin wie a, wobetumi afa nkwammoaa biako afi nkwaboaa biara mu na wɔasɔ ahwɛ sɛ ebia CDH1 mu nsakrae no wɔ hɔ anaa. Awofo no betumi apaw nkwaboaa a enni mutation no na wɔde ahyɛ ɛna no awotwaa mu.

Nea etwa to no, nea ɛsɛ sɛ yɛma ɛtra yɛn adwenem

Sɛ wuhu sɛ wowɔ Hereditary Diffuse Gastric Cancer Syndrome (HDGC) a, ebetumi ayɛ osuahu a ɛkanyan nkate kɛse, na ebia ɛsɛ sɛ wusi gyinae akɛse. Eyinom betumi aka wo ne w’abusua. Gye wo bere susuw nneɛma ho yiye a wommɔ hu. Bisa nsɛm pii sɛnea wuhia. W’aduruyɛ kuw no wɔ ha sɛ wɔbɛboa wo ma woahu ɔkwan a eye sen biara a wobɛfa so afa saa akwantu yi mu. Kae sɛ, nhumu ne ade a edi kan. Ɛnyɛ wo nko ara.

` HDGC, awosu mu kokoram, yafunu mu kokoram, CDH1 awosu mu abɔde, yafunu mu kokoram, nufu mu kokoram, awosu mu nhwehwɛmu, endoscopy, gastrectomy, kokoram a wosiw ano