Omanyi kookolo ono atatera kulabika? Ka twogere ku NUT Carcinoma

Wali owuliddeko ku NUT Carcinoma? Oboolyawo si bwe kiri. Kubanga kika kya kookolo atatera kulabika, atatera kulabika nnyo era akula mangu. Naye kikulu nnyo okukimanya, kubanga embeera eno esobola okukula mu muntu yenna. Kale leero tugenda kukyogerako mu bujjuvu katono, nga tulinga ayogera ne mukwano gwaffe.

NUT Carcinoma kye ki?

Mu ngeri ennyangu, NUT Carcinoma kika kya kookolo ekikula amangu ennyo, ekikambwe . Kitwalibwa ng’ekisinga okubeera ekizibu mu kookolo w’obutoffaali obuyitibwa squamous cell carcinomas. Kati oyinza okuba nga weebuuza obutoffaali obuyitibwa squamous cells kye ki. Bino kika kya butoffaali obusangibwa mu lususu lwaffe. Tekikoma awo, naye n’ebitundu ebimu eby’omunda mu mubiri gwaffe nabyo bibikkiddwa obutoffaali buno.

NUT Carcinoma eno eva ku nkyukakyuka mu buzaale mu buzaale bwaffe. Okubeera omutuufu, kiva ku kikyamu mu ggiini eyitibwa `NUTm1`. Omanyi obuzaale buno buwa obutoffaali bwaffe ebiragiro ku ngeri gye bukolamu. Kale, bwe wabaawo ensobi mu biragiro bino, kwe kugamba, `enkyukakyuka`, n'obutoffaali obulamu butandika okufuuka `obutoffaali bwa kookolo`. Olwo obutoffaali buno bwa kookolo ne bukuŋŋaana ne bukola `ebizimba`.

Ebiseera ebisinga, kookolo zino eza NUT zikula wakati mu mubiri gwaffe, oba okuyita ku ``midline`` . Eno y’ensonga lwaki emabegako zaali ziyitibwa NUT-midline carcinoma. Wabula ebizimba bino bisobola n’okukula mu bitundu by’omubiri ebirala.

Ebizimba bino ebya kookolo bisobola okuva wa?

Abantu abazuuliddwa nga balina NUT Carcinoma balina ebizimba mu bifo bino wammanga ku mibiri gyabwe:

• Omutwe naddala mu nnyindo (guno gwe gusinga okubeera) .
• Ku bulago (kino nakyo kitera okulabibwa) .
• Mu mawuggwe (kino nakyo kya bulijjo) .
• Mu kitundu ekiri wakati mu kifuba, ekifo omutima n’amawuggwe we bibeera (the `mediastinum`) (kino nakyo kya bulijjo) .
• Olubuto oluyitibwa pancreas
• Ensigo
• Endwadde z’ekibumba
• Olubuto
• Ekibumba
• Mu magumba (`Magumba`) .

Kookolo ono ayitibwa NUT Carcinoma , asobola okukula n’okusaasaana amangu ennyo, ne bw’aba ajjanjabiddwa . Ekyo kye kintu ekisinga okuba eky’akabi ku kyo.

NUT Carcinoma atatera kubaawo kwenkana wa?

Kino mu butuufu kitwalibwa nga kookolo atatera kulabika . Kyokka, wayinza okubaawo abalwadde bangi okusinga bwe tulowooza. Ekitongole kya International NUT Midline Carcinoma Registry kitegeeza nti buli mwaka abantu 20 bokka be bafuna obulwadde buno.

Ekimu ku bivuddeko omuwendo guno omutono kwe kukaluubirirwa okuzuula obulwadde buno. Bannasayansi baazuula engeri enkulu eya kookolo ono, ``mutation`` mu ``NUTm1`` gene, mu 2004. Kale, si malwaliro gonna nti galina ``ebikozesebwa mu kukebera`` ebisobola okuzuula gene eno.

Kilowoozeeko ng’okuzuula obulwadde obupya. Kitwala akaseera ebigezo ebituufu okubeerawo buli wamu.

Ate era, NUT Carcinoma kyangu okutabulwa n’ebika bya kookolo ebirala ebya bulijjo. Kisoboka okumanya obulungi oba kookolo ye NUT Carcinoma singa enkyukakyuka y’obuzaale bwa `NUTm1` ezuulibwa. Abantu abamu abazuuliddwa nga balina `kookolo w'omutwe n'ensingo`, `kookolo w'amawuggwe`, n'ebika bya kookolo ebirala ebimu mu butuufu bayinza okuba n'enkyukakyuka eno ey'obuzaale.

