Tiyeni tiphunzire za njira yaposachedwa yodziwira khansa pogwiritsa ntchito dontho la magazi (Liquid Biopsy)?

Anthu ambiri amachita mantha akamva mawