Ua manaʻo wau he ʻeha ʻōpū ia, akā he maʻi ʻaʻai GIST anei kēia? (Gastrointestinal Stromal Tumor)

Ke ʻeha nei paha ʻoe i kekahi manawa i ka ʻōpū? A i ʻole ke manaʻo nei ʻoe i ka luhi ʻē aʻe no ke kumu ʻole? Manaʻo paha ʻoe he mea ia e pili ana i kāu mea e ʻai nei i kēia mau lā, a i ʻole he hihia gastritis paha. ʻO ia ka mea hiki ke lilo i ka hapa nui o nā hihia. Akā, ʻoiai he mea kakaikahi, hiki i kēia mau hōʻailona ke lilo i hōʻailona o kahi maʻi kanesa kakaikahi, ʻaʻole maʻamau. ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā. ʻO ia ʻo GIST, a i ʻole Gastrointestinal Stromal Tumor. Mai makaʻu i kou lohe ʻana i ka inoa, e kamaʻilio mākou e pili ana i nā mea āpau me ka maʻalahi a me ka maopopo.

I ka ʻōlelo maʻalahi, he aha kēia GIST?

ʻO GIST ke kū nei no Gastrointestinal Stromal Tumor . E wehewehe kākou i kēia mau huaʻōlelo.

• ʻŌpū Gastro: Pili kēia i kā mākou ʻōnaehana hoʻoheheʻe. ʻO ia hoʻi, ke ala e hele ai ka meaʻai a mākou e ʻai ai - ka waha, ka esophagus, ka ʻōpū, ka ʻōpū liʻiliʻi, a me ka ʻōpū nui.
• Stromal: Pili kēia i kahi ʻano kiko kūikawā i loaʻa i loko o nā paia o ko mākou mau kino a hana ma ke ʻano he kākoʻo no kēlā mau kino.
• Puʻupuʻu: Ua lohe paha ʻoe i kēia. ʻO ke ʻano o kēia he puʻupuʻu.

I ka ʻōlelo maʻalahi, ʻo GIST kahi puʻupuʻu kanesa e hoʻomaka ana i loko o kahi ʻano cell kūikawā i loko o ka paia o kahi ʻōkana i loko o kā mākou ʻōnaehana hoʻoheheʻe (ʻo ka hapa nui o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi).

He ʻano maʻi ʻaʻai laha ʻole kēia no ka hui o nā sarcomas palupalu. I loko o nā paia o ko kākou ʻōpū, aia nā pūnaewele kūikawā i kapa ʻia ʻo "nā pūnaewele interstitial o Cajal." E noʻonoʻo i kēia mau pūnaewele e like me ka pacemaker o ko kākou ʻōpū. Kōkua kēia mau pūnaewele i ka hoʻomalu ʻana i nā ʻūmiʻi rhythmic e pono ai e hoʻokuke i ka meaʻai ma o nā ʻōpū. Hoʻokumu ʻia nā puʻupuʻu GIST ke loaʻa kahi kīnā i loko o kēia mau pūnaewele, e hoʻoulu ai iā lākou e māhelehele me ka ʻole o ke kāohi.

Hiki i kēia mau cysts ke liʻiliʻi e like me ka mea holoi penikala i kekahi manawa. Ke liʻiliʻi lākou, hiki iā lākou ke noho no nā makahiki me ka ʻole o ka hōʻike ʻana i nā hōʻailona. Eia nō naʻe, ulu mālie kekahi mau cysts a hoʻomaka e hana i nā hōʻailona e hōʻoluʻolu ʻole ai iā mākou.

He aha nā hōʻailona hiki ke loaʻa o GIST?

ʻO ka hapa nui o ka manawa, ʻike ʻia kēia mau puʻupuʻu i ka wā o kahi scan a i ʻole ke ʻoki kino i hana ʻia no kekahi kumu ʻē aʻe, me ka ʻole o nā hōʻailona. Akā inā loaʻa nā hōʻailona, ​​​​hiki iā lākou ke nānā aku penei. E kau kākou iā lākou i loko o kahi papa maʻalahi e hoʻomaopopo.

No ke aha i ulu ai kēia GIST? He aha ke kumu?

