Kodi pali wina m'banja mwanu, makamaka ali wamng'ono, amene wadwala khansa ya m'matumbo? Kapena dokotala wakuuzani kuti muli ndi ma polyp ambiri m'matumbo mwanu? Mwina izi zikuchitika chifukwa cha matenda a majini omwe amapezeka m'mabanja. Lero tikambirana za vuto limodzi losowa koma lofunika kwambiri. Ndi FAP, kapena Familyal Adenomatous Polyposis. Ngakhale kuti dzinali ndi lovuta pang'ono, tiyeni timvetse mosavuta.
Mwachidule, kodi FAP ndi chiyani?
FAP ndi matenda a majini omwe amatha kufalikira kuchokera ku mibadwomibadwo. Anthu omwe ali ndi vutoli amakhala ndi zotupa zambiri zotchedwa adenomas , zomwe zimatha kukhala khansa, m'matumbo awo ndi m'matumbo.
Tsopano mwina mukuganiza kuti, "Kodi ndi zachilendo kukhala ndi chotupa m'matumbo mwanu?" Inde, ndi zachilendo kuti anthu ena akhale ndi chotupa chimodzi kapena ziwiri izi akamakula. Koma munthu amene ali ndi FAP akhoza kukhala ndi chotupa mazana, mwina zikwizikwi, izi. Ndipo zimayamba ali wamng'ono kwambiri, mwina ali ndi zaka 15 kapena 16.
Ma polyps amenewa si khansa poyamba. Koma amatchedwa 'precancerous'. Izi zikutanthauza kuti ngati sanalandire chithandizo, pali chiopsezo chachikulu chakuti imodzi kapena zingapo mwa ma polyps amenewa pamapeto pake zidzasanduka khansa ya m'matumbo .
Tangoganizirani momwe zingakhalire zovuta kuchotsa mazana ambiri a zotupa izi chimodzi ndi chimodzi. N'zosatheka. Ndicho chifukwa chake, kuti athetse chiopsezo chachikuluchi, madokotala amalimbikitsa kuchotsa matumbo onse akuluakulu mwa opaleshoni, kuchotsa colectomy yonse . Nthawi zina, rectum imachotsedwanso (proctocolectomy).
Popanda opaleshoni iyi, anthu ambiri omwe ali ndi FAP mwina adzadwala khansa ali ndi zaka zapakati. Komanso, anthu omwe ali ndi FAP ali pachiwopsezo chokhala ndi zotupa osati m'matumbo okha komanso m'mbali zina za thupi (monga m'mimba, m'matumbo ang'onoang'ono, pakhungu, ndi mafupa). Chifukwa chake, ngakhale m'matumbo atachotsedwa, adzafunika kukaonana ndi dokotala nthawi zonse pa moyo wawo wonse.
Kodi chiopsezo cha khansa ndi chiyani ndi FAP?
Ngati sichinalandire chithandizo, FAP ili ndi mwayi wokwana 100% woti idwale khansa ya m'matumbo. Uwu ndi vuto lalikulu kwambiri. Anthu omwe ali ndi FAP amadwala khansa ali aang'ono kwambiri komanso mwachangu kuposa munthu wamba. Chifukwa chake, ngati mukudziwa kuti m'banja mwanu muli mbiri ya FAP, mwana wanu ayenera kuchitidwa opaleshoni ya m'matumbo chaka chilichonse kuyambira ali ndi zaka 10.
Kuwonjezera pa khansa ya m'matumbo, anthu omwe ali ndi FAP ali pachiwopsezo chotenga mitundu ina ya khansa.
| Mtundu wa khansa | Ngozi yochitika ( mwangozi ) |
|---|---|
| Khansa ya m'matumbo | ~8% |
| Khansa ya chithokomiro cha papillary | ~2% |
| Khansa ya kapamba | ~2% |
| Khansa ya chiwindi (Hepatoblastoma) - makamaka mwa ana | ~1.5% |
| Khansa ya m'mimba | ~1% |
| Zotupa za muubongo ndi msana | Zochepera 1% |
Kodi pali mitundu yosiyanasiyana ya ma FAP?
