Kua kite koe i tētahi panonitanga o ō tikanga puku, mamae puku, toto rānei i roto i tō tūtae i ēnei rā? Kaua e warewaretia ēnei tohu, me te whakaaro he mea noa. He tohu pea ēnei mō te matepukupuku koroni. I tēnei rā, e kōrero ana tātou mō tētahi momo matepukupuku koroni he mea motuhake ake, engari he mea waimarie ake. Ko te ingoa ko MSI-H.
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He whakarāpopototanga, he aha tēnei matepukupuku koroni MSI-H?
Hei mārama ki tēnei, me titiro tuatahi tātou ki te DNA i roto i ngā pūtau o tō tātou tinana. Whakaarohia tō tātou DNA he mekameka roa. He rite tonu te momo o ngā poroporo o tēnei mekameka e piri ana ki a ia. Ko ēnei wāhanga DNA kua tāruaruatia e kiia ana he microsatellites.
Ināianei, ina wehea ngā pūtau o tō tātou tinana, ā, ka hangaia he pūtau hou, ka puta he tārua o tēnei mekameka DNA. I ētahi wā ka puta he hapa (ngā whakarerekētanga ira) ina hangaia ēnei tārua. Kaua e manukanuka, he pūnaha tō tō tātou tinana pērā i te 'pirihimana e kimi ana i ngā hapa'. Ko te ingoa o te pūnaha Mismatch Repair (MMR) . Ka tirohia e ia ngā hapa i roto i aua tārua DNA, ā, ka whakatika tonu i aua hapa.
Heoi, i roto i ētahi pūtau matepukupuku, kāore tēnei pūnaha MMR e mahi tika. Ka kiia e mātou ko te dMMR (Deficient DNA Mismatch Repair). Kātahi, nā te mea kāore he tangata hei whakatika i ngā hapa i roto i aua tārua DNA, ka kohikohi ngā hapa, ā, ka tino koretake te DNA. Koinei te āhua o ngā microsatellites tino koretake, e kiia nei e mātou ko te MSI-H (Microsatellite Instability-High) .
He mea whakamiharo, he mea pai tēnei "kore pumau" o te DNA i ētahi wā. He pai ake te urupare a ngā mate pukupuku MSI-H ki tētahi maimoatanga e kiia nei ko te immunotherapy i ētahi atu momo mate pukupuku. Hei tāpiri, he pai te āhua o tō rātou tirohanga.
He aha ngā tohu pea o te matepukupuku MSI-H?
Kāore pea ngā tohu e puta i ngā wā katoa, engari ki te puta mai ngā tohu, he rite tonu ki ērā o te mate pukupuku koroni noa.
| Kāwai tohu | Ngā mea hei tiro |
|---|---|
| Ngā huringa o ngā nekehanga o te puku | Te korere, te kōroke, te mākū rānei o te puku i muri i te nekenga o te puku. |
| Te toto i roto i te tūtae | He tūtae parauri pouri, he tūtae mangu rānei, he toto rānei mai i te tō. |
| Te mamae o te puku | Mamae puku, pupuhi. |
| Ētahi atu āhuatanga o te tinana | Te ngenge kore e taea te whakamārama, te ngaro o te hiahia kai, te taumaha. |
He mea nui: Ehara i te mea he mate pukupuku te katoa e pāngia ana e ēnei tohu. Heoi , ki te mea he toto kei roto i tō tūtae, he mamae nui rānei tō puku, me toro atu ki te tākuta tonu. Ki te roa atu i te rua wiki te roa o ētahi atu tohu, me rapu tohutohu hauora koe.
I ētahi wā, ko te tohu tuatahi o tēnei mate pukupuku he whakamātautau toto e whakaatu ana i te iti o te maha o ngā toto whero (anemia). Nā te toto i roto i ngā whekau tēnei.
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Check Availability →Ngā take me ngā āhuatanga mōrearea mō te whakawhanaketanga o te mate pukupuku MSI-H
Ko te tino take o te mate pukupuku MSI-H ko ngā hapa o ngā ira MMR i kōrerotia e tātou i mua ake nei. He maha ngā wā ka puta ēnei i te wā e ora ana te tangata, kāore he take motuhake.
Engari mō te 5% pea o te hunga e pāngia ana e te mate pukupuku koroni, ka tukuna iho tēnei hapa ira i roto i ngā whakatipuranga. Ka kiia tēnei ko te Lynch syndrome . Mena kei roto i tō whānau tēnei mate, ka nui ake tō tūponotanga ki te pāngia e te mate pukupuku koroni.
Hei tāpiritanga, kei reira ētahi āhuatanga o tō tātou āhua noho ka whakapiki ake i te mōrearea o te mate pukupuku.
| Ngā āhuatanga mōrearea kāore e taea e tātou te whakahaere | Ngā āhuatanga mōrearea ka taea e tātou te whakahaere |
|---|---|
| Neke atu i te 50 tau te pakeke | Momonatanga |
| He hītori whānau mō te mate pukupuku koroni | Mate huka momo 2 |
| Ngā mate tuku iho pērā i te Lynch syndrome | Te momi hikareti |
| Kei a koe ngā mate pēnei i te mate a Crohn | Te inu nui rawa |
| He polyps kei roto i te koroni | Ka nui rawa te kai i te mīti whero me te mīti tukatuka |
Me pēhea te tautuhi i te mate?
