Eyi yɛ kokoram soronko bi a ɛwɔ akyi berɛmo mu: Momma yensua MSI-H ho ade kɛkɛ! (Microsatellite Instability-Kokoram a Ɛkɔ Anim) .

So woahu nsakrae a aba wo dwensɔtwaa mu, wo yafunu mu yaw, anaa mogya a ɛwɔ wo nsu mu nnansa yi? Mma w’ani ngu saa sɛnkyerɛnne ahorow yi so, nsusuw sɛ ɛyɛ nea ɛfata. Wobetumi ayɛ kokoram a ɛwɔ akyi berɛmo mu ho sɛnkyerɛnne. Ɛnnɛ, yɛreka kokoram bi a ɛwɔ akyi berɛmo mu a ɛyɛ soronko kakra, nanso ɛyɛ anigye kakra nso ho asɛm. Wɔfrɛ no MSI-H.

Sɛ yɛbɛka no tiawa a, dɛn ne saa MSI-H kokoram a ɛwɔ akyi berɛmo mu yi?

Nea ɛbɛyɛ na yɛate eyi ase no, ma yenni kan nhwɛ DNA a ɛwɔ yɛn nipadua mu nkwammoaa mu no. Fa yɛn DNA sɛ nkɔnsɔnkɔnsɔn tenten bi. Saa nkɔnsɔnkɔnsɔn yi wɔ nhwiren a ɛte saa ara a wɔde abata ho mpɛn pii. Wɔfrɛ DNA afã horow a wɔtaa yɛ yi microsatellites.

Afei, sɛ yɛn nipadua mu nkwammoaa mu paapae na nkwammoaa foforo ba a, wɔyɛ DNA nkɔnsɔnkɔnsɔn yi bi. Ɛtɔ mmere bi a mfomso (mutations) betumi aba bere a wɔyɛ saa mfonini ahorow yi no. Nanso mma ɛnhaw wo, yɛn nipadua wɔ nhyehyɛe bi te sɛ ‘polisifo a wɔhwehwɛ mfomso’. Wɔfrɛ no Mismatch Repair (MMR) nhyehyɛe. Ɛhwɛ sɛ mfomso bi wɔ saa DNA mfonini ahorow no mu na esiesie ntɛm ara.

Nanso, wɔ kokoram nkwammoaa bi mu no, saa MMR nhyehyɛe yi ntumi nyɛ adwuma yiye. Yɛfrɛ no dMMR (DNA Mismatch Repair a enni hɔ). Afei, esiane sɛ obiara nni hɔ a obesiesie mfomso ahorow a ɛwɔ saa DNA mfonini ahorow no mu nti, mfomso ahorow boaboa ano na DNA no ntumi nnyina koraa. Ɛno ne tebea a ɛwɔ microsatellite ahorow a entumi nnyina kɛse, a yɛfrɛ no MSI-H (Microsatellite Instability-High) .

Dɛn ne MSI-H kokoram ho sɛnkyerɛnne ahorow a ebetumi aba?

Ebia ɛnyɛ bere nyinaa na sɛnkyerɛnne ahorow no bɛda adi, nanso sɛ sɛnkyerɛnne ahorow no da adi a, ɛte sɛ nea ɛwɔ kokoram a ɛtaa ba wɔ akyi berɛmo mu no.

Nea ɛho hia: Ɛnyɛ obiara a ɔwɔ saa sɛnkyerɛnne ahorow yi na ɔwɔ kokoram. Nanso , sɛ mogya wɔ wo nsu mu anaasɛ wo yafunu mu yɛ wo yaw kɛse a, kɔ oduruyɛfo nkyɛn ntɛm ara. Sɛ sɛnkyerɛnne afoforo kɔ so bɛboro adapɛn abien a, akyinnye biara nni ho sɛ ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu.

Ɛtɔ da bi a, kokoram yi ho sɛnkyerɛnne a edi kan ne mogya mu nhwehwɛmu a ɛkyerɛ sɛ mogya mu nkwammoaa kɔkɔɔ dodow sua (anemia). Eyi fi mogya a ɛtɔ wɔ dwensɔtwaa mu.

Nea ɛde ba ne asiane ahorow a ɛma obi nya MSI-H kokoram

Nea ɛde MSI-H kokoram ba titiriw ne MMR awosu mu nkwaadɔm a yɛadi kan aka ho asɛm no mu sintɔ ahorow. Eyinom taa ba wɔ obi nkwa nna mu, a ntease pɔtee biara nni ho.

Nanso wɔ nnipa bɛyɛ 5% a wonya kokoram wɔ wɔn akyi berɛmo mu no, wɔde saa awosu mu dɛmdi yi kɔ awo ntoatoaso ahorow mu. Yɛfrɛ eyi Lynch syndrome . Sɛ obi a ɔwɔ w’abusua mu wɔ saa tebea yi a, asiane kɛse nso wɔ hɔ sɛ wubenya kokoram wɔ akyi berɛmo mu.

Nea ɛka ho no, nneɛma bi wɔ yɛn asetra kwan mu a ɛma asiane a ɛwɔ hɔ sɛ yebenya kokoram no yɛ kɛse.

Ɔkwan bɛn so na wobetumi ahu yare no?

Sɛ wo duruyɛfo gyina wo sɛnkyerɛnne ahorow so susuw sɛ kokoram a, ɔde wo bɛkɔ akɔyɛ nhwehwɛmu mpɛn pii.

1. Colonoscopy: Wɔde afiri a ɛyɛ mmerɛw a mfoninitwa afiri abata ho fa akyi berɛmo no mu de hwehwɛ akyi berɛmo no nyinaa mu. Saa bere yi de, woyi ntini ketewaa bi fi baabi a ɛyɛ adwenem naayɛ ma wɔhwehwɛ mu. Wɔfrɛ eyi biopsy .

2. Molecular nhwehwɛmu: Wɔyɛ nhwehwɛmu titiriw de hu awosu mu nsakrae, i.e. MSI-H tebea, wɔ ntini nhwɛsode a wɔfaa fii biopsy no mu. Wɔde mfiridwuma te sɛ IHC , PCR , ne NGS na ɛyɛ eyi.

3. Mfoniniyɛ mu nhwehwɛmu: Wɔyɛ scan te sɛ CT ne MRI de hwɛ sɛ kokoram no atrɛw akɔ akwaa afoforo mu anaa.

Dɛn ne ayaresa ahorow a wɔde sa MSI-H kokoram?

Ayaresa no gyina baabi a kokoram no akɔ ne baabi a atrɛw akodu so. Ayaresa atitiriw abien na ɛwɔ hɔ.

Sɛɛgyiri

Sɛ kokoram no ntrɛw nkɔ mmeae afoforo a, ade a edi kan a ɛsɛ sɛ wɔyɛ ne sɛ wɔbɛfa oprehyɛn so ayi akisikuru no afi hɔ. Oprehyɛn ko a wɔbɛyɛ no betumi ayɛ soronko a egyina kokoram no kɛse so.

Nnuru a wɔde ma

Ɛha na MSI-H kokoram pɔtee no ba.

• Nkwammoaa a ɛko tia nyarewa: Eyi ne MSI-H kokoram ayaresa a ɛho hia na edi mu sen biara .. Fa no sɛ yɛn nipadua mu nkwammoaa a ɛko tia nyarewa no wɔ ‘on’/‘off’ switch. Ɛtɔ mmere bi a kokoram nkwammoaa de anifere dum saa switch yi na wɔde wɔn ho sie yɛn nipadua no ahobammɔ. Nnuru a wɔde sa nipadua no mu tumi a ɛko tia nyarewa (checkpoint inhibitors) san sɔ saa ‘dum’ switch no, na ɛboa ma nipadua no mu tumi a ɛko tia nyarewa no hu kokoram nkwammoaa na ɛsɛe.
• Nnuru a wɔde sa yare: Nnuru a ano yɛ den a wɔde ma de kum kokoram nkwammoaa. Ɛtɔ mmere bi a, wɔde di dwuma ansa na wɔayɛ oprehyɛn anaa bere a wɔayɛ oprehyɛn akyi.
• Targeted Therapy: Nnuru a wɔde si protein anaa akwan pɔtee bi a ɛboa ma kokoram nkwammoaa nyin na esiw ano a wɔde ma.

MSI-H kokoram a wɔde tra ase

Ɛho hia yiye sɛ wobɛkɔ so anya nipadua ne adwene mu akwahosan pa bere a wɔreyɛ kokoram ayaresa no.

• Adidi: Sɛ woyɛ oprehyɛn wie a, di wo duruyɛfo akwankyerɛ akyi na di aduan a ɛnyɛ den sɛ wobɛyam na protein pii wom. Ɛyɛ papa sɛ wobɛtew nnuan a ɛma gas (sɛ nhwɛso no, kabege, bankye) ne nam a wɔayɛ no foforo a wodi so.
• Apɔw-mu-teɛteɛ: Apɔw-mu-teɛteɛ a ɛnyɛ den te sɛ nantew sɛnea wubetumi biara betumi ayɛ nea mfaso wɔ so kɛse ama wo nipadua ne w’adwene. Nanso hwehwɛ wo duruyɛfo ansa na woafi apɔw-mu-teɛteɛ biara ase.
• Adwene mu akwahosan: Ɛyɛ ade a ɛfata sɛ wobɛte dadwen ne ehu nka wɔ mmere a ɛte sɛɛ mu. Mfa wo nkate nhyɛ toa mu wɔ wo mu. Wo ne obi a wowɔ ne mu ahotoso, w’abusua nkasa, na sɛ ɛho hia a, hwehwɛ mmoa fi adwenemyare ho ɔfotufo hɔ.