Owulidde ku kookolo w’olubuto ow’obuzaale? (Hereditary Diffuse Gastric Cancer - HDGC) Ka twogere ku nsonga eno!

Leero tugenda kwogera ku mbeera ey’amaanyi abantu bangi gye batamanyi. Kino kika kya kookolo w’olubuto nga ya nsikirano. Abasawo bakiyita `(Hereditary Diffuse Gastric Cancer)` oba `(HDGC)` mu bufunze. Singa omuntu mu maka go abadde n’embeera eno, oba bw’oba ​​oyagala okumanya ebisingawo ku nsonga eno, ekitundu kino kijja kuba kikulu nnyo gy’oli. Tofaayo, ka tukyogereko mu ngeri ennyangu.

Kino `(HDGC)` kye ki?

Mu ngeri ennyangu, HDGC mbeera ya bulabe ya kookolo ey’obuzaale. Kino kitegeeza nti obulamu bwo bwonna obw’okufuna kookolo w’olubuto (Gastric cancer) bweyongera ebitundu nga 70%. Si ekyo kyokka, abakyala abasikira embeera eno nabo balina obulabe obweyongedde ebitundu 42% obw’okufuna ekika kya kookolo w’amabeere ekigere , Lobular Breast Cancer (LBC) .

Abantu abalina embeera eno eya `(HDGC)` basikira obuzaale obukyusiddwa (`(mutated gene)`) okuva ku omu ku bazadde baabwe. Ebiseera ebisinga, eno ye ggiini eyitibwa `(CDH1)` . Naye oluusi obuzaale obulala buyinza okukwatibwako. `(CDH1)` ye ggiini eziyiza ebizimba (`(obuzaale obuziyiza ebizimba)`). Kino bwe kikyusibwa, tekikola bulungi kufuga kookolo. Lowooza ku kino, obuzaale buno bulinga omupoliisi mu mubiri gwaffe alemesa obutoffaali bwa kookolo okukula. Kale kiki ekibaawo singa omupoliisi oyo anafuwa? Ekyo kye kibaawo ne wano.

Kookolo w'olubuto "diffuse" kye ki?

Kati katulabe kino `(Diffuse Gastric Cancer)` kye ki. Kino kika kya kookolo w’olubuto. Naye mu kifo ky’okukula mu kifo kimu nga kookolo omulala, ono asaasaana mu bbugwe w’olubuto yenna mu bubinja obutonotono obw’obutoffaali. Kiringa amazzi agakulukuta nga gasaasaana ku bbugwe. Olw’ensonga eno, ekisenge ky’olubuto kigonvuwa ne kikaluba. Mpola mpola, kisaasaana ne kituuka mu layeri enzito ez’ekisenge ky’olubuto.

Kookolo w’olubuto ow’ekika kino kizibu katono okuzuula kubanga talabika bulungi ku kukebera ebifaananyi ebya bulijjo. Ate era, obubonero butera okulabika ng’obulwadde bumaze okusaasaana, mu mitendera egy’oluvannyuma. Mu kiseera ekyo, kookolo ayinza okuba nga yasaasaana (yasaasaana) okuyita mu bbugwe w’olubuto okutuuka mu bitundu ebiriraanyewo, gamba ng’ekibumba oba amagumba.

Embeera eno ya bulijjo etya?

Nga twogera ku mbeera `(HDGC)`, kiteeberezebwa nti abantu nga bataano ku kkumi ku nkumi kkumi basobola okusikira embeera eno nga bazaalibwa. Ebitundu nga 20% ku kookolo yenna ow’olubuto wa kika kya `(diffuse)`. Ebitundu nga 2% ku kookolo ezo ezisaasaana za nsikirano `(HDGC).` Wadde nga kookolo w'olubuto okutwalira awamu asinga mu nsi za Asia okusinga mu nsi z'amawanga g'obugwanjuba, embeera eno eya `(HDGC)` etera okuloopebwa mu nsi z'amawanga g'obugwanjuba.

Bubonero ki obw'embeera ya `(HDGC)`?

Nga bwe twagambye emabegako, obubonero bwa kookolo w’olubuto ow’ekika kino asaasaana buyinza obutalabika okutuusa ng’obulwadde busaasaana (metastasized). Eno y’ensonga lwaki kikulu okumanya akabi embeera eno gy’esobola okutambulira mu maka. Mu HDGC, kookolo akula ku myaka emito katono okusinga mu kookolo omulala. Abantu abasinga bazuulibwa nga tebannaweza myaka 40.