Inde, pali mtundu waukulu wa FAP ndi mitundu ingapo yaing'ono yomwe ndi yosiyana pang'ono komanso yosaopsa kwenikweni. Tiyeni tiwone zomwe zili.
| Mtundu wa FAP | Kufotokozera |
|---|---|
| Classic FAP (Classic FAP) | Mtundu uwu ndi wofala kwambiri. Ma polyps opitilira 100, mwina zikwizikwi, amakula m'matumbo. |
| Kuchepetsa FAP (AFAP) | Izi sizili zovuta kwenikweni. Chiwerengero cha ma cysts omwe amakula m'matumbo ndi pakati pa 20 ndi 100. |
| Matenda a Gardner | Izi zikufanana ndi Classic FAP, zomwe zikutanthauza kuti zotupa zoposa 100 zimakula. Kuphatikiza apo, mitundu ina ya zotupa imakulanso m'mbali zina za thupi, mwachitsanzo, pakhungu, minofu yofewa, ndi mafupa. |
| Matenda a Turcot | Izi zimapangitsa kuti zotupa zambiri zipangike m'matumbo, komanso kuti khansa ipangike muubongo. |
Kodi kusiyana pakati pa FAP ndi Lynch Syndrome ndi kotani?
Matenda a Lynch ndi matenda ena a majini omwe amatha kufalikira m'mibadwo yambiri ndikuwonjezera chiopsezo cha khansa ya m'matumbo. Koma pali kusiyana kwakukulu pakati pa awiriwa. Anthu omwe ali ndi matenda a Lynch samakhala ndi ma polyp mazana ambiri, monga momwe amachitira mu FAP. Nthawi zina, ma polyp amodzi kapena awiri amakula, ndipo amatha kukhala khansa mwachangu. Ichi ndichifukwa chake nthawi zina Lynch syndrome imatchedwa "nonpolyposis". Matenda onsewa amayamba chifukwa cha zolakwika m'majini osiyanasiyana.
Kodi zizindikiro za FAP ndi ziti?
Mu FAP, zotupa za m'matumbo zimayamba kukula msanga kwambiri kuposa anthu ambiri, nthawi zambiri ali aang'ono. Zotupa zimenezi nthawi zambiri sizimayambitsa zizindikiro zilizonse mpaka zitakula kwambiri. Ichi ndichifukwa chake kuyezetsa ndikofunikira kwambiri.
Komabe, chifukwa chiwerengero cha ma cysts ndi chachikulu kwambiri ndipo amakula mofulumira, nthawi zina zizindikiro zimatha kuwoneka. Zizindikiro zotere ndi monga:
- Kutuluka magazi m'thupi
- Kutsegula m'mimba kosalekeza
- Kupweteka kwa m'mimba kosatha
Kuonjezera pa izi, anthu omwe ali ndi FAP angakhalenso ndi zizindikiro zakunja zomwe dokotala angathe kuziona mosavuta.
- Dermatofibromas: Matumbo olimba ngati zipsera omwe amapangika pansi pa khungu.
- Ma cysts a Epidermal: Matumbo ozungulira odzazidwa ndi keratin omwe amapangika pansi pa khungu.
- Ma Osteomas:Zotupa zomwe si khansa zomwe zimapangika m'mafupa. Izi nthawi zambiri zimapezeka m'chigaza kapena m'chiuno.
- Mano owonjezera kapena mano okhudzidwa: Izi zitha kuzindikirika ndi X-ray ya mano.
- Madontho a retina okhala ndi utoto (CHRPE): Izi zitha kuwoneka panthawi yoyezetsa maso. Komabe, nthawi zambiri sizimakhudza masomphenya.
Kodi chifukwa chachikulu cha FAP ndi chiyani?
