I chhungkuaah hian, a bik takin kum naupang takah, colon cancer vei an awm em? A nih loh leh doctor-in i colon-ah polyp tam tak i nei tih a hrilh che em? Hei hi chhungkaw hrang hranga kal thin genetic condition vang pawh a ni mai thei. Vawiin hian chutiang dinhmun hmuh tur awm lo mahse pawimawh tak pakhat chu kan sawi dawn a ni. FAP, a nih loh leh Familial Adenomatous Polyposis a ni. A hming hi a buaithlak deuh nachungin, awlsam takin i hrethiam ang u.
A awlsam zawngin FAP chu eng nge ni?
FAP hi genetic condition a ni a, thlah khat atanga thlah dangah a inthlak danglam thei a ni. Hetiang natna vei te hian an colon leh rectum-ah adenomas tih hming pu tumor tam tak an nei a, chu chu cancer-ah a chang thei a ni.
Tunah chuan, "I colon-ah cyst awm hi thil pangngai a ni em?" Ni e, mi thenkhat tan chuan an upat deuh deuh chuan heng cyst pakhat emaw pahnih emaw an neih hi thil pangngai a ni. Mahse FAP vei chuan heng cyst za tam tak, sang tam tak pawh a nei thei. And it starts at a very young age , kum 15 emaw 16 emaw pawh nise.
Heng polyp te hi a tir lamah chuan cancer an ni lo. Mahse ‘precancerous’ an ti thung. Chumi awmzia chu enkawl loh chuan heng polyp zinga pakhat emaw, a aia tam emaw chu a tawpah chuan colorectal cancer -ah a lo chang thei tihna a ni tihna a ni.
Chûng tumor za tam tak chu pakhat hnu pakhata paih chhuah a harsat dân tûr chu han ngaihtuah teh. Practically chuan thil theih loh a ni. Chuvangin, he hlauhawmna nasa tak hi enkawl turin doctor-te chuan surgery hmanga intestine lian zawng zawng, total colectomy . A chang chuan, rectum pawh lakchhuah a ni (proctocolectomy).
He surgery hi awm lo se chuan FAP vei tam zawk chuan kum chanve velah cancer an vei ngei ang. Tin, FAP vei te hi colon-ah chauh ni lovin taksa peng dang (entir nan, pum, small intestine, vun, leh ruh)-ah te tumor vei an hlauhawm hle bawk. Chuvangin colon an lakchhuah hnuah pawh an dam chhungin medical checkup neih reng a ngai dawn a ni.
FAP hmang hian cancer vei theihna chu eng nge ni?
Enkawl loh chuan FAP hian colon cancer a vei theihna chance 100% vel a nei a ni . Hei hi dinhmun pawi tak a ni. FAP vei te hian kum upa zawkah leh mi pangngai aia rang zawkin cancer an vei thin. Chuvangin, chhungkaw history-ah FAP a awm tih i hriat chuan i fa chu kum 10 a\angin kum tin colonoscopy a nei tur a ni.
Colon cancer bakah hian FAP vei te hian cancer chi dang vei an hlauhawm hle bawk.
| Cancer chi hrang hrang | A lo awm theihna (a chance ) . |
|---|---|
| Duodenal cancer a ni | ~8% a ni. |
| Papillary thyroid cancer natna a ni | ~2% a ni. |
| Pancreatic cancer natna a ni | ~2% a ni. |
| Liver cancer (Hepatoblastoma) - a bik takin naupangte tan | ~1.5% a ni. |
| Pum cancer a ni | ~1% a ni. |
| Thluak leh ruhro (spinal tumor) te | 1% aia tlem lo . |
FAP chi hrang hrang a awm em?
Ni e, FAP chi khat ber leh sub-type engemaw zat a awm a, chu chu a danglam deuh a, a na lo zawk bawk. Eng nge an nih i en ang u.
| FAP type a ni | Hrilhfiahna |
|---|---|
| Classic FAP (Classic FAP) tih a ni. | Hei hi a tam ber chi a ni. Colon chhungah hian polyp 100 chuang, sang tam tak pawh a awm thei. |
| Attenuated FAP (AFAP) tih a ni. | Hei hi a pawi deuh deuh. Intestine-a cyst lo awm zat hi 20 leh 100 inkar a ni. |
| Gardner natna a ni | Hei hi Classic FAP nen a inang a, tumor 100 chuang a lo awm tihna a ni. Chu bâkah, taksa pêng dang, entîr nân, vun, soft tissue, leh ruh-ah te pawh tumor chi dang a lo awm bawk. |
| Turcot natna a ni | Hei hian intestine-ah tumor tam tak a siam a, chubakah thluaka cancer tumor a siam bawk. |
FAP leh Lynch Syndrome hi eng nge an danglamna?