I ka hapanui o nā hihia, ʻo ke kumu nui o GIST ka loli ʻana o kekahi o kā mākou mau genes. E noʻonoʻo i nā genes i loko o ko mākou kino e like me kahi puke kuhikuhi no ko mākou kino e ulu a hana. Aia kahi ʻaoʻao ma kēia puke kuhikuhi i kapa ʻia ʻo `(KIT gene)`. Wahi a nā kuhikuhi ma kēia ʻaoʻao, ua hoʻokumu ʻia a kāohi ʻia nā cell i kapa ʻia ʻo `(interstitial cells of Cajal)` a mākou i kamaʻilio ai ma mua.

Akā i kekahi manawa, ua hewa ka pela ʻana o kahi leka a i ʻole kahi huaʻōlelo ma kēia ʻaoʻao `(KIT gene)`. Ua like ia me kahi hewa paʻi. I ka lāʻau lapaʻau, ua kapa ʻia kēia he `(mutation)`. Ma muli o kēia hewa, hāʻawi ka gene KIT i nā kuhikuhi hewa e hana i kahi protein kūikawā i kapa ʻia ʻo `(KIT CD117)`. Ma muli o kēia protein hewa, loaʻa mau i kēlā mau cell kahi hōʻailona e "hoʻomau i ka māhele ʻana, hoʻomau i ka māhele ʻana." ʻO ia ka manawa e ulu ai kēlā mau cell me ke kāohi ʻole a hana i kahi puʻupuʻu.

Hoʻololi pinepine ʻia kēia mau loli hoʻoilina i ko kākou ola ʻana. ʻO ia hoʻi, ʻaʻole ia he mea i hānau ʻia me kākou.

Eia nō naʻe, he mea kākaʻikahi loa, hiki ke hoʻopili ʻia kēia kūlana i nā kūlana genetic i hoʻoili ʻia mai kēlā hanauna a i kēia hanauna. ʻO kekahi o kēia mau hihia:

• ʻO ka maʻi GIST Familial: He maʻi laha ʻole kēia. I kēia hihia, hoʻoilina ke keiki i ka gene KIT kīnā mai kekahi makua. I kēia hihia, hiki ke ulu aʻe nā puʻupuʻu GIST i ka wā ʻōpiopio, a i ʻole e ulu aʻe ma mua o hoʻokahi puʻupuʻu.
• ʻAno Neurofibromatosis 1: He kūlana hoʻoilina nō hoʻi kēia. Hoʻoulu ia i nā puʻupuʻu e hana i loko o nā ʻiʻo aʻalolo o ke kino. ʻOi aku ka nui o ka pilikia o ka poʻe me kēia kūlana i ka loaʻa ʻana o ka GIST ma mua o ka heluna kanaka maʻamau.
• ʻO ka maʻi Carney-Stratakis: He ʻano laha ʻole kēia, he ʻano hoʻoilina. ʻO ka poʻe me kēia ʻano, aia lākou i ka pilikia nui o ka loaʻa ʻana o GIST.

Pehea e ʻike ai nā kauka i ka GIST?

Ke hele ʻoe e ʻike i ke kauka me nā hōʻailona i ʻōlelo ʻia ma luna, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona. Pehea ka lōʻihi o ko lākou ʻike ʻana, pehea ko lākou manaʻo, a pēlā aku. A laila e nānā ʻo ia iā ʻoe. Eia kekahi, e paipai ʻo ia i kekahi mau hoʻokolohua e hoʻoholo ai i ke kumu pololei o ka maʻi.

Nā hoʻokolohua nui i hana ʻia

• ʻO ka endoscopy luna: ʻO kēia ka hoʻāʻo mua i hana ʻia. I ka pōkole, ua hoʻokomo ʻia kahi ʻōmole me kahi kāmela liʻiliʻi i hoʻopili ʻia ma o ka waha a nānā ʻia ka esophagus, ka ʻōpū, a me ka hapa mua o ka ʻōpū liʻiliʻi. Hiki i kēia ke nānā pololei i nā puʻupuʻu a me ke kahe ʻana o ke koko.
• CT scan: Lawe kēia i nā kiʻi ʻokiʻoki o loko o ko mākou kino. Ua like ia me ka ʻoki ʻana i kahi ʻāpana berena. Hiki i kēia ke hōʻike maopopo i ka nui o ka puʻupuʻu, kona wahi, a inā ua pālahalaha aku i nā ʻōpū ʻē aʻe, e like me ke akepaʻa.
• Biopsy:ʻO kēia ka hoʻāʻo koʻikoʻi loa e hōʻoia i ka maʻi 100% o ka manawa. I ka wā o ka endoscopy a i ʻole kekahi ʻano hana ʻē aʻe, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupuʻu kānalua. A laila, nānā ʻia ka ʻiʻo ma lalo o kahi microscope i loko o kahi keʻena hoʻokolohua e ʻike inā he mau pūnaewele GIST ia.
• Nānā PET: I kekahi mau hihia, ʻoiai inā he kānalua ua pālahalaha ke kanesa i nā ʻāpana ʻē aʻe o ke kino, hiki ke hana ʻia kēia hoʻāʻo.