Mena kei te whakapae tō tākuta he mate pukupuku koe i runga i ō tohumate, ka tukuna koe e ia mō ētahi whakamātautau.
1. Te tirotiro koroni: Ka whakauruhia he ngongo ngāwari me te kāmera e piri ana mā roto i te nono hei tirotiro i te koroni katoa. I tēnei wā, ka tangohia he wahi kiko iti mai i tētahi wāhi whakapae hei tirotiro. Ka kiia tēnei he koiora .
2. Ngā whakamātautau ngota: Ka whakahaerehia ngā whakamātautau motuhake hei kite i ngā huringa ira, arā, te tūnga MSI-H, i roto i te tauira kiko i tangohia mai i te koiora. Ka whakamahia ngā hangarau pēnei i te IHC , PCR , me te NGS mō tēnei.
3. Ngā whakamātautau whakaahua: Ka mahia ngā matawai pēnei i te CT me te MRI hei tirotiro mēnā kua horapa te mate pukupuku ki ētahi atu okana.
He aha ngā maimoatanga mō te matepukupuku MSI-H?
Ko te maimoatanga e whakawhirinaki ana ki te taumata o te mate pukupuku me te tawhiti kua horapa. E rua ngā kōwhiringa maimoatanga matua.
Pokanga
Mena kāore anō te matepukupuku kia horapa ki ētahi atu wāhi, ko te mahi tuatahi ko te tango i te puku mā te pokanga. Tērā pea ka rerekē te momo pokanga i runga i te rahi o te matepukupuku.
Rongoā
Koinei te wāhi e whai wāhi ai te motuhaketanga o te mate pukupuku MSI-H.
- Ārai Mate: Koinei te maimoatanga tino nui me te angitu mō te mate pukupuku MSI-H.Whakaarohia he pātene 'kā'/'whakaweto' ā ō tātou pūtau ārai mate. I ētahi wā ka āta whakawetohia e ngā pūtau matepukupuku tēnei pātene, ka huna i ngā parepare o tō tātou tinana. Ka whakawetohia anō taua pātene 'whakaweto' e ngā rongoā ārai mate (ngā aukati tirotiro), ka āwhina i te pūnaha ārai mate ki te kimi me te whakangaro i ngā pūtau matepukupuku.
- Te rongoā matū: Te hoatu i ngā rongoā kaha hei patu i ngā pūtau matepukupuku. I ētahi wā ka whakamahia i mua atu, i muri rānei i te pokanga.
- Whakaora Whaiaro: Te hoatu i ngā rongoā e aro ana, e aukati ana hoki i ngā pūmua motuhake, i ngā tukanga rānei e āwhina ana i te tipu o ngā pūtau matepukupuku.
Te noho tahi me te mate pukupuku MSI-H
He mea tino nui te pupuri i te hauora tinana me te hauora hinengaro i te wā e rongoatia ana te mate pukupuku.
- Kai: Whai muri i te pokanga, whai i ngā tohutohu a tō tākuta, ā, kai i tētahi kai e ngāwari ana te nakunaku, e nui ana hoki te pūmua. He pai ake te whakaiti i te kai i ngā kai e whakaputa ana i te hau (hei tauira, te kāpeti, te pīni) me ngā mīti tukatuka.
- Whakakorikori Tinana: He tino whai hua ngā mahi whakakorikori tinana māmā pēnei i te hikoi i ngā wā katoa e taea ana e koe mō tō tinana me tō hinengaro. Engari me pātai atu ki tō tākuta i mua i te tīmatanga o tētahi kaupapa whakakorikori tinana.
- Hauora hinengaro: He mea noa te manukanuka me te mataku i ēnei wā. Kaua e huna ō kare ā-roto. Kōrero ki tētahi e whakawhirinaki ana koe, ki tō whānau, ā, rapu āwhina mai i tētahi kaitohutohu hauora hinengaro mēnā e tika ana.
He teitei ake te auau whakaora o te mate pukupuku MSI-H ki te whakaritea ki ētahi atu momo mate pukupuku koroni, ina koa mēnā ka kitea wawe, ā, he tino pai ngā hua ka puta mai i ngā maimoatanga pēnei i te immunotherapy.
Karere Tangohia ki te Kāinga
- Ko te MSI-H he momo matepukupuku koroni motuhake e pāngia ai e te hapa o te pūnaha whakatika DNA (MMR) o ngā pūtau matepukupuku.
- Nā te "pūmaukore" nei, ka tino pai te urupare a ēnei mate pukupuku ki te rongoā ārai mate.
- Mena kei a koe ngā tohu e pā ana ki te mate pukupuku koroni (ngā panonitanga o te tūtae, te mamae o te puku, te toto), kaua e warewarehia, engari me toro atu ki tō tākuta tonu.
- He tino nui te tūponotanga ka ora ngā mate pukupuku MSI-H mēnā ka kitea wawe. Nō reira, he mea nui kia kaua e mataku, engari me rapu tohutohu hauora me te maimoatanga tika.
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