Obubonero obukulu buyinza okuba:

• Obulumi mu lubuto (naddala mu kitundu kya waggulu ekya kkono eky’olubuto) .
• Okuzimba olubuto, okuzimba omubiri
• Okuziyira n’okusiiyibwa
• Endya
• Okugejja
• Obukoowu obuyitiridde, obukoowu
• Okukaluubirirwa okumira emmere
• Omusaayi mu musulo (`(Omusaayi mu musulo)`)
• Okusesema omusaayi (`(Okusesema omusaayi)`)
• Jaundice (okufuuka okwa kyenvu kw’amaaso n’olususu) .

Oluusi, ekizibu ky’okuzaalibwa ekiyitibwa cleft lip oba cleft palate nakyo kiyinza okuba akabonero akasooka ak’obulwadde buno. Kino kiri bwe kityo kubanga enkyukakyuka eno mu buzaale esobola okuleeta obuzibu buno obw’okuzaalibwa. Wabula ebiseera ebisinga, emimwa egyakutuka tegikwatagana na HDGC. Kyokka bw’oba ​​wazaalibwa n’obulemu obw’engeri eno era ng’omuntu mu maka go abadde n’obulwadde bwa kookolo obw’ekika kino, oyinza okwekengera katono.

Kiki ekivuddeko okutondebwawo kwa `(HDGC)` eno?

HDGC bulwadde bwa buzaale . Kibaawo ng’enkyukakyuka mu emu ku buzaale obuziyiza ebizimba bwe twayogeddeko emabegako ekyusa pulogulaamu mu DNA yo. Obuzaale obuziyiza ebizimba bugamba obutoffaali okufuga okwawukana n’okukula kw’obutoffaali. Kale obuzaale buno bwe butakola bulungi, kookolo asobola okukula.

Osikira obuzaale buno obukyusiddwa okuva ku maama wo oba kitaawo. Enkyukakyuka esikira mu ngeri eno eyitibwa enkyukakyuka mu layini y'obuwuka . Kikosa obuzaale bw’obutoffaali bwo obw’okuzaala.

Kino `(HDGC)` kisikira kitya?

HDGC mbeera ya autosomal dominant . Kino kitegeeza nti olina okuba ne kkopi emu yokka ey’obuzaale obukyusiddwa okusobola okusikira obulwadde buno. Kiyinza okusikira okuva ku maama wo oba kitaawo. Singa omu ku bazadde bo aba n’enkyukakyuka eno, ggwe oba baganda bo mulina emikisa gya 50% okugisikira. Kilowoozeeko ng’omukisa gw’ekinusu okujja waggulu ku mitwe oba emikira.

Buli muntu asikira enkyukakyuka mu buzaale afuna kookolo?

Nedda, enkyukakyuka mu buzaale gy’osikira okuva mu bazadde bo ekosa kkopi emu yokka ey’obuzaale obuziyiza kookolo mu buli katoffaali. Naye buli katoffaali kalina kkopi bbiri ez’obuzaale buno, emu ya maama wo ate endala ya kitaawo. Kale ne bw’oba ​​tosikira nkyukakyuka y’emu okuva mu bazadde bombi, okyalina kkopi y’obuzaale obukola mu ngeri eya bulijjo.

Kookolo okusobola okukula, enkyukakyuka eyokubiri (`(somatic mutation)`) .Kiteekwa okubaawo mu bitundu by’omubiri kookolo w’akola (i.e., olubuto oba ebitundu by’amabeere) mu bulamu bwo. Enkyukakyuka eno ey’okubiri era eziyiza kkopi endala ey’obuzaale. Wano kookolo w’atandika okukula.

Kiki ekivaako enkyukakyuka eno ey’okubiri?

Mu butuufu, tetumanyi nsonga ntuufu lwaki kino kituuse. Naye ensonga ez’enjawulo ziyinza okubaako kye zikola. Okukwatibwa kw'obutonde kutera okukola kinene mu "kusitula" endwadde z'obuzaale. Obuzaale obulala nabwo buyinza okukwatibwako. Amaka agamu agatambuza obuzaale bwa HDGC galina kookolo mungi okusinga amalala.

Ebimu ku bintu ebiyinza okuvaako kookolo w’olubuto okulwala obutonde bye bino:

• Okunywa sigala
• Okunywa omwenge ekisusse
• Okulya ennyo ennyama emmyufu (nga ennyama y’ente, ey’endiga) .
• (H. pylori) obulwadde (buno buwuka obuleeta amabwa mu lubuto) .

Enkola y'okugezesa `(HDGC)` eri etya?

Ne bw’oba ​​tonnaba kufuna bubonero, bwe wabaawo ensonga lwaki olowooza nti oli mu bulabe (okugeza, singa omuntu mu maka go abadde n’ebika bya kookolo bino, oba bw’oba ​​obadde okeberebwa obuzaale okwazudde enkyukakyuka mu buzaale bwa `(CDH1)`), omusawo ayinza okukusindika okukeberebwa `(HDGC)`.

Omusawo wo ajja kubala akabi ko okusinziira ku byafaayo by’amaka go ne/oba ebyava mu kukeberebwa kw’obuzaale. Era bayinza okunoonya ebikulembera kookolo mu bitundu byo. Okugeza bayinza okunoonya embeera eyitibwa Lobular Carcinoma In Situ (LCIS) mu mabeere oba obutoffaali obw’ekika kya signet-ring mu lubuto. Zino nkyukakyuka nga bukyali eziyinza okufuuka kookolo.

HDGC ezuulibwa etya?

Bw’oba ​​olina obubonero bwa kookolo w’olubuto agenda mu bitundu ebirala, omusawo ajja kunoonya obujulizi bwa kookolo mu bbugwe w’olubuto lwo. Bajja kutwala sampuli z’ebitundu by’omubiri (tissue samples) bazikebere nga bakozesa microscope. Singa kookolo w’olubuto asangibwa mu bitundu ebirala, era singa omuntu mu maka go abadde alina kookolo ow’ekika kino, omusawo ayinza okukugamba nti okebere obuzaale .

Mu kiseera kino, abalwadde nga 40% abalina HDGC bazuuliddwa nga balina enkyukakyuka eno eya CDH1. Enkyukakyuka endala ziyinza okuba nga zeenyigiddemu, naye CDH1 ye nsonga enkulu gye tumanyi era gye tusobola okuzuula. Bw’oba ​​olina, y’engeri enkakafu ey’okuzuula HDGC. Wabula bw’oba ​​olina ebyafaayo by’amaka ga kookolo w’olubuto ow’ekika kino asaasaana, oyinza okuzuulibwa nti olina HDGC ne bw’oba ​​tolina nkyukakyuka ya CDH1.

Bikebere ki ebikozesebwa okuzuula (HDGC)?

Ebigezo bino osobola okubikola okuzuula obulwadde buno:

• Okukebera obuzaale:Kino kwekebeza musaayi. Sampuli y’omusaayi gwo bagiggyibwako ne yeekenneenyezebwa okulaba oba waliwo enkyukakyuka yonna mu buzaale ekwatagana n’endwadde z’obuzaale. Abantu abamu bafuna okukeberebwa kuno kubanga balina ebyafaayo by’amaka g’endwadde z’obuzaale. Abalala bafuna okukeberebwa kw’obuzaale okw’ekika kino kubanga tebamanyi byafaayo bya bulamu bwa maka gaabwe, olw’okuba bamanyi oba olw’okuba bategese okuzaala.
• Upper endoscopy (EGD test): Kino kigezo okutunuulira munda mu nkola yo ey’omu lubuto eya waggulu (i.e., esophagus, olubuto) n’okwata sampuli z’ebitundu by’omubiri. Kino kyetaagisa nnyo mu kuzuula kookolo w’olubuto naddala ekika kino ekya kookolo asaasaanidde. Omusawo w’omu lubuto (omusawo mukugu mu ndwadde z’omu lubuto) kino akikola. Ayingiza ekyuma ekiwanvu (endoscope) nga kiriko kkamera entono ng’ayita mu kamwa n’akka wansi mu nnywanto yo n’ayingira mu lubuto lwo. Sampuli z’ebitundu by’omubiri nazo zisobola okutwalibwa nga ziyita mu ttanka. Kyokka ne bwe wabaawo enkola zino, kiyinza okuba ekizibu okuzuula kookolo w’olubuto agenda mu bitundu ebirala. Olw’okuba kibunye nnyo, omusawo ayinza obutasobola kukiraba oba okukifuna mu sampuli z’ebitundu by’omubiri. N’olwekyo, omusawo anoonya kookolo ow’ekika kino alina okuba ng’atendekeddwa n’obumanyirivu obw’enjawulo.
• MRI y’amabeere: Olw’okuba kookolo w’amabeere ow’omu lubuto (lobular breast cancer) tazuulibwa mu kukebera amabeere okwa bulijjo, abasawo bagamba nti ogenda kukola MRI. Singa MRI eraga ekintu kyonna ekitali kya bulijjo, bagiteekako akabonero era omusawo omulala n’akwata sampuli y’ebitundu by’omubiri.
• Biopsy: Omusawo akwata sampuli y’ebitundu by’omubiri n’abisindika mu laabu okukeberebwa mu microscope. Okukebera kuno kuyinza okukakasa oba sampuli y’ebitundu by’omubiri erimu obutoffaali bwa kookolo.