He aha nā lāʻau lapaʻau no GIST?

ʻO ka lāʻau no GIST e pili ana i ka nui o ka puʻupuʻu, kona wahi, a inā ua pālahalaha i nā wahi ʻē aʻe. ʻElua ʻano nui o ka lāʻau.

1. ʻoki kino:

I ka hapanui o nā hihia, ʻo ka lāʻau lapaʻau maikaʻi loa no nā puʻupuʻu GIST ʻo ia ka wehe loa ʻana i ka puʻupuʻu me ke ʻoki ʻana. Inā liʻiliʻi ka puʻupuʻu a ʻaʻole i pālahalaha i nā wahi ʻē aʻe, hiki i ke ʻoki wale nō ke hoʻōla loa i ka maʻi.

2. Hoʻōla i kuhikuhi ʻia:

ʻO kēia ka mea kipi loa e pili ana i ka mālama ʻana iā GIST. ʻAʻole e like me ka chemotherapy maʻamau, ua like kēia mau lāʻau me nā "pōkā akamai." Hoʻopili pololei lākou i ka protein KIT kīnā a mākou i kamaʻilio ai ma mua. No laila, he liʻiliʻi loa ka pōʻino i nā cell olakino.

• Ma mua o ke ʻoki kino: Inā nui loa ka puʻupuʻu a paʻakikī ke ʻoki ʻana, hāʻawi mua ʻia kēia lāʻau lapaʻau i kuhikuhi ʻia a laila hana ʻia ke ʻoki kino ma hope o ka emi ʻana o ka puʻupuʻu.
• Ma hope o ke ʻoki kino: Inā aia kahi pilikia o ka maʻi e hoʻi hou mai ma hope o ke ʻoki kino, hāʻawi ʻia kēia mau lāʻau lapaʻau e hōʻemi i kēlā pilikia.
• Inā ua pālahalaha ke kanesa: Inā ua pālahalaha loa ke kanesa e hiki ʻole ke wehe ʻia, pono paha ʻoe e lawe i kēia mau lāʻau lapaʻau no ke koena o kou ola e kāohi i ka maʻi a hōʻemi i nā hōʻailona.

He aha kāu e manaʻo ai i ka wā e noho ana me kahi maʻi GIST?

Ma hope o ka mālama ʻana, hiki ke hoʻomaikaʻi ʻia nā hōʻailona, ​​a i kekahi manawa e ho'ōla loa ʻia ka maʻi. Eia nō naʻe, he kūlana ka GIST e loaʻa ana ka manawa e hoʻi hou mai ai. No laila, he mea nui loa ia e hoʻomau i ka launa pū me kāu kauka oncologist nāna e mālama iā ʻoe ma hope o ka mālama ʻana.

E loaʻa iā ʻoe nā manawa hoʻopaʻa me kāu kauka i kēlā me kēia 3 a 6 mahina. I loko o kēia mau manawa, e hana ʻia nā hoʻokolohua e nānā i nā hōʻailona o ka hoʻi hou ʻana.

• Nā scan CT
• Nā kiʻi MRI
• Nā scan PET

Hana mākou i nā hoʻokolohua e like me kēia e hōʻoia ai ua maikaʻi nā mea a pau.

No ka mea, he maʻi laha ʻole ka GIST, he mea maʻamau ke manaʻo i ka haʻalulu a me ka makaʻu ke aʻo ʻoe e pili ana i ia mea. Akā e hoʻomanaʻo, aia nā lāʻau lapaʻau kūpono loa no kēia maʻi. ʻAʻole ʻoe hoʻokahi. Aia kāu hui lapaʻau, ʻohana, a me nā hoaaloha e kōkua iā ʻoe. E aʻo e pili ana i kēia maʻi, e nīnau i nā nīnau, a e kū i ka lāʻau lapaʻau me ka maikaʻi.