Monga tanenera kale, FAP imayamba chifukwa cha kusintha kwa majini. Jini yomwe imakhudza izi imatchedwa jini la APC (Adenomatous Polyposis Coli) .
Chilichonse m'thupi lathu chimayendetsedwa ndi majini, monga pulogalamu ya pakompyuta. Jini ya APC iyi ndi 'jini yoletsa chotupa'. Izi zikutanthauza kuti, ntchito yayikulu ya jini iyi ndikuletsa maselo kuti asagawane mosalamulirika ndikupanga zotupa. Monga momwe mabuleki amagwirira galimoto.
Munthu amene ali ndi FAP ali ndi jini ya APC yosinthika, zomwe zikutanthauza kuti ndi yolakwika. Kenako, monga galimoto yokhala ndi mabuleki osweka, maselo amagawikana mosalamulirika ndikupanga zotupa zambirimbiri.
Chilema ichi chimabadwa nacho. Ngati m'modzi mwa makolo ali ndi kusintha kwa majini a APC, mwanayo ali ndi mwayi wa 50% wobadwa nacho . Izi zikutanthauza kuti mwana aliyense akhoza kukhala nacho kapena ayi. Komabe, pafupifupi 30% ya anthu omwe apezeka ndi FAP alibe mbiri ya m'banja. Izi zikutanthauza kuti chilema ichi cha majini chabwera m'thupi lawo posachedwapa (kusintha koyambirira).
Kodi mavuto omwe angakhalepo chifukwa cha FAP ndi ati?
Vuto lofunika kwambiri komanso loopsa lomwe mungathane nalo ndi FAP ndi khansa ya m'matumbo . Chiwopsezochi chimachepa kwambiri pamene m'matumbo muchotsedwa opaleshoni. Komabe, pali mavuto ena okhala opanda m'matumbo. Njira yoyendetsera matumbo imasinthidwa. Pachifukwa ichi, thumba la ileostomy kapena thumba la ileal lingagwiritsidwe ntchito.
Popeza vuto la majini a APC limapezeka mu selo lililonse m'thupi, zotupa zimathanso kupangika kunja kwa matumbo. Zina mwa izi zimakhala ndi chiopsezo chokhala khansa.
- Ma polyps a m'mimba: Izi zimakula pafupifupi mwa aliyense amene ali ndi FAP. Ambiri mwa awa amatha kukhala khansa ya m'mimba, m'mitsempha ya ndulu, kapena m'mitsempha ya kapamba.
- Matenda a m'mimba: Ngakhale amapezeka mwa anthu pafupifupi 90%, ochepa okha, pafupifupi 1%, ndi omwe amasanduka khansa.
- Zotupa za Desmoid: Izi si khansa. Koma zimatha kukhala zoopsa kwambiri ndipo zimatha kufalikira ku ziwalo ndi mitsempha yamagazi yapafupi, kuziwononga. N'zovuta kuzichotsa ndipo zimatha kubwerera.
- Khansa ya chithokomiro: Izi zitha kuchitika mwa anthu pafupifupi 2% omwe ali ndi FAP. Nthawi zambiri matendawa amatha kuchiritsidwa kwathunthu.
- Khansa ya chiwindi: hepatoblastoma, makamaka kwa ana omwe ali ndi FAPPali chiopsezo chochepa chotenga khansa ya chiwindi yosowa kwambiri yotchedwa.
Kodi imachiritsidwa ndi kuyendetsedwa bwanji?
Ndondomeko ya chithandizo cha FAP ingagawidwe m'magawo awiri: opaleshoni ndi kuyezetsa kwa moyo wonse.
1. Opaleshoni
Anthu ambiri omwe ali ndi FAP yachikhalidwe adzafunika kuchitidwa opaleshoni yonse ya m'mimba, yomwe imaphatikizapo kuchotsa m'mimba wonse, ali ndi zaka za m'ma 20 kapena kumayambiriro kwa zaka za m'ma 30. Dokotala wanu adzasankha nthawi ndi momwe angachitire opaleshoniyi, kutengera vuto lanu.