Naye kati, olw’okuba okumanya kookolo ow’ekika kino kweyongedde, era olw’okuba tekinologiya ow’okuzuula enkyukakyuka eno mu buzaale alongooseddwa, kyangu eri abakugu mu kookolo okuzuula kookolo wa NUT okusinga bwe kyali edda.

Ani afuna obulwadde bwa NUT Carcinoma?

Kookolo ono asinga kuzuulibwa mu bavubuka . Emyaka egy’omu makkati nga bazuuliddwa obulwadde buno giri nga 24. Kino kitegeeza nti nga kitundu ku abo abazuuliddwa tebannaweza myaka 24, ate ekitundu ekirala bakulu.

Kyokka kookolo ono asobola okukula mu muntu yenna . Kizuuliddwa mu baana abaakazaalibwa, ne mu bantu abali mu myaka gyabwe egy’obukulu 80. Kale tekisoboka kulowooza nti tekijja kubaawo okusinziira ku myaka gyokka.

Bubonero ki obwa NUT Carcinoma?

Ebiseera ebisinga, kookolo ono talaze bubonero bwonna mu ntandikwa . Obubonero butandika okulabika nga kookolo akuze katono n’atandika okukosa ebitundu ebyetoolodde ekizimba. Mu kiseera ekyo, ebiseera ebisinga oyinza okuwulira ng’okooye era nga tolina bulungi.

Olw’okuba ebizimba bitera okuva mu bifo ebiyitibwa sinus cavities n’amawuggwe, obubonero obusinga okuloopebwa bukwatagana nabyo.

Obubonero obutera okulabika:

• Obukoowu/obukoowu obuyitiridde (`Obukoowu`) .
• Okugejja mu ngeri etategeerekeka
• Ekizimba ekiruma

Obubonero bw’okuzimba ekizimba mu sinus:

• Puleesa ya sinus, okunyiga oba okulumwa
• Okuvaamu omusaayi mu nnyindo emirundi mingi
• Okuzibikira ennyindo oba okuzibikira
• Okufiirwa obusimu bwo obw’okuwunyiriza

Obubonero bw’ekizimba ky’amawuggwe:

• Okussa obubi oba obuzibu mu kussa
• Okusesema okutambula obutasalako (okusesema okutambula obutasalako) .

Totya NUT Carcinoma olw’okuba olina obubonero buno. Naye singa obubonero buno busigala, .Kikulu nnyo okulaba omusawo ddala n’okufuna amagezi.

Kiki ekivaako kookolo wa NUT?

Kookolo ono ava ku kugatta obuzaale bubiri obw’enjawulo, ne bukola obuzaale obw’enjawulo obw’omugatte (`hybrid gene` oba `fusion gene`). Mu buli mulwadde alina NUT Carcinoma, ensengekera y’obutonde `NUTm1` egattibwa n’obuzaale obulala obutateekeddwa kugattibwa nayo. Ensengekera y’obutonde eya `NUTm1` tereeta kookolo ku bwayo, naye obuzaale buno obw’omugatte obupya bwe buleetera obutoffaali bwa kookolo okukula.

Mu bantu nga 75% abalina kookolo wa NUT, obuzaale bwa `NUTm1` bwegatta n'obuzaale bwa `BRD4`. Mu bitundu nga 15% ebirala, obuzaale bwa `NUTm1` bugattibwa n'obuzaale bwa `BRD3`. Tekitera nnyo, kiyinza okugattibwa n’obuzaale obulala.

Bannasayansi n’okutuusa kati tebakakasa kiki ekivaako enkyukakyuka zino ez’obuzaale. Naye ekintu kimu kyeyoleka bulungi: tezisikira. Era n’ebintu ebitera okuleeta kookolo, gamba ng’okunywa sigala n’okukwatibwa ebirungo ebivaako kookolo, tebirabika nga bye bikwatibwako. Okunoonyereza okusingawo kwetaagibwa okutegeera ekikwata ku nkyukakyuka zino ez’obuzaale.

NUT Carcinoma azuulibwa atya?

Abasawo bazuula obulwadde buno nga bayita mu kukebera omubiri (biopsy). Kino kizingiramu okuggya akatundu akatono okuva mu kizimba nga bakozesa empiso ey’enjawulo eriko ekituli. Olwo sampuli eno esindikibwa mu laabu okukeberebwa obutoffaali bwa kookolo.

Omusawo wo era ajja kukozesa enkola ez’enjawulo ez’okukuba ebifaananyi okutunuulira ekizimba ekiri munda mu mubiri gwo n’okumanya omutendera gwakyo. Okuteeka kookolo mu mitendera y’enkola y’okuzuula engeri kookolo gy’ali ow’amaanyi, okusinziira ku bunene bw’ekizimba, ekifo we kiri, n’okumanya oba kisaasaanye (ekibunye) okuva ku kizimba ekisookerwako okutuuka mu bitundu by’omubiri ebirala. Okusaasaana kwa kookolo kubaawo ng’obutoffaali bwa kookolo bwekutudde ku kizimba ekyasooka, ne buyita mu mazzi g’ennywanto oba mu musaayi, ne bukola ebizimba ebipya mu bitundu oba ebitundu eby’ewala.

CT scan ne MRI scan zisobola okulaga ekizimba we kiri mu mubiri. Sikaani ya PET esobola okumanya oba kookolo asaasaanidde.

Bikebere ki ebikolebwa okuzuula obulwadde buno?

Okugezesebwa okw’enjawulo okuyitibwa `Immunohistochemistry` kukolebwa mu laboratory okuzuula oba obuzaale bwa `NUTm1` buli mu sampuli y’okukebera omubiri. Singa obuzaale bwa `NUTm1` bubaawo mu sampuli (`positive`), buzuulibwa nga NUT Carcinoma.

Ebigezo ebirala ebiyinza okukolebwa okuzuula obuzaale buno kwe kugezesebwa kwa Fluorescence In Situ Hybridization (FISH) oba okukebera obuzaale obulala obw’enjawulo.

NUT Carcinoma ajjanjabwa atya?

Osobola okuggyawo ekizimba.Kiyinza okwetaagisa okulongoosebwa n’okujjanjaba eddagala eriyitibwa radiation therapy. Singa kookolo asaasaanidde okusukka ekizimba, n’eddagala eriweweeza ku bulwadde buno liyinza okuweebwa. Emirundi mingi, emu oba eziwera ku bujjanjabi buno buweebwa wamu.

Wabula okujjanjaba kookolo wa NUT kizibu nnyo. Ebiseera ebisinga, obujjanjabi ne bwe bulemesa kookolo okweyongera, ajja kutandika okukula n’okuddamu okusaasaana oluvannyuma lw’akaseera.

Ekisinga obukulu mu biseera nga bino kwe kusigala ng’oli mugumu. Tulina okuwuliriza abasawo bye boogera era kino tukitunuulire wamu nabo.

Bw’oba ​​ozuuliddwa nti olina NUT Carcinoma, okugezesebwa mu malwaliro kuyinza okuba obujjanjabi obusinga obulungi . Okugezesebwa mu malwaliro kwe kunoonyereza okugezesa obujjanjabi obupya oba enkola z’obujjanjabi. Mu kiseera kino bannassaayansi bali mu kunoonyereza ku bujjanjabi obugendereddwamu obulwadde bwa NUT Carcinoma. Obujjanjabi obugendereddwamu bujjanjabi obugenderera enkyukakyuka mu buzaale ereetera obutoffaali obulamu okufuuka kookolo.

Emu ku bujjanjabi obugendereddwamu ku kookolo wa NUT ye `BET` inhibitors . Eddagala lino ligenderera obuzaale bubiri, `BRD4` ne `BRD3`, obutera okukwatagana n'obuzaale bwa `NUTm1`. Ebiziyiza bino, nga bigattiddwa wamu n’obuzaale obwo `NUTm1`, biyimiriza okukula kw’obutoffaali bwa kookolo.

NUT Carcinoma asobola okuwona?

Ebyembi, tewali ddagala lya NUT Carcinoma. Ye kookolo akula amangu ennyo era asaasaana mangu mu bitundu by’omubiri ebirala. Ku kigero, abantu abafuna obujjanjabi bawangaala emyezi nga 10 oluvannyuma lw’okuzuulibwa nti balina obulwadde buno. Abantu babiri ku basatu ku buli bantu kkumi abazuuliddwa nga balina NUT Carcinoma bawangaala emyaka ebiri.