Kiki ekibaawo oluvannyuma lw'okuzuulibwa nti kirina `(HDGC)`?

Bw’oba ​​olina dda kookolo, omusawo ajja kwogera naawe ku ngeri y’okujjanjaba. Ne bw’oba ​​tonnaba kufuna kookolo, bw’oba ​​olina obulwadde buno, omusawo ajja kukuwa amagezi okwekebeza kookolo buli kiseera, nga bwe kyayogeddwa waggulu. Okulongoosa okuziyiza y’engeri endala gy’osobola okwogerako n’omusawo wo.

Kookolo w’olubuto agenda mu bitundu ebirala ajjanjabwa atya?

Okulongoosa ebiseera ebisinga bwe bujjanjabi obusooka ku kookolo obuyinza okuggyibwawo ng’olongooseddwa. Bw’oba ​​olina HDGC, omusawo wo ajja kutera okukugamba nti olongoose olubuto lwonna . Kino kiri bwe kityo kubanga HDGC erina akabi kanene okusaasaana ewala nga tennazuulibwa.

Mu kulongoosa olubuto lwonna, omusawo alongoosa olubuto lwo lwonna n’agatta enkomerero y’omusuwa gwo butereevu ku kyenda kyo ekitono. Kisoboka okubeera nga tolina lubuto naye waliwo ebizibu ebimu ebivaamu. Oluvannyuma lw’okulongoosebwa, oyinza okufuna obujjanjabi obulala (adjuvant therapies) nga radiation therapy oba chemotherapy.

Olw’okuba abakyala abalina `(HDGC)` nabo bali mu bulabe bw’okufuna kookolo w’amabeere ow’omu lubuto (`(LBC)`), balina okumanya buli kiseera obubonero bwa `(LBC)` nga bajjanjabwa. Bwoba olina `(LBC)`, obujjanjabi butera kutandikira ku kulongoosa kookolo w'amabeere. Olwo ne baweebwa obujjanjabi obw’enjawulo.

Obulamu obusuubirwa n'embeera ya `(HDGC)` bwe buliwa?

Obulamu obusuubirwa businziira ku kuzuula n’okujjanjaba kookolo nga bukyali. Ne bwe baba nga bakeberebwa buli kiseera, kino kiyinza okuba ekizibu. Singa kookolo w’olubuto agenda mu bitundu ebirala akwatibwa n’ajjanjabibwa nga bukyali, omuwendo gw’abantu abawangaala mu myaka etaano gusukka ebitundu 90%. Wabula singa kizuulibwa kikeerezi, oluvannyuma lw’okuyingirira ekisenge ky’olubuto, omuwendo gukendeera okutuuka wansi wa bitundu 30%.

Eno y’ensonga lwaki tugamba nti kikulu nnyo okumanya ebyafaayo by’amaka n’okunoonya amagezi g’abasawo bw’oba ​​oli mu bulabe.

Waliwo engeri y'okuziyiza `(HDGC)`?

Bw’oba ​​olina enkyukakyuka y’obuzaale bwa `(CDH1)` (ekwatagana n’obulabe obw’okwongera okufuna kookolo), waliwo enkola eziwerako ez’okuziyiza z’osobola okukola. Ku bantu abatalina nkyukakyuka eno entongole ey’obuzaale, akabi n’ebipimo tebinnyonnyoddwa bulungi. Osobola okwogera n’omusawo wo ku bulabe bwo ku bubwo n’engeri gy’oyinza okulondamu.