2. Kuwunika nthawi zonse
Mudzayenera kuyesedwa mitundu yosiyanasiyana musanachite opaleshoni komanso mutatha opaleshoni, komanso nthawi yonse ya moyo wanu. Iyi ndiyo njira yabwino kwambiri yotetezera moyo wanu.
| Mtundu wa mayeso | Cholinga | Nthawi yovomerezeka nthawi zambiri |
|---|---|---|
| Colonoscopy | Kufufuza ngati pali zotupa m'matumbo ndi m'matumbo. | Kwa iwo omwe ali pachiwopsezo, chaka chilichonse kuyambira ali ndi zaka 10 mpaka opaleshoni. |
| Sigmoidoscopy | Kuyang'ana thumba lotsala la rectum kapena ileal pambuyo pa opaleshoni. | Pambuyo pa opaleshoni, miyezi 6-12 iliyonse kapena chaka chimodzi kapena zinayi zilizonse. |
| Endoscopy yapamwamba | Kufufuza zotupa m'mimba ndi m'matumbo ang'onoang'ono (m'matumbo). | Pafupipafupi monga momwe dokotala wanenera. |
| Kujambula kwa Ultrasound | Kwa khansa ya chithokomiro kapena chiwindi. | Pa upangiri wa dokotala. |
| Kujambula kwa CT kapena MRI | Kufufuza ngati pali zotupa za desmoid. | Pa upangiri wa dokotala. |
Kodi moyo uli bwanji ndi FAP?
Ndizachibadwa kumva chisoni komanso kudabwa mukazindikira kuti muli ndi matenda a majini ngati awa. Komabe, kudziwa za matendawa msanga ndiyo njira yabwino kwambiri yothanirana ndi chiopsezo chanu cha khansa.
Ndi chithandizo choyenera chamankhwala komanso kuyezedwa nthawi zonse, munthu amene ali ndi FAP akhoza kukhala ndi moyo wabwinobwino, wautali, komanso wathanzi . Pambuyo pochotsa m'matumbo, chiopsezo chachikulu chimachokera ku khansa zina za m'mimba kapena zotupa za desmoid. Koma izi ndizosowa kwambiri kuposa khansa ya m'matumbo.
Ngakhale opaleshoni ndi kusintha kwakukulu pa moyo, ndi ukadaulo wapamwamba wamakono, opaleshoni ya laparoscopic ingakuthandizeni kuchira mwachangu.
Chofunika kwambiri ndikudziwa kuti simuli nokha. Pali madokotala, abale, ndi abwenzi omwe angakutsogolereni ndikukuthandizani paulendowu. Chifukwa chake, ngati muli ndi mafunso kapena nkhawa, lankhulani ndi dokotala wanu za iwo momasuka.
Uthenga Wopita Nawo Kunyumba
- FAP ndi matenda oopsa a majini omwe amafalikira m'mibadwo yambiri ndipo amachititsa kuti zotupa zambirimbiri zipangidwe m'matumbo.
- Ngati sichinachiritsidwe, chiopsezo chotenga khansa ya m'matumbo chimakhala pafupifupi 100%.
- Ngati wina m'banja mwanu wakhala ndi khansa ya m'matumbo kapena zotupa zingapo ali wamng'ono, lankhulani ndi dokotala wanu za kuyezetsa majini.
- Kuzindikira msanga ndi kuyezetsa magazi nthawi zonse n'kofunika kwambiri kuti apulumutse miyoyo. Ana omwe ali pachiwopsezo ayenera kuyamba kuyezetsa magazi ali ndi zaka 10.
- Chithandizo chachikulu chopewera chiopsezo cha khansa ndi opaleshoni yochotsa matumbo akuluakulu (colectomy).
- Ndi chithandizo chamankhwala choyenera komanso kuyang'aniridwa bwino, mutha kukhala ndi moyo wathanzi komanso wathanzi ngakhale mutakhala ndi FAP.
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