Lynch syndrome hi genetic condition dang a ni a, thlah kal zelah a kai darh thei a, colon cancer vei theihna a tipung bawk. Mahse an pahnih inkarah hian danglamna pawimawh tak a awm. Lynch syndrome vei te hian FAP-a an tih angin polyp za tam tak an nei lo. A châng chuan, polyp pakhat emaw pahnih emaw a lo awm a, rang takin cancer an nei thei bawk. Chuvangin Lynch syndrome hi "nonpolyposis" condition tia sawi a ni fo thin. Heng dinhmun pahnihte hi gene hrang hranga chhiatna avanga lo awm a ni.
FAP natna lan chhuahna chu engte nge ni?
FAP-ah chuan colon tumor hi mipui zawng zawng aiin a lo awm hma hle a, kum naupang zawkah a lo awm fo thin. Heng tumor te hian hlauhawm taka an lian hma chuan symptoms an nei lo fo thin . Chuvang chuan screening hi a pawimawh em em a ni.
Mahse, cyst hi a tam em em a, a thang chak em em bawk a, a chang chuan symptoms a lo lang thei bawk. Chutiang chhinchhiahnate chu:
- Rectal atanga thisen chhuak
- Diarrhea awm reng
- Chronic pum na
Hei bakah hian FAP vei te hian pawn lam symptoms an nei thei bawk a, chu chu doctor-in awlsam taka a hmuh theih a ni.
- Dermatofibromas: Vun hnuaia hnah khauh tak, hliam ang chi, vun hnuaia lo awm.
- Epidermal cysts: Keratin-a khat, vun hnuaia lo awm, spherical lumps.
- Osteomas te chu: 1.1.Ruh chhunga lo awm cancer ni lo tumor. Chungte chu luruh emaw, pelvis emaw-ah hmuh tur a awm fo.
- Extra teeth emaw impacted teeth emaw: Hengte hi ha X-ray hmangin hriat theih a ni.
- Pigmented retinal spots (CHRPE): Hengte hi mit enfiahnaah hmuh theih a ni. Mahse, a tlangpuiin mit hmuhna a nghawng lo.
FAP awm chhan ber chu eng nge ni?
Kan sawi tawh ang khan FAP hi gene mutation avanga lo awm a ni. Hei hi tibuaitu gene chu APC (Adenomatous Polyposis Coli) gene an ti a.
Kan taksaa thil awm zawng zawng hi computer program ang maia gene-in a thunun vek a ni. He APC gene hi ‘tumor suppressor gene’ a ni. Chu chu, he gene hnathawh ber chu cell-te chu thunun theih loha an inthen darh a, tumor an siam loh nan a titawp tihna a ni. Car brake ang mai a ni.
FAP vei chuan APC gene mutated a nei a, chu chu a chhia tihna a ni. Tichuan, motor brake chhe tawh ang maiin, cell-te chu thunun theih lohvin an inṭhen a, tumor za tam tak an siam a ni.
He genetic defect hi rochun a ni. Nu leh pa zinga pakhatin he APC gene mutation hi a neih chuan naupang chuan a rochun theihna chance 50% a nei a ni . Chumi awmzia chu naupang tin hian an nei thei a, an nei lo thei tihna a ni. Mahse, FAP vei hmuhchhuah zinga 30% vel chuan chhungkaw history an nei lo. Hei hian tun hnaiah an taksaah he genetic defect hi a lo awm tihna a ni (original mutation).
FAP avanga harsatna awm thei te chu engte nge ni?
FAP hmanga enkawl tur complication pawimawh leh hlauhawm ber chu colon cancer hi a ni . Hetiang hlauhawmna hi colon surgery hmanga lakchhuah a nih chuan nasa takin a tlahniam thin. Mahse, colon tel lova nun kawngah harsatna engemaw zat a awm. Bowel movement kalphung a inthlak danglam thin. Chumi atan chuan ileostomy pouch emaw ileal pouch emaw hman theih a ni.
APC gene defect hi taksa cell tinah a awm avangin intestine pawnah pawh tumor a lo awm thei bawk. Chung zinga ṭhenkhat chu cancer vei theihna an nei.
- Duodenal polyps: Hengte hi FAP vei zawng zawngah te hian a lo awm thin. Chung zinga tlemte chu duodenum, bile duct emaw pancreatic duct emaw cancer-ah a chang thei a ni.
- Stomach polyps: Mi 90% vel ah a awm a, mahse za zela tlemte, 1% vel chauh cancer ah an lo awm thin.