Naye, nga bwe kiri ku kookolo yenna, okuteebereza kwo, oba engeri gy’onookwatamu obujjanjabi, kisinziira ku bintu bingi. Ekifo ekizimba we kiri, oba kisobola okuggyibwawo ddala nga kilongooseddwa oba obujjanjabi obw’amasannyalaze, era okunoonyereza okumu kulaga nti obuzaale obulala obugattibwa n’obuzaale bwa NUTm1 nabwo bukola kinene.

Omusawo wo ajja kukunnyonnyola ebiruubirirwa by’obujjanjabi okusinziira ku ngeri gy’ozuddemu obulwadde.

Nze nneerabirira ntya?

Kikulu okwetooloola abantu be weesiga n’okuwagira mu kiseera kino. Kozesa eby’obugagga byonna ebiriwo okukuyamba okutambulira mu kusoomoozebwa okujja n’okuzuula kuno.

Obujjanjabi obukkakkanya obulumi okuva eri omusawo woManya ku mpeereza. Abakugu mu kujjanjaba okukkakkanya obulumi basobola okukuyamba okuddukanya ebipya bye weetaaga mu bulamu bwo olw’okuzuula kuno. Ziyinza okukuyamba okuddukanya ebizibu ebiva mu bujjanjabi bw’eddagala n’obusannyalazo, n’okukuyamba okugumira obuvunaanyizibwa obwa bulijjo obujja ne kookolo.

Jjukira nti toli wekka. Tolonzalonza kusaba buyambi na buwagizi.

Bibuuzo ki bye nnina okubuuza omusawo wange?

Waliwo ebintu bingi by’oyinza okwagala okubuuza omusawo mu kiseera nga kino. Bino bye bimu ku byokulabirako:

• Kookolo asaasaana?
• Nneetaaga okulaba omusawo omukugu oba okugenda mu ddwaaliro erigere okujjanjabibwa?
• Bujjanjabi bwa ngeri ki gy’oteesa?
• Migaso ki n’akabi akayinza okuva mu bujjanjabi?
• Biruubirirwa ki eby’obujjanjabi?
• Osobola okunnyamba okufuna obuyambi obulala, omuli n‟obujjanjabi obw‟okukkakkanya obulumi?

Obujjanjabi bwa NUT Carcinoma butera okuba obw’amaanyi. Olw’okuba otera okugenda ew’omusawo wa kkansa n’okunyigirizibwa mu bulamu obwa bulijjo, okugumira obulwadde bwa kookolo kiyinza okuba ekizibu. Ebikozesebwa mu by’obujjanjabi nga palliative care bisobola okuyamba. Era okutuuka ku baagalwa bo kiyinza okukuwa amaanyi amangi. Okuva lw’ofuna okuzuulibwa kwo, kyetaagisa okwogera mu lwatu ne ttiimu yo ey’okulabirira kookolo okutegeera engeri z’okulabirira ezisinga obulungi okugenda mu maaso. Buli muntu by’ayitamu ku kookolo bya njawulo. Ttiimu yo ey’abasawo eriwo okukulambika mu kiseera kino ekizibu.

Ebintu ebikulu by'olina okujjukira (Take-Home Message)

Okay, kale ka tufunze ebintu ebikulu by'olina okujjukira okuva mu bye twogeddeko:

• NUT Carcinoma kika kya kookolo atatera kulabika, naye asaasaana mangu nnyo, akola nnyo.
• Kino kiva ku nkyukakyuka mu ggiini ``NUTm1``. Kino si kintu ekisikira.
• Obubonero butera okulabika nga kookolo amaze okugenda mu maaso katono. Tokibuusa maaso, era funa amagezi g’abasawo bw’oba ​​olina obubonero bwonna obutali bwa bulijjo obusigala.
• Okuzuula obulwadde buno kyetaagisa okukeberebwa omubiri (biopsy) n’okukeberebwa mu ngeri ey’enjawulo ey’obuzaale.
• Obujjanjabi buzibu, naye okunoonyereza kugenda mu maaso ku bujjanjabi obupya. Okugezesebwa mu malwaliro kuyinza okuba enkola ennungi.
• Okulabirira okukkakkanya obulumi n‟obuwagizi bw‟abaagalwa bo kikulu nnyo ku lugendo luno.
• Yogera mu lwatu ku buli kimu ne ttiimu yo ey’abasawo.

Nsuubira nti amawulire gano ga mugaso gy’oli. Okumanya obulwadde buno kijja kukuyamba okusalawo obulungi ng’ekiseera kituuse.

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