So woate sɛ w’abusua mufo pii anya kokoram a ɛwɔ akyi berɛmo mu, titiriw ansa na wɔredi mfe 50? Anaasɛ awotwaa mu kokoram abu so kɛse wɔ mmea a wɔwɔ w’abusua mu no mu? Ɛyɛ ade a ɛfata sɛ yɛte ehu ne dadwen kakra nka bere a yɛte nsɛm a ɛte sɛɛ no. Nanso ɛho hia sen sɛ wubesuro sɛ wubehu eyi. Ɛnnɛ yɛbɛka kokoram ho asiane tebea soronko bi a wobetumi de afi awo ntoatoaso so akɔ awo ntoatoaso so ho asɛm. Yɛfrɛ eyi HNPCC.
Dɛn ankasa ne HNPCC?
Sɛ yɛbɛka no tiawa a, HNPCC yɛ Hereditary Nonpolyposis Colorectal Cancer . Wɔ Sinhala kasa mu no, ɛkyerɛ biribi te sɛ "Hereditary Nonpolyposis Colorectal Cancer." Nanso saa nsɛm no mu yɛ den yiye, ɛnte saa? Enti momma yɛnkae no kɛkɛ sɛ HNPCC.
Eyi yɛ kokoram ho asiane a yebetumi anya afi awo ntoatoaso so akɔ awo ntoatoaso so esiane nsakrae bi (nsakrae) a ɛba yɛn awosu mu nkwaadɔm mu nti. Eyi ka dwensɔtwaa kɛse a ɛyɛ wo dwensɔtwaa no fã a etwa to no titiriw. Nanso edin "Nonpolyposis" no kyerɛ "non-polyposis". Nea enti a ɛte saa ne sɛ, mpɛn pii no, nyini nketenkete a wɔfrɛ no "polyps" ba wɔ dwensɔtwaa no mu ansa na kokoram a ɛwɔ akyi berɛmo mu aba. Nanso, obi a ɔwɔ HNPCC no nnya polyps a ɛte saa pii, nanso asiane kɛse wom sɛ obenya kokoram.
Enti so Lynch yare no nso yɛ HNPCC?
Yiw, wɔtaa de edin abien yi di dwuma ma tebea koro. Nanso nsonsonoe ketewaa bi wɔ mfiridwuma mu. Lynch syndrome ne awosu mu tebea a ɛde ba. Ɛne sɛ, sɛ obi wɔ awosu mu nkwaadɔm mu nsakrae a ɛne Lynch syndrome wɔ abusuabɔ a, asiane kɛse wom sɛ obenya kokoram tebea bi a wɔfrɛ no HNPCC.
Mpɛn pii no, sɛ obi a onnii mfe 50 nya kokoram bi a ɛne Lynch syndrome wɔ abusuabɔ te sɛ akisikuru, awotwaa mu kokoram, dwensɔtwaa ketewaa mu kokoram, anaa awotwaa mu kokoram a, wɔkyerɛ sɛ abusua no wɔ tebea bi a wɔfrɛ no HNPCC. Saa kokoram ahorow yi taa ba wɔ dwensɔtwaa kɛse no fã nifa so.
Saa tebea yi abu so dɛn? Dɛn ne sɛnkyerɛnne ahorow no?
HNPCC yɛ kokoram a ɛwɔ akyi berɛmo mu nyinaa mu 2% kosi 4% wɔ wiase nyinaa. Eyi kyerɛ sɛ kokoram a ɛwɔ akyi berɛmo mu 100 biara mu bɛyɛ 2 kosi 4 fi awosu mu ade yi. Ɛwom sɛ ebetumi aka obiara de, nanso nnipa a wonnii mfe 50 na wɔtaa hu.