- Desmoid tumors: Hengte hi cancer a ni lo. Mahse an chetsual thei hle a, a bul hnaia taksa peng leh thisen kalna kawngah an darh thei a, an tichhe thei bawk. An paih chhuah harsa a, an lo kir leh thei bawk.
- Thyroid cancer: Hei hi FAP vei zinga 2% velin a awm thei. Chungte chu tihdam theih vek an ni fo.
- Liver cancer: hepatoblastoma, a bik takin naupang FAP vei te tanLiver cancer chi khat hmuh tur awm lo tak, an tih mai chu a vei theihna chance tlem a awm.
Engtin nge enkawl leh enkawl a nih?
FAP enkawlna tur ruahmanna hi hmun hnih ah then theih a ni a, chungte chu surgery leh dam chhung testing te an ni.
1. Surgery tih a ni
Classic FAP vei tam zawk chuan kum 20 emaw 30 hma lam emaw chuan total colectomy an neih a ngai dawn a, chu chu colon pumpui lakchhuahna a ni. I doctor chuan he surgery hi engtikah nge tih tur leh tih dan tur a rel ang a, i dinhmun a zirin a rel ang.
2. Screening neih fo thin
Operation hma leh operation hnuah test hrang hrang i neih a ngai dawn a, i dam chhung zawng pawhin i test a ngai dawn a ni. Hei hi i nunna humhimna tha ber a ni.
| Test chi hrang hrang | Chhan | A tlangpuiin hun hman dan tur ruahman |
|---|---|---|
| Colonoscopy hmanga enfiah a ni | Colon leh rectum-a tumor awm leh awm loh enfiah nan. | Risk nei tan chuan kum 10 atanga operation thlengin kum tin . |
| Sigmoidoscopy hmanga enfiah a ni | Operation hnua rectum emaw ileal pouch emaw la awmte enfiah turin. | Surgery hnuah thla 6-12 danah emaw, kum 1-4 danah emaw tih tur a ni. |
| Upper endoscopy hmanga enfiah a ni | Pum leh small intestine (colon)-a tumor awm leh awm loh enfiah nan. | Doctor-in a rawt angin hun bi neiin. |
| Ultrasound hmanga scan a ni | Thyroid emaw liver cancer emaw tan chuan. | Damdawi lam thurawn angin. |
| CT emaw MRI emaw hmanga tih theih a ni | Desmoid tumor awm leh awm loh enfiah nan. | Damdawi lam thurawn angin. |
FAP nen hian nun hi engtin nge a awm?
Hetiang genetic condition i nei tih i hriat hian lungngaihna leh mangang taka i awm hi thil pangngai a ni. Mahse, he natna chungchang hi hriat hmasak hi cancer hlauhawmna enkawl dan tha ber a ni.
Damdawi lam enkawlna dik leh checkup neih fo chuan FAP vei chu nun pangngai, rei tak, hrisel takin a nung thei a ni . Colon lakchhuah hnuah chuan a hlauhawmna ber chu gastrointestinal tract cancer dang emaw desmoid tumor emaw atanga lo chhuak a ni. Mahse hengte hi colon cancer aiin a tlem zawk hle.
Surgery hi nun tidanglamna lian tak ni mahse, tunlai technology changkang tak tak nen chuan laparoscopic surgery hian i dam chak thei hle.
A pawimawh ber chu nangmah chauh i ni lo tih hriat hi a ni. He zinkawngah hian doctor, chhungte, leh thiante kaihruai thei leh thlawp thei che an awm. Chuvangin, zawhna emaw, ngaihtuahna emaw i neih chuan i doctor nen inhawng takin sawi rawh.
Take-Home Thuchah a ni
- FAP hi genetic disease na tak a ni a, thlah kal zelah a awm a, colon-ah hian tumor za tam tak a lo awm thin.
- Enkawl loh chuan colon cancer vei theihna hi 100% vel a ni.
- I chhungte zingah mi pakhatin kum naupan lai atanga colon cancer emaw, tumor tam tak emaw a neih chuan i doctor nen genetic testing neih chungchang sawipui rawh .
- Nunna chhanhim nan a hmaa hriatchhuah leh screening neih fo hi a pawimawh hle. Naupang hlauhawm tak takte tan kum 10 a\angin screening neih tan tur a ni.
- Cancer hlauhawmna venna atana enkawlna ber chu surgery hmanga intestine lian tak lakchhuah (colectomy) a ni.
- Damdawi lam enkawlna leh enkawlna dik tak nen chuan FAP hmang pawhin nun famkim leh hrisel takin i nung thei ang.
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