Okulongoosa mu ngeri y’okuziyiza obulwadde

Bw’oba ​​omaze emyaka egitakka wansi wa 20 ng’olina HDGC era nga tolina buzibu bulala bwa bulamu bunene, omusawo ayinza okukuwa amagezi okulongoosebwa olubuto lwonna mu ngeri ey’okuziyiza . Wadde ng’okufiirwa olubuto kuyinza okubaako ebikosa enkola yo ey’okugaaya emmere, ebizibu bino byangu okuddukanya okusinga okukola ku kookolo w’olubuto agenda mu maaso.

Ku abo abataali beetegefu kukola mitendera gino, enkola ya "linda n'okutunuulira" esobola okutwalibwa, nga eno erimu okukebera ennyo ekyenda ekya waggulu n'okukebera sampuli z'okukebera mu ngeri ey'ekifuulannenge. Naye ne bwe wabaawo okulondoola okumpi bwe kuti, HDGC eyinza obutazuulibwa nga bukyali (nga obujjanjabi businga okukola obulungi).

Ebizibu ebiva mu kulongoosa olubuto lwonna:

• Dumping syndrome: Emmere bw’eyita butereevu okuva mu nnywanto n’eyingira mu kyenda ekitono, eyitira mu kyenda ekitono amangu okusinga ku kya bulijjo. Kino kiyinza okuleeta enkyukakyuka ez’amaanyi mu busimu mu nkola y’okugaaya emmere, ekivaako obubonero ng’okuziyira, ekiddukano, ne ssukaali omutono mu musaayi. Obubonero buno osobola okubufuga ng’okyusa mu ngeri gy’olya. Obubonero buno bujja kukendeera okumala ekiseera.
• Obutanywa n’endya embi: Olubuto bwe luggyibwamu, ekitundu ky’olubuto ekirimu asidi n’enziyiza eziyamba okugaaya emmere kibula. Kino kiyinza okutangira emmere okumenyekamenyeka obulungi n’okulemesa omubiri okunyiga ebiriisa. Kino kiyinza okuvaako endya embi. Kino kiyinza okuyambibwa ng’okyusa mu mmere gy’olya n’okumira emmere erimu ebiriisa.

Okubuulirira ku buzaale n’okuteekateeka amaka

Ku bantu abalina enkyukakyuka y’obuzaale bwa CDH1, okubuulirira ku buzaale kuyinza okuyamba ennyo mu kuteesa ku nteekateeka y’amaka. Kino kiyinza okukuyamba okutegeera akabi akali mu mwana wo okusikira embeera ya HDGC. Bw’oba ​​oteekateeka okuzaala, engeri emu gy’oyinza okuddukanyaamu akabi ako kwe kulonda In Vitro Fertilization (IVF) .

Mu IVF, amagi n’ensigo biggyibwa mu maama ne taata ne bifumbirwa mu laabu. Oluvannyuma lw’enkwaso okukula, akatoffaali kamu okuva mu buli nkwaso kasobola okuggyibwa ne kakeberebwa oba waliwo enkyukakyuka ya CDH1. Abazadde basobola okulonda embuto ezitaliimu nkyukakyuka eno ne baziteeka mu nnabaana wa maama.

N’ekisembayo, kiki ky’olina okukuuma mu birowoozo

Okuzuula nti olina obulwadde bwa Hereditary Diffuse Gastric Cancer Syndrome (HDGC) kiyinza okukukwatako ennyo, era oyinza okusalawo ebinene. Bino bisobola okukukosa ggwe n’ab’omu maka go. Twala obudde olowooze ku bintu nga tosattira. Buuza ebibuuzo bingi nga bwe weetaaga. Ttiimu yo ey’abasawo eri wano okukuyamba okuzuula engeri esinga obulungi ey’okutambuliramu olugendo luno. Jjukira nti okumanyisa abantu gwe mutendera ogusooka. Toli wekka.

` HDGC, kookolo ow’obuzaale, kookolo w’olubuto, CDH1 gene, kookolo w’olubuto, kookolo w’amabeere, okukebera obuzaale, endoscopy, gastrectomy, okuziyiza kookolo