Esia nye dɔgbo me dɔdzẽ ƒomevi tɔxɛ aɖe: Mina míasrɔ̃ nu tso MSI-H ŋu ko! (Microsatellite Mamaɖemaɖe-Dzogome Dɔdzẽ si Gãna)

Ðe nède dzesi tɔtrɔ le wò dɔgbo ƒe nɔnɔmewo, ƒodo me veve, alo ʋu si le wò aɖuɖɔ me nyitsɔ laa? Mègaŋe aɖaba ƒu dzesi siawo dzi, anɔ susum be wosɔ o. Woate ŋu anye dɔgbo me dɔdzẽ ƒe dzesiwo. Egbea, míele nu ƒom tso dɔgbo me dɔdzẽ ƒomevi aɖe si le etɔxɛ vie, gake eganye dzɔgbenyui vie hã ŋu. Woyɔe be MSI-H.

Kpuie ko la, nukae nye MSI-H dɔgbo me dɔdzẽ sia?

Be míase esia gɔme la, mina míalé ŋku ɖe DNA si le míaƒe ŋutilã ƒe lãmenugbagbeviwo me ŋu gbã. Bu míaƒe DNA be enye kɔsɔkɔsɔ didi aɖe. Kuku ƒomevi ɖeka ma ke le kɔsɔkɔsɔ sia ŋu zi gbɔ zi geɖe. Woyɔa DNA ƒe akpa siawo siwo wogbugbɔ gblɔna be microsatellites.

Fifia, ne míaƒe ŋutilã ƒe lãmenugbagbeviwo ma eye lãmenugbagbevi yeyewo va dzɔ la, wowɔa DNA kɔsɔkɔsɔ sia ƒe kɔpiwo. Ɣeaɖewoɣi la, vodadawo (nutations) ate ŋu adzɔ ne wowɔ kɔpi siawo. Gake mègatsi dzi o, ɖoɖo aɖe le míaƒe ŋutilã me abe ‘kpovitɔ si dia vodadawo’ ene. Woyɔe be Mismatch Repair (MMR) ƒe ɖoɖo. Eléa ŋku ɖe vodada siwo le DNA ƒe kɔpi mawo me ŋu eye wòɖɔa wo ɖo enumake.

Gake le kansadɔlékui aɖewo me la, MMR-mɔ̃ sia mewɔa dɔ nyuie o. Míeyɔa esia be dMMR (DNA ƒe Masɔmasɔ Dzadzraɖo si gbɔdzɔ). Emegbe esi ame aɖeke meli si aɖɔ vodada siwo le DNA ƒe kɔpi mawo me ɖo o ta la, vodadawo ƒoa ƒu eye DNA la meganɔa te kura o. Emae nye nɔnɔme si me microsatellite siwo meli ke kura o, siwo míeyɔna be MSI-H (Microsatellite Instability-High) .

Nukawoe nye MSI-H kansa ƒe dzesi siwo ate ŋu anɔ ame ŋu?

Ðewohĩ dzesiawo madze ɣesiaɣi o, gake ne dzesiawo dze la, wosɔ kple dɔdzẽ si bɔ ɖe dɔgboa me tɔ.

Vevietɔ: Menye amesiame si ŋu dzesi siawo le lae kansa le o. Gake , ne ʋu le wò aɖuɖɔ me alo ƒodo le veve sem vevie la, yi ɖɔkta gbɔ enumake. Ne dzesi bubuwo gakpɔtɔ li wu kwasiɖa eve la, ele be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo godoo.

Ɣeaɖewoɣi la, kansa sia ƒe dzesi gbãtɔe nye ʋudodokpɔ si ɖee fia be ʋumenugbagbevi dzĩwo ƒe xexlẽme mede ame dzi o (ʋusɔgbɔdɔ). Esia tso ʋu si dona le dɔgboa me gbɔ.

Nusiwo gbɔ MSI-H kansa xɔxɔ tsona kple afɔku siwo le eme

Nu vevitɔ si gbɔ MSI-H kansa tsonae nye MMR domenyiŋusẽfianu siwo ŋu míeƒo nu tsoe va yi ƒe gbegblẽ. Zi geɖe la, nusiawo dzɔna le ame ƒe agbenɔɣi, le susu aɖeke koŋ ta o.

Gake le amesiwo ade 5% siwo xɔa dɔdzẽ le dɔgboa me gome la, domenyiŋusẽfianu ƒe gbɔdzɔgbɔdzɔ sia toa dzidzimewo me. Míeyɔa esia be Lynch ƒe dɔlélea . Ne dɔléle sia le wò ƒomea me tɔ aɖe ŋu la, àte ŋu axɔ dɔdzẽ le dɔgbo me hã.

Tsɔ kpe ɖe eŋu la, nanewo le míaƒe agbenɔnɔ me siwo nana kansa xɔxɔ ƒe afɔkua dzina ɖe edzi.

Aleke woawɔ anya dɔlélea?

Ne wò ɖɔkta susu be kansa le wò dzesiwo ta la, aɖo wò ɖe dodokpɔ geɖe wɔwɔ me.

1. Dɔgbomekpɔkpɔ: Wodea mɔ̃ si te ŋu trɔna bɔbɔe si me fotoɖemɔ̃ le la to aɖuɖɔtoea me be woado dɔgboa bliboa kpɔ. Le ɣeyiɣi sia me la, woɖea lãkusi sue aɖe tso teƒe si ŋu ɖikeke le be woadoe kpɔ. Woyɔa esia be biopsy .

2. Molekyulã dodokpɔwo: Wowɔa dodokpɔ tɔxɛwo tsɔ dea dzesi domenyiŋusẽfianu ƒe tɔtrɔ, i.e. MSI-H ƒe nɔnɔme, le lãkusi ƒe kpɔɖeŋu si woɖe tso biopsy me. Wozãa mɔ̃ɖaŋunuwo abe IHC , PCR , kple NGS ene hena esia wɔwɔ.

3. Nɔnɔmetatawo dodokpɔ: Wowɔa fotowo abe CT kple MRI ene be woakpɔe ɖa be kansa la kaka ɖe ŋutinu bubuwo me hã.

Nukawoe nye MSI-H kansa ƒe atikewo?

Atikewɔwɔ nɔ te ɖe afisi kansa la le kple afisi wòkaka ɖo dzi. Atikewɔwɔ ƒe mɔnu vevi eve li.

Amekoko

Ne kansa mekaka ɖe teƒe bubuwo o la, afɔɖeɖe gbãtɔe nye be woaɖe dɔdzẽa ɖa to amekoko me. Amekoko ƒomevi ate ŋu ato vovo le kansa ƒe lolome nu.

Atikewo zazã

Afi siae MSI-H kansa ƒe vovototodedeameme va le vevie le.

• Dɔlélenutsiŋutete ƒe atikewɔwɔ: Esiae nye MSI-H kansa dada vevitɔ kekeake eye wòkpɔa dzidzedze wu .. Bu míaƒe dɔlélenutsiŋutete ƒe lãmenugbagbeviwo ŋu be ‘ʋu’/‘tsi’ ƒe ʋuƒo le wo ŋu. Ɣeaɖewoɣi la, kansa lãmenugbagbeviwo tsia ʋuƒo sia aɖaŋutɔe eye woɣlana ɖe míaƒe ŋutilã ƒe ametakpɔnuwo. Dɔlélenutsiŋutete ƒe atikewo (checkpoint inhibitors) gaʋua ‘tsi’ ma, si kpena ɖe dɔlélenutsiŋutete ŋu be wòake ɖe kansa lãmenugbagbeviwo ŋu ahatsrɔ̃ wo.
• Atikewɔwɔ: Atike sesẽwo nana be woatsɔ awu kansa lãmenugbagbeviwo. Wozãnɛ ɣeaɖewoɣi do ŋgɔ na amekoko alo le amekoko vɔ megbe.
• Targeted Therapy: Atike siwo tɔa ŋku protein alo dɔwɔwɔ tɔxɛ aɖewo siwo kpena ɖe kansa lãmenugbagbeviwo ŋu be woatsi la nana.

Agbenɔnɔ kple MSI-H kansa

Ele vevie ŋutɔ be woalé ŋutilã kple susu ƒe lãmesẽ nyui me ɖe asi le kansa dada me.

• Nuɖuɖu: Ne èwɔ dɔ na wò vɔ la, wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi eye nàɖu nuɖuɖu si me woate ŋu aɖu bɔbɔe eye protein sɔ gbɔ ɖe eme. Anyo wu be woaɖe nuɖuɖu siwo me gas le (e.g., cabbage, beans) kple lã siwo ŋu wotrɔ asi le ɖuɖu dzi akpɔtɔ.
• Kamedede: Kamedede bɔbɔewo abe azɔlizɔzɔ alesi nàte ŋui ene ate ŋu aɖe vi na wò ŋutilã kple susu ŋutɔ. Gake bia wò ɖɔkta hafi nàdze kamedede ƒe ɖoɖo ɖesiaɖe gɔme.
• Susu ƒe lãmesẽ: Esɔ be nàtsi dzimaɖi ahanɔ vɔvɔ̃m le ɣeyiɣi siawo tɔgbe me. Mègatsɔ wò seselelãmewo ade aŋetu me le ememe o. Ðo dze kple amesi dzi nèka ɖo, wò ƒomea, eye nàdi kpekpeɖeŋu tso susumedɔléle ŋuti aɖaŋuɖola gbɔ ne ehiã.