Wɔ mfiase no, HNPCC ntaa mfa sɛnkyerɛnne biara mma. Ɛno ne ɔfã a ɛyɛ hu sen biara. Nanso bere a kokoram no reyɛ kɛse no, ebia wubefi ase ahu sɛnkyerɛnne ahorow te sɛ eyinom.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛmu |
|---|---|
| Yafunu mu yaw anaasɛ yafunu a ɛyɛ hyew | Yafunu mu yaw a ɛkɔ so daa, a wontumi nkyerɛkyerɛ mu anaasɛ atenka a ɛyɛ ma bere nyinaa. |
| Akɔnnɔ | Aduan ho akɔnnɔ a ɛyera. |
| Mogya a ɛwɔ nsu mu | Mogya a ɛyɛ tumm anaa foforo a wubehu wɔ wo nsu mu. Mma w’ani ngu eyi so denam wu a wubesusuw sɛ ɛyɛ akisikuru no so. |
| Ɔbrɛ a ɛtaa ba | Ɔbrɛ kɛse a wobɛte nka bere a woada yiye anaa woagye w’ahome mpo akyi. |
| Mu duru a wɔtew so a ntease biara nnim | Sɛ wo mu duru so tew mpofirim a wunni adidi anaa woteɛteɛ w’apɔw mu a, ɛsɛ sɛ ɛhaw wo. |
Nea ɛho hia ne sɛ ɛnyɛ obiara a ɔwɔ saa sɛnkyerɛnne ahorow yi na ɔwɔ kokoram. Nanso sɛ wokɔ so nya saa sɛnkyerɛnne ahorow yi biako anaa nea ɛboro saa a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn kɔhwehwɛ afotu.
Dɛn nti na HNPCC nya nkɔso? So ɛyɛ ɔyare mmoawa?
Ade titiriw nti a ɛte saa ne yɛn awosu mu nkwaadɔm. Fa no sɛ yɛn nipadua te sɛ nhoma kɛse bi, na awosu mu nneɛma ne akwankyerɛ a wɔakyerɛw wɔ saa nhoma no mu. Nkwammoaa biara a ɛwɔ yɛn nipadua mu no yɛ adwuma sɛnea akwankyerɛ ahorow yi kyerɛ. Ɛtɔ da bi a, nkyerɛwde mu mfomso (mutations) wɔ akwankyerɛ ahorow yi mu.
Mpɛn pii no, yɛn nipadua no wɔ awosu mu nkwaadɔm soronko a ebetumi ahu mfomso ahorow yi na asiesie. Te sɛ obi a ɔrekenkan nhoma bi mu nsɛm a wɔayɛ no yiye. Wɔ Lynch yare no mu no, eyinom ne MLH1, MSH2, MSH6, PMS2, ne EPCAM.Sɛ saa awosu mu nkwaadɔm a wɔfrɛ no "nteɛso" yi di dɛm a, wontumi nsiesie mfomso afoforo bere a nkwammoaa mu apaapae no. Bere kɔ so no, ɛda adi sɛ saa nkwammoaa a asɛe yi boaboa wɔn ho ano na wɔbɛyɛ kokoram nkwammoaa.
Eyi nyɛ yare a wɔde kɔ nnipa mu. Worentumi nkyere denam aduan a wubedi anaasɛ wo ne obi a ɔwɔ HNPCC a wobɛkɔ so. Nanso, awosu mu nkwaadɔm mu nsakrae a ɛde ba no betumi afi awo ntoatoaso so akɔ awo ntoatoaso so. Fa no sɛ ɛna no anaa agya no wɔ saa awosu mu nkwaadɔm mu nsakrae yi. Afei 50% wɔ hɔ sɛ wɔn mma no mu biako benya saa awosu mu abɔde no. Ɛno kyerɛ sɛ sɛ mmofra baanu wɔ hɔ a, wɔn mu biako betumi anya asiane awosu mu abɔde yi. Ɛno nti na nnipa pii a wɔwɔ mmusua a ɛtete saa mu nya kokoram no.
Ɔkwan bɛn so na oduruyɛfo hu HNPCC?
Sɛ wokɔ oduruyɛfo nkyɛn a wowɔ sɛnkyerɛnne ahorow a woaka ho asɛm wɔ atifi hɔ no a, ade a edi kan a ɔbɛyɛ ne sɛ obetie wo sɛnkyerɛnne no yiye na wayɛ nipadua mu nhwehwɛmu. Afei, wobebisa nsɛm pii afa w’abusua aduruyɛ ho abakɔsɛm ho .
- "So wo maame, wo papa, wo nuanom anya kokoram?"
- "Sɛ ɛte saa a, na kokoram bɛn? Mfe bɛn mu na enyaa?"
- "Nnipa baahe na wɔwɔ w'abusua mu a wɔanya kokoram?"
Saa nsɛmmisa yi ho hia yiye efisɛ sɛ abusua no mufo pii anya kokoram wɔ wɔn akyi berɛmo anaa awotwaa mu, titiriw wɔ wɔn mmofraase a, ebia oduruyɛfo no besusuw sɛ HNPCC na ɛwɔ hɔ.
Afei, nhwehwɛmu titiriw a wɔbɛyɛ de ahu sɛ ebia wowɔ kokoram wɔ wo menewam ne akyi berɛmo mu nhwehwɛmu . Nea ɛka eyi ho ne sɛ wode afiri ketewaa bi a wɔde mfoninitwa afiri ketewaa bi abata ho bɛhwehwɛ wo dwensɔtwaa nyinaa mu. Sɛ wohu biribi a ɛyɛ adwenem naayɛ a, wɔfa ntini ketewaa bi na wɔde kɔ aduruyɛdan mu ma wɔyɛ ho nhwehwɛmu (wɔyɛ biopsy).
Sɛnea ɛbɛyɛ na wɔasi HNPCC tebea so dua no, ɛho hia sɛ wɔyɛ sɔhwɛ titiriw pii:
1. Awosu mu Nhwehwɛmu: Wɔfa wo mogya bi na wɔsɔ hwɛ sɛ ebia awosu mu nsakrae bi abata Lynch yare no ho anaa.
2. Tumor tissue testing: Sɛ kokoram wɔ hɔ a, wɔsɔ kokoram nkwammoaa no hwɛ sɛ ebia agyiraehyɛde pɔtee bi a ɛfa HNPCC ho anaa.
3. Tebea afoforo a wɔpow: Tebea foforo bi wɔ hɔ a wonya fi awo mu a wɔfrɛ no Familial Adenomatous Polyposis (FAP) . Wɔ FAP mu no, polyps ɔhaha anaa mpempem pii ba wɔ akyi berɛmo no mu. Eyi nsi wɔ HNPCC mu. Enti, wo duruyɛfo no bɛhwɛ sɛ tebea abien yi mu nea ɛwɔ he.
Dɛn ne ayaresa ahorow a wɔde sa HNPCC?
Sɛ HNPCC nti kokoram ba wɔ akyi berɛmo mu a, ayaresa titiriw ne oprehyɛn a wɔbɛyɛ de ayi kokoram no ne ntini a atwa ho ahyia no afi hɔ. Wɔfrɛ saa oprehyɛn yi colectomy . Wobetumi ayɛ no akwan horow so.
- Partial Colectomy: Wɔyi akyi berɛmo no fã a kokoram no wɔ no nkutoo.
- Total Colectomy:Woyi akyi berɛmo no nyinaa fi hɔ. Wɔtaa kamfo oprehyɛn yi kyerɛ obi a ɔwɔ HNPCC na ama asiane a ɛwɔ hɔ sɛ obenya kokoram foforo daakye no so atew.
- Protectectomy: Woyi akyi berɛmo no ka dwensɔtwaa kɛse no ho.
Ayaresa afoforo
Sɛ kokoram no atrɛw (atrɛw) akɔ nipadua no afã afoforo a, ebia ayaresa afoforo ho behia de aka oprehyɛn ho.
- Nnuru a wɔde sa yare: Nnuru a ano yɛ den a wɔde ma de sɛe kokoram nkwammoaa.
- Nkwammoaa a ɛko tia nyarewa no ayaresa: Yɛn nipadua no ankasa nipadua mu tumi a ɛko tia nyarewa a ɛkanyan no ma ɛko tia kokoram nkwammoaa. Saa ayaresa yi taa di yiye ma kokoram ahorow a HNPCC de ba no.
Sɛ wo anaa w’abusua mu obi wɔ saa tebea yi a, wo duruyɛfo na ɔbɛkyerɛ ayaresa a eye sen biara. Ɔbɛsua wo tebea no ho ade yiye na wama wo ayaresa nhyehyɛe a ɛfata sen biara.
Nneɛma a ɛsɛ sɛ obi a ɔne HNPCC te hu
Sɛ wohu sɛ wowɔ HNPCC a, ɛkyerɛ sɛ ɛnyɛ dwensɔtwaa mu kokoram nko na ɛwɔ asiane mu sen onipa a ɔte saa no, na mmom kokoram ahorow afoforo pii nso. Enti, ɛsɛ sɛ aduruyɛ mu nhwehwɛmu a wɔyɛ no daa yɛ w’asetra fã.
