So woate Lynch Syndrome ho asɛm pɛn? Ebia saa din yi yɛ foforo kakra ma wo. Nanso ɛyɛ awosu mu tebea a efi awo ntoatoaso so kɔ awo ntoatoaso so a ɛma asiane a ɛwɔ hɔ sɛ yebenya kokoram no yɛ kɛse. Eyi ma asiane a ɛwɔ hɔ sɛ wubenya kokoram no yɛ kɛse, titiriw ansa na woadi mfe 50. Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka kakra bere a wote nsɛmfua "ebia wubenya kokoram" no. Nanso nea ɛho hia sen biara ne sɛ wubenya tebea horow a ɛtete saa ho nsɛm yiye. Enti ɛnnɛ yɛbɛka eyi ho asɛm tiawa, wɔ ɔkwan a wubetumi ate ase so.
Sɛ yɛbɛka no tiawa a, dɛn ne Lynch Syndrome?
Fa no sɛ yɛn nipadua te sɛ afiri a ɛyɛ den a ɛyɛ adwuma sɛnea akwankyerɛ nhoma kɛse bi (DNA) kyerɛ no. Yɛn awosu mu nkwaadɔm te sɛ nkyerɛwde a ɛwɔ akwankyerɛ nhoma yi mu no. Ɛtɔ da bi a, mfomsoɔ bi wɔ saa akwankyerɛ nwoma yi mu, anaa ‘mfomsoɔ a ɛba wɔ nkyerɛwee mu’. Wɔ aduruyɛ mu no, wɔfrɛ eyi awosu mu nkwaadɔm mu nsakrae.
Lynch syndrome yɛ tebea a awosu mu nsakrae na ɛde ba. Yɛn nipadua no wɔ awosu mu abɔde soronko bi a ehu mfomso ahorow a ɛwɔ yɛn DNA mu na esiesie. Wɔfrɛ eyi sɛ ``mismatch repair (MMR)`` gene. Ɛte sɛ ''repair team'' wɔ yɛn nipadua mu. Obi a ɔwɔ Lynch syndrome wɔ sintɔ bi wɔ awosu mu nkwaadɔm a ɛwɔ ''repair team'' yi mu biako mu. Enti, wontumi nsiesie mfomso a ɛwɔ DNA mu no yiye. Nkwammoaa a mfomso ahorow yi wom no boaboa ano na bere kɔ so no, ɛda adi sɛ wɔbɛyɛ kokoram.
Saa tebea yi betumi aka obiara. Efisɛ ɛyɛ awosu mu tebea. Ɛtɔ mmere bi a wubetumi anya saa awosu mu abɔde a asɛe yi afi wo maame anaa wo papa hɔ. Ɛntaa mma koraa sɛ saa awosu mu nsakrae yi betumi aba obi foforo nipadua mu a obiara nni abusua no mu. Sɛ wohwɛ akontaabu a ɛwɔ ɔman te sɛ Amerika mu a, wobu akontaa sɛ bɛyɛ nnipa 279 biara mu biako wɔ saa tebea yi.
Nsɛnkyerɛnne bɛn na obi a ɔwɔ Lynch yare no betumi anya?
Ade a ɛho hia sɛ yɛhyɛ no nsow wɔ ha ne sɛ Lynch yare no nni sɛnkyerɛnne pɔtee biara. Mmom no, ɛyɛ kokoram ahorow a tebea no de ba no ho sɛnkyerɛnne. Eyinom mu nea abu so sen biara ne kokoram a ɛwɔ akyi berɛmo mu.
