Oligodendroglioma: Mina míasrɔ̃ nu tso ahɔhɔ̃meka sia ƒomevi ŋu le nya bɔbɔewo me

Ðe ta ɖua wò zi geɖe le susu manɔmeea? Alo ɖe alɔ̃madɔmadɔ dze dziwò zi gbãtɔ le wò agbe mea? Ɣeaɖewoɣi la, nusi gbɔ nu siawo tsona vevie wue nye ahɔhɔ̃ me dɔdzẽ. Nya siawo sese gɔ̃ hã nana míevɔ̃na ŋutɔ, alo? Gake egbea míele nu ƒom tso ahɔhɔ̃ me dɔdzẽ ƒomevi aɖe si mebɔ vie o, gake wòwɔa nu nyuie ŋutɔ le atikewɔwɔ me ŋu. Emae nye oligodendroglioma.

Kpuie ko la, nukae nye oligodendroglioma?

Oligodendroglioma nye dɔdzẽ si dona le ahɔhɔ̃a me. Ƒã ŋutɔ hafi ate ŋu adze le aklã me hã. Dɔdzẽ siawo dona tso lãmenugbagbevi tɔxɛ aɖe si le míaƒe lãmekawo me si woyɔna be glial cells me. Ne míagblɔe tututu la, tso lãmenugbagbevi siwo woyɔna be ‘oligodendrocytes’ le glial lãmenugbagbevi mawo dome.

Fifia ɖewohĩ ànɔ nusi glial cells siawo, oligodendrocytes, nye ŋu bum. Tsɔe be míaƒe lãmekawo nye dɔwɔƒe gã aɖe. Dɔwɔla siwo woyɔna be ahɔhɔ̃mekawoe wɔa dɔ vevitɔ si le eme. Woawoe tsɔa gbedasiwo tso ahɔhɔ̃a me yia ŋutilã me kple tso ŋutilã me yia ahɔhɔ̃ me. Eyata kpekpeɖeŋunalawo ƒe ƒuƒoƒo aɖe li siwo kpena ɖe ahɔhɔ̃meka siawo ŋu, kpɔa wo ta, eye wonaa nunyiame si wohiã la wo. Emawoe nye glial lãmenugbagbeviwo .

Eyata nukae nye oligodendrocyte siawo?

Ŋkɔ sia ɖi nusi wɔ nuku vie, alo? Helagbe me nya geɖee wotsɔ wɔe.

• Oligo (Oligo-): sue
• Dendro (-dendro-): abe ati ene
• Cytes (-cytes): lãmenugbagbeviwo

Kpuie ko la, efia be "lãmenugbagbevi sue siwo ƒe alɔwo le abe ati ene." Lãmenugbagbevi siawo ƒe dɔwɔwɔ le vevie ŋutɔ. Alɔ didi aɖe si woyɔna be axon le míaƒe ahɔhɔ̃mekawo si. Afi siae elektrikŋusẽ ƒe dzesiwo zɔna le. Abe elektrikka ene. Eyata ametakpɔnu aɖe le axon sia ŋu. Woyɔa esia be myelin ƒe akɔta. Esia wɔnɛ be dzesiwo zɔna kabakaba eye tsi aɖeke metoa wo me o. Lãmenugbagbevi siawo siwo woyɔna be oligodendrocytes ye wotsɔ wɔa myelin-kplo ma . Oligodendrocyte lãmenugbagbevi ɖeka ate ŋu awɔ myelin-kplo ƒo xlã axon si me ahɔhɔ̃meka siwo ade 30-40 le le etame kple ete. Esia tae wogblɔna be eƒe alɔwo le abe ati ene.

Eyata oligodendroglioma nye dɔdzẽ si dona tso oligodendrocy lãmenugbagbeviwo ƒe mama si dzi womeɖu o me, siwo wɔa dɔ vevi ma.

Ðe nuku siawo ƒomevi aɖewo lia?

Ɛ̃. Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) ma dɔdzẽ siawo ɖe akpa vovovowo me (dzesiwo) le woƒe sesẽme nu. Le esia nu la, oligodendroglioma ƒomevi vevi eve ye li. Mina míalé ŋku ɖe esia ŋu le mɔ bɔbɔe aɖe nu be míase egɔme.

Nukae nye oligodendroglioma ƒe dzesiwo?

Zi geɖe la, ahɔhɔ̃mekawo ƒe dzesiwo dzena ne dɔdzẽa lolo ale gbegbe be wòdze ahɔhɔ̃meka siwo ƒo xlãe la tete gɔme. Oligodendroglioma ƒe dzesi eve siwo bɔ wue nye taɖuame kple alɔ̃madɔmadɔ . Le nyateƒe me la, amesiwo ŋu dɔléle sia le dometɔ siwo ade 80% xɔa alɔ̃dɔdɔ.

Esia le alea elabena zi geɖe la, dɔdzẽ sia ƒomevi dzɔna le ahɔhɔ̃mekawo, si nye míaƒe ahɔhɔ̃ ƒe akpa si le gota wu, si me ʋuʋudedi le la me. Dɔwɔƒe siwo kpɔa míaƒe gbesiagbedɔwo, abe nukpɔkpɔ, nuƒoƒo, kple lãmekawo dzi ɖuɖu ene dzi le nuto sia me. Ne dɔdzẽ aɖe ʋã teƒe siawo la, alɔ̃madɔmadɔ ate ŋu adzɔ.

Tsɔ kpe ɖe alɔ̃madɔmadɔ ŋu la, "dzesi siwo ŋu wotsia dzi ɖo" hã ate ŋu ado mo ɖa, si fia be kuxi aɖe le ahɔhɔ̃a ƒe akpa aɖe koŋ . Esiawo dometɔ aɖewoe nye:

• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ alo lãmetutudɔ le ŋutilã ƒe akpa ɖeka alo mo ƒe akpa ɖeka .
• Tosese ƒe dɔmawɔmawɔ nyuie.
• Nuƒoƒo alo nya si ame bubuwo gblɔna gɔmesese sesẽ (aphasia).
• Nukpɔkpɔ gbɔdzɔ, nukpɔkpɔ eve, nukpɔkpɔ si me mekɔ o.
• Ŋkuɖodzinyawo ƒe kuxiwo.
• Tamebubu kple susu tsɔtsɔ ɖo nu ŋu sesẽ.

Nuka gbɔe nɔnɔme sia tso?

Esia nye nya vevi aɖe ŋutɔ. Be woakpɔe be oligodendroglioma le eŋu la, ele be domenyiŋusẽfianu ƒe tɔtrɔ eve nanɔ anyi.

Tsɔe be nuɖaɖa ŋuti gbalẽ gã aɖe li si naa mɔfiame lãmenugbagbevi siwo le míaƒe ŋutilã me. Míeyɔa esia be DNA. Woyɔa nusiwo me woƒo DNA sia nu ƒu ɖo be domenyiŋusẽfianu. Ne lãmenugbagbeviwo ma la, wowɔa nuɖaɖagbalẽ sia ƒe kɔpi. Ɣeaɖewoɣi la, vodadawo ate ŋu adzɔ le kɔpiwɔwɔ ma me. Enyo, vodada mawo tɔgbe eve gbɔe esia tso.

1. 1p/19q co-deletion: Woɖea míaƒe domenyiŋusẽfianu ƒe akpa sue eve siwo nye xexlẽdzesi 1 kple xexlẽdzesi 19 ɖa. Esiae nye domenyiŋusẽfianu ƒe dzesi vevitɔ le dɔdzẽ siawo me.

2. IDH1 alo IDH2 ƒe tɔtrɔ: Tɔtrɔ aɖe dzɔna le domenyiŋusẽfianu si wɔa enzyme si kpena ɖe lãmenugbagbeviwo ƒe dɔwɔwɔ ŋu le míaƒe ŋutilã me la me.

Vaseɖe fifia la, womede dzesi afɔku bubu aɖeke le nɔnɔme sia ŋu o.

Kuxi kawoe esia ate ŋu ahe vɛ?

Kuxi siwo ahɔhɔ̃ me dɔdzẽ hena vɛ nɔ te ɖe afisi wòle kple eƒe lolome dzi. Nu vevi siwo ŋu wòle be míakpɔ nyuie le dometɔ aɖewoe nye:

• Tɔtrɔ vɔ̃ɖi: Ɣeaɖewoɣi la, dɔdzẽ si mebɔ o (Dzeside 2) ate ŋu atrɔ le ɣeyiɣi aɖe megbe eye wòazu kansa si ƒe dzeside deŋgɔ (Dzeside 3).
• Nɔnɔme siwo le abe ʋusɔgbɔdɔ ene: Ne dɔdzẽa le tsitsim la, nyaƒoɖeamenu si le ahɔhɔ̃a me dzina ɖe edzi, si wɔnɛ be ʋukawo dona, si wɔnɛ be nɔnɔme siwo ɖi ʋusɔgbɔdɔ.
• Tɔtrɔ siwo vaa taɖu ƒe ƒuwo me: Dɔdzẽ siawo ate ŋu asesẽ le calcium si le eme ta. Dɔdzẽ si le tsitsim blewu ate ŋu agblẽ nu le taɖu ƒe ƒuwo hã ŋu.

Aleke woawɔ anya dɔléle sia?

Ne èyi wò ɖɔkta gbɔ ne dzesiwo dze le ŋuwò la, awɔ ɖe afɔɖeɖe ʋɛ aɖewo dzi.

1. Lãmetsiŋusẽ kple lãmekawo dodokpɔ: Ðɔkta la alé ŋku ɖe wò dadasɔ, lãmekawo ƒe ŋusẽ, nukpɔkpɔ, kple wò susu ƒe dɔwɔwɔ ŋu.

2. Diagnostic imaging: Wowɔa scans be woakpɔ ta la me.

• CT scan (Computed Tomography): Zi geɖe la, esiae nyea nu gbãtɔ si wowɔna ne nane abe alɔ̃dɔdɔ ene dzɔ. Woate ŋu akpɔ dɔdzẽ siawo nyuie le CT-mɔ̃ dzi elabena calcium le wo me.
• MRI scan (Magnetic Resonance Imaging): Esia ate ŋu ana woalé ŋku ɖe ahɔhɔ̃mekawo, lolome, kple afisi dɔdzẽa le ŋu tsitotsito.

3. 3. .Brain Biopsy: Esiae nye dodokpɔ si ɖo kpe dɔlélea dzi 100% . Scan ɖeɖe dzaa mate ŋu anyae kple kakaɖedzi be oligodendroglioma ye o. Le lãmenugbagbeviwo ɖeɖe me la, ahɔhɔ̃ŋutinunyala aɖe wɔa dɔ nɛ ɖea dɔdzẽa ƒe akpa sue aɖe ŋutɔ ɖa heɖonɛ ɖe nudokpɔƒe. Le afima la, wotsɔa nusuekpɔmɔ̃ léa ŋku ɖe lãmenugbagbeviawo ŋu. Woléa ŋku ɖe domenyiŋusẽfianu ƒe tɔtrɔ siwo ŋu míeƒo nu tsoe va yi, 1p/19q ƒe co-deletion kple IDH ƒe tɔtrɔ ƒe anyinɔnɔ hã ŋu . Ne wo ame evea siaa li la, ke oligodendroglioma ye wònye godoo.

Nukawoe nye atikewɔmɔnuawo? Ðe wòanya wɔ be woadae keŋkeŋa?

Nya nyuiae nye be, ne wotsɔ oligodendroglioma sɔ kple ahɔhɔ̃meka ƒomevi bubuwo la, enye dɔdzẽ siwo woate ŋu ada wu eye woate ŋu ada wo wu la dometɔ ɖeka. Zi geɖe la, wozãa atike vovovowo tsɔ daae.

Amekoko

Taɖodzinu gbãtɔ kple vevitɔe nye be woaɖe dɔdzẽa ƒe akpa gãtɔ ɖa alesi woate ŋui to amekoko me. Ɣeaɖewoɣi la, woate ŋu aɖe dɔdzẽa ɖa keŋkeŋ. Esia nɔ te ɖe nu geɖe dzi, siwo dometɔ aɖewoe nye dɔdzẽa ƒe lolome, afisi wòle, kple wò ɖɔkta ƒe nuteƒekpɔkpɔ.

Atikewo zazã

Wozãa atikewo tsɔ wua lãmenugbagbevi ɖesiaɖe si ate ŋu asusɔ le amekoko vɔ megbe. Atike nyui geɖe li na oligodendroglioma.

• PCV dada ƒe ɖoɖo: Esia nye atike etɔ̃ ƒe ƒuƒoƒo: procarbazine, lomustine, kple vincristine.
• Temozolomide: Wozãa atike sia ɣeaɖewoɣi ɖe PCV teƒe elabena eƒe nugbegblẽ le ame ŋu ʋɛ aɖewo koe le eŋu eye eƒe dɔwɔwɔ sɔ kple PCV tɔ ŋutɔ.

Kekeli ƒe Dɔdamɔnu

Esia bia be woatsɔ keklẽŋusẽ si me ŋusẽ geɖe le (si sɔ kple X-ray) aɖo afisi dɔdzẽa le, atsɔ atsrɔ̃ kansa lãmenugbagbevi ɖesiaɖe si susɔ esime woaɖe nusiwo gblẽ le lãmenugbagbevi siwo le lãmesẽ me siwo ƒo xlãe ŋu dzi akpɔtɔ.

Wò ɖɔkta kple atikewɔlawo ƒe ƒuƒoƒoa atso nya me ɖekae atso nya me le atikewɔwɔ si sɔ na wò, ɣeyiɣi didi si wòaxɔ, kple nenye be èhiã atikewɔmɔnu alo keklẽŋusẽdɔdamɔnu le amekoko vɔ megbe.

Aleke agbea anɔ kple dɔléle sia? (Nukpɔsusu) .

Gɔmesese le eŋu be amesiame navɔ̃ eye wòatsi dzodzodzoe ne ese ahɔhɔ̃ me dɔdzẽ ŋu nya. Gake oligodendroglioma menye nɔnɔme si me mɔkpɔkpɔ nabu le o.

Ƒe atɔ̃ ƒe agbetsitsi ƒe agbɔsɔsɔme - amesiwo le agbe ƒe alafa memamã le ƒe 5 le dɔlélea kpɔkpɔ vɔ megbe - le 69% va ɖo 90% dome na dɔdzẽ siwo ƒe dzeside mede o. Le dɔdzẽ siwo ƒe dzesi deŋgɔ gɔ̃ hã gome la, ele 45% va ɖo 76% dome. Akɔntabubuwo koe esiawo nye, wò nɔnɔme ate ŋu anyo wu sã.

Azɔ hã, wole numekuku wɔm fifia le atike yeye siwo tsɔa IDH ƒe nugbagbevi ƒe tɔtrɔ tɔa ŋku dɔdzẽ siawo ŋu, ale be mɔkpɔkpɔ nyui nanɔ mía si ɖe etsɔme ŋu.

Nusiwo nàte ŋu awɔ kple nya siwo nàbia wò ɖɔkta

Ne dɔléle sia le ŋuwò la, ele vevie be nàwɔ ɖe mɔfiame siwo wò atikewɔlawo ƒe ƒuƒoƒoa na dzi. Ele vevie be nàyi atikewɔƒea ɖe game dzi eye nàno wò atikewo nyuie. Atikewɔwɔ ate ŋu agblẽ nu le ame ŋu. Mègavɔ̃ be yeaƒo nu tso wo ŋu na wò ɖɔkta ahasrɔ̃ nu tso nusi woate ŋu awɔ tso wo ŋu o.

Mègahe ɖe megbe le nya siawo biabia wò ɖɔkta ŋu o:

• Afɔɖeɖe (grade) ka mee nye dɔdzẽa le?
• Afikae esia le le ahɔhɔ̃a me? Ŋutete kawo dzie wòate ŋu akpɔ ŋusẽ ɖo?
• Atikewɔwɔmɔnu kawoe le asinye?
• Ðe woate ŋu aɖe dɔdzẽ sia ɖa keŋkeŋ to amekoko mea?
• Nukawoe nye atikewɔwɔa ƒe nugbegblẽ le ame ŋu alo kuxi siwo dona tso eme?
• Ðe mehiã atikewɔmɔnu, keklẽŋusẽdɔdamɔnu, alo evea siaa?
• Aleke atikewɔwɔ ƒe ɖoɖowɔɖia le?
• Dzesi kawoe wòle be mayi atikewɔƒe le atikewɔwɔ me alo le atikewɔwɔ vɔ megbe? (e.g., taɖuame sesẽ, alɔ̃madɔmadɔ si gbugbɔna).