Ebia wo duruyɛfo betu wo fo sɛ kɔyɛ kokoram ahorow yi mu nhwehwɛmu daa:
- Awotwaa
- Ovarian a ɛwɔ nipadua no mu
- Yafunu
- Asaabo ne nsu a wɔde gu nipadua mu
- Adwene
- Wedeɛ
Ebia eyi bɛyɛ te sɛ nea ɛyɛ hu. Nanso ade a eye sen biara wɔ ha ne sɛ wobehu ntɛm . Sɛ wɔyɛ nhwehwɛmu daa a, sɛ kokoram fi ase nya mpo a, wobetumi akyere no ntɛm koraa. Afei hokwan a ɛwɔ hɔ sɛ wɔbɛsa no yare na wɔasa no koraa no dɔɔso kɛse.
Wontumi nsa Lynch yare no, efisɛ ɛyɛ biribi a ɛwɔ yɛn awosu mu. Nanso, wobetumi asa kokoram a HNPCC de ba no. Oprehyɛn te sɛ total colectomy nso betumi asiw kokoram a ɛwɔ akyi berɛmo mu ano.
Mɛyɛ dɛn adi asiane a ɛwɔ hɔ no ho dwuma?
Sɛ wowɔ abusua abakɔsɛm a ɛkyerɛ sɛ wowɔ HNPCC anaa Lynch syndrome a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wo ne wo duruyɛfo bɛkasa afa ho. Ɔno na obesi gyinae sɛ ebia ɛsɛ sɛ woyɛ awosu mu nhwehwɛmu anaa.
Sɛ wogye tom sɛ wowɔ Lynch syndrome awosu mu nkwaadɔm mu nsakrae a, ebia wo duruyɛfo betu wo fo sɛ fi ase hwehwɛ kokoram a ɛwɔ akyi berɛmo mu, te sɛ akyi berɛmo mu nhwehwɛmu, wɔ wo mfe 20 mu.
Nea ɛka ho no, wubetumi atew kokoram ho asiane so bio denam asetra a ɛfata a wobɛkɔ so akura mu no so:
- Kwati sigaretnom koraa.
- Di aduan a ɛkari pɛ na ahoɔden wom (fa nhabannuru, nnuaba, ne nnuan a ahoɔdennuru pii wom ka ho).
- Yɛ apɔw-mu-teɛteɛ daa.
- To nsa a wonom ano hye.
- Kura wo nipadua mu duru a ɛfata mu.
- Ma wɔnyɛ nhwehwɛmu a oduruyɛfo no kamfo kyerɛ no nyinaa wɔ bere ano.
Nkrasɛm a Wɔde Kɔ Fie
- HNPCC yɛ asiane a ɛma obi nya kokoram a ɛwɔ akyi berɛmo mu a awosu mu nsakrae (Lynch syndrome) a ɛde kɔ awo ntoatoaso ahorow mu na ɛde ba.
- Eyi nyɛ yare a wɔde kɔ nnipa mu. Nanso, hokwan wɔ hɔ 50% sɛ mmofra benya awosu mu abɔde a ɛde ba no afi wɔn awofo hɔ.
- Sɛ w’abusua no mufo pii anya kokoram wɔ akyi berɛmo mu anaa awotwaa mu kokoram, titiriw ansa na woadi mfe 50 a, hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa afa ho.
- Mma w’ani ngu sɛnkyerɛnne ahorow te sɛ yafunu a ɛtaa yɛ basaa, mogya a ɛba nsu mu, ne wo mu duru a ɛso tew a wontumi nkyerɛkyerɛ so no so.
- Nnipa a wɔwɔ HNPCC no wɔ asiane kɛse mu sɛ wobenya kokoram ahorow afoforo de aka akyi berɛmo mu kokoram ho. Enti, aduruyɛ mu nhwehwɛmu a wɔyɛ no daa no betumi aboa ma wɔagye nnipa nkwa.
- Wobetumi atew kokoram ho asiane so denam asetra a ɛfata a wobedi akyi ne sigaretnom a wɔbɛkwati so.
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