Enti, sɛnkyerɛnne ahorow bi a ɛtaa ba a ebia ɛne kokoram a ɛwɔ akyi berɛmo mu no wɔ abusuabɔ ni:
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛmu |
|---|---|
| Mogya a ɛwɔ nsu mu | Ebia nsu no yɛ kɔkɔɔ anaa tuntum tuntum a mogya afra mu. |
| Yafunu mu yaw anaasɛ akisikuru | Yafunu a ɛtaa yɛ no yaw anaasɛ ne ho nyɛ no dɛ. |
| Nsakrae a ɛba wɔ dwensɔtwaa mu | Akisikuru anaa akisikuru a efi ase mpofirim, anaasɛ nsu a ɛyɛ tratraa sen sɛnea ɛtaa ba. |
| Ɔbrɛ a ɛtaa ba | Ɔbrɛ a ɛkɔ so daa ɛmfa ho sɛ obi gye n’ahome yiye no. |
| Boa a ne ho popo anaasɛ ne ho popo | Sɛ wote nka sɛ wo ho ayɛ wo ma anaasɛ wo ho ayɛ wo hyew bere a woadi kakra mpo a. |
| Akisikuru anaa ɔfe | Akisikuru anaa ɔfe a ɛnyɛ nea ɛda adi pefee sɛ ɛde ba. |
Nea ɛho hia ne sɛ ɛnyɛ obiara na onya saa sɛnkyerɛnne ahorow yi. Ɛtɔ da bi a, ebia kokoram no renda sɛnkyerɛnne biara adi kosi sɛ ɛbɛkɔ anim kɛse. Enti, sɛ wokɔ so nya saa sɛnkyerɛnne yi biako anaa nea ɛboro saa a, hwɛ hu sɛ wobɛkɔ wo duruyɛfo nkyɛn akɔhwehwɛ afotu.
Kokoram ahorow bɛn na ebetumi aba esiane tebea yi nti?
Lynch syndrome nyɛ tebea a ebue kwan ma kokoram biako pɛ. Ɛma asiane a ɛwɔ hɔ sɛ obi benya kokoram wɔ nipadua no afã horow pii no yɛ kɛse. Akwaa a ɛwɔ asiane mu no betumi ayɛ soronko a egyina awosu mu abɔde a mfomso wom no so. `MLHL`, `MSH2`, `MSH6`, `PMS2` ne `EPCAM` ne awosu mu nkwaadɔm atitiriw anum a ɛka ho.
Kokoram ahorow bi a Lynch syndrome ma asiane a ɛwɔ hɔ sɛ wobenya no yɛ kɛse wɔ ase hɔ.
| Kokoram su | Nipadua fã a ɛfa ho |
|---|---|
| Kokoram a ɛwɔ akyi berɛmo ne akyi berɛmo mu | Nnuan a wɔyam |
| Awotwaa/Endometrial kokoram | Mmea awo nhyehyɛe |
| Kokoram a ɛwɔ awotwaa mu | Mmea awo nhyehyɛe |
| Yafunu mu kokoram | Nnuan a wɔyam |
| Kokoram a ɛba dwensɔtwaa nketenkete mu | Nnuan a wɔyam |
| Kokoram a ɛwɔ dwensɔtwaa mu | Nnuan a wɔyam |
| Kokoram a ɛwɔ ntini a ɛwɔ soro | Nsuo a ɛkɔ nipadua no mu |
| Amemene mu kokoram | Ntini a ɛma nipadua no yɛ adwuma |
| Honam ani kokoram | Wedeɛ |
Kokoram a ɛwɔ akyi berɛmo mu a Lynch syndrome de ba no yɛ soronko kakra. Wonyin ntɛmntɛm sen kokoram a ɛtaa ba no.Bere a egye bɛyɛ mfe 10 ansa na obi a ɔte ase no polyp ketewaa no abɛyɛ kokoram no, egye afe biako anaa abien pɛ ma obi a ɔwɔ Lynch syndrome.
Afei nso, esiane tebea yi nti, obi a bere bi anya kokoram a ɛwɔ akyi berɛmo mu na ne ho atɔ no no wɔ asiane kɛse sɛ obenya kokoram koro no ara bio.
Susuw ho hwɛ, asiane bɛyɛ 15% wɔ hɔ sɛ kokoram bɛsan anya bio wɔ mfe 10 mu bere a wɔayɛ oprehyɛn ayi kokoram a edi kan no afi hɔ akyi. Saa asiane yi betumi akɔ soro akodu 40% wɔ mfeɛ aduonu akyi, ne 60% wɔ mfeɛ aduasa akyi. Eyi kyerɛ sɛnea nhwehwɛmu a wɔyɛ no daa ho hia.
Ɔkwan bɛn so na wɔde eyi kɔ awo ntoatoaso mu?
Lynch syndrome yɛ tebea a efi awo ntoatoaso so kɔ awo ntoatoaso so wɔ ``autosomal dominant`` kwan so. Eyi kyerɛ kɛkɛ sɛ sɛ ɔwofo biako pɛ , ɛna no anaa agya no, na ɔwɔ awosu mu abɔde a asɛe no mpo a, hokwan 50% wɔ hɔ sɛ abofra no benya bi. Wei kyerɛ sɛ abofra biara wɔ hokwan 50% sɛ obenya bi na 50% nso wɔ hokwan sɛ ɔrennya bi.
Enti, sɛ wo anaa w’abusua mu obi wɔ Lynch syndrome a, ɛho hia yiye sɛ wobɔ w’abusua mufo a aka no amanneɛ. Titiriw no, ɛsɛ sɛ wɔka asiane yi ho asɛm kyerɛ wo nuanom, wo mma, ne w’awofo. Sɛ wɔde wɔn kɔ awosu mu nhwehwɛmu ne afotu mu a, ebetumi agye wɔn nkwa mpo.
Mɛyɛ dɛn ahu sɛ mewɔ saa tebea yi? Sɔhwɛ ahorow bɛn na ɛsɛ sɛ meyɛ?
Ɔkwan a eye sen biara a wobɛfa so ahu sɛ wowɔ Lynch yare no ne sɛ wobɛyɛ awosu mu nhwehwɛmu . Mpɛn pii no, eyi hwehwɛ sɛ wogye mogya. Anaasɛ wɔfa buccal swab fi w’ano mu. Saa sɔhwɛ yi betumi ahu pɛpɛɛpɛ sɛ ebia wowɔ awosu mu nkwaadɔm a yɛadi kan aka ho asɛm te sɛ MLHL ne MSH2 no mu nsakrae anaa.
Sɛ wohu sɛ wowɔ Lynch syndrome a, ade a edi hɔ a ɛho hia sen biara ne sɛ wobɛkɔ akɔyɛ nhwehwɛmu daa na ama woahu kokoram ntɛm. Wo duruyɛfo no bɛyɛ nhwehwɛmu nhyehyɛe a ɛfata wo.
| Sɔhwɛ | Sɛnea wɔyɛ ne bere a wɔkamfo kyerɛ |
|---|---|
| Colonoscopy a wɔde hwɛ nipadua no mu | Colonoscopy yɛ adeyɛ a wɔde afiri teateaa bi a mfoninitwa afiri wom fa akyi berɛmo no mu de hwehwɛ akyi berɛmo no mu. Wɔtaa kamfo kyerɛ afe anaa abien biara . |
| Ultrasound a Wɔde Fa Awotwaa Mu | Wɔ mmea fam no, wɔkamfo kyerɛ sɛ wɔnyɛ akyi berɛmo mu nhwehwɛmu, a nea ɛka ho ne sɛ wɔde afiri a wɔde hwehwɛ nneɛma mu fa awotwaa no mu na wɔhwehwɛ awotwaa ne awotwaa mu afe abien biara . |
| Nsu mu nhwehwɛmu | Nya kokoram ahorow a ɛfa asaabo ho ho ntease titiriw denam nsu a wɔde yɛ nhwehwɛmu a wobɛsɔ ahwɛ so. Ɛyɛ papa sɛ wobɛyɛ eyi afe biara . |
| Atifi Endoscopy a Wɔde Yɛ Adwuma | Tube a wɔde mfoninitwa afiri ahyɛ mu de ahwehwɛ yafunu ne dwensɔtwaa ketewa no atifi. Wɔkamfo kyerɛ sɛ mfe 3-5 biara . |
| Biopsy a wɔde hwehwɛ nipadua mu | Sɛ wohu ntini anaa akisikuru bi a ɛyɛ adwenem naayɛ wɔ atifi hɔ nhwehwɛmu no mu a, wɔfa nhwɛsode ketewaa bi na wɔsɔ hwɛ sɛ kokoram nkwammoaa wɔ hɔ anaa. |
Ɔkwan bɛn so na wɔsa Lynch yare no?
Mprempren wonni aduru biara a wɔde bɛsa awosu mu tebea a wɔfrɛ no Lynch syndrome no. Enti, ade titiriw a wɔde wɔn adwene si so wɔ ayaresa mu ne sɛ wobehu kokoram nkwammoaa no afi nipadua no mu na wɔayɛ no oprehyɛn. Sɛ wotumi hu kokoram no na woyi fi hɔ ansa na atrɛw akɔ nipadua no afã afoforo a, nea efi mu ba no di yiye paa.
Eyi hwehwɛ sɛ nnuruyɛfo kuw a wɔyɛ adwuma ahorow pii. Sɛ nhwɛso no, yafunu ne akyi berɛmo ho animdefo, oprehyɛn ho animdefo, mmea kokoram ho animdefo, ne kokoram ho animdefo bom sa tebea yi.
Nnipa binom, titiriw mmea a wɔawie wɔn mmusua no, paw sɛ wobetwa awotwaa anaasɛ wobetwa awotwaa no ansa na yare biara aba na ama asiane a ɛwɔ hɔ sɛ wobenya awotwaa anaa awotwaa mu kokoram daakye no so atew. Saa ara nso na wɔn a asiane kɛse wom sɛ wobenya kokoram wɔ wɔn akyi berɛmo mu no betumi apaw sɛ wɔbɛyɛ colectomy. Eyinom yɛ ankorankoro gyinaesi ahorow ankasa, na ɛsɛ sɛ wosi bere a wo ne wo duruyɛfo abɔ nkɔmmɔ kɛse akyi.
So Lynch syndrome ne HNPCC yɛ ade koro?
Ebia woate edin `HNPCC (Hereditary Non-Polyposis Colorectal Cancer)` nso. Wɔtaa de Lynch syndrome ne HNPCC di dwuma de sesa wɔn ho wɔn ho, nanso mfiridwuma mu nsonsonoe ketewaa bi da abien no ntam.
Sɛ yɛbɛka no tiawa a, egyina abusua abakɔsɛm so na wɔde edin HNPCC no di dwuma. Ɛne sɛ, sɛ abusua bi mufo pii anya kokoram a ɛte sɛɛ a, wɔka sɛ saa abusua no wɔ HNPCC. Nanso Lynch syndrome ne din a wɔde ato awosu mu nkwaadɔm mu nsakrae pɔtee a ɛde ba no akyi. Enti, abusua a wɔwɔ HNPCC mufo nyinaa betumi anya Lynch syndrome awosu mu nkwaadɔm mu nsakrae. Afei nso, wobetumi aka sɛ obi a onya awosu mu nkwaadɔm mu nsakrae foforo a obiara nni abusua no mu no nso wɔ Lynch yare no.
Obiara mpɛ sɛ ɔbɛte nsɛm a ɛne sɛ, "Wowɔ kokoram." Ebia ɛsɛ sɛ obi a ɔwɔ Lynch syndrome te saa nsɛm no wɔ n’asetra mu bere bi. Nanso ɛnyɛ wiase awiei. Sɛ wunim wo tebea no, wo ne wo duruyɛfo yɛ adwuma, na woyɛ kokoram ho nhwehwɛmu daa a, wobetumi ahu kokoram biara na wɔasa no ntɛm ara. Sɛ wohu no ntɛm na wɔsa no yare a, ɛno ne ɔkwan a eye sen biara a wobɛfa so anya asetra a ahoɔden wom na anigye wom.
Nkrasɛm a Wɔde Kɔ Fie
- Lynch syndrome yɛ awosu mu yare a ɛkɔ so wɔ awo ntoatoaso ahorow mu na ɛma kokoram ho asiane yɛ kɛse.
- Sɛ ɔwofo biako pɛ na ɔwɔ saa awosu mu abɔde a ɛtɔ sin yi mpo a, abofra wɔ hokwan 50% sɛ obenya bi.
- Sɛ wohu sɛ wo anaa w’abusua mu bi anya saa yare yi a, ɛho hia paa sɛ wobɛka ho asɛm kyerɛ abusua no mufo afoforo a wɔbɛn wo.
- Ɛwom sɛ wontumi nsa saa awosu mu tebea yi de, nanso ɔkwan a eye sen biara a wobetumi afa so asiw kokoram ano anaasɛ wobehu ntɛm ne sɛ wɔbɛyɛ aduruyɛ mu nhwehwɛmu daa.
- Sɛ wohu kokoram ntɛm na wosa no a, ebetumi ama woanya nea edi mu kɛse na ama woanya asetra a ahoɔden wom.
- Bere nyinaa wo ne wo duruyɛfo nkasa na ɔnyɛ nhwehwɛmu nhyehyɛe a ɛfata wo na di biribiara a ɛhaw wo ho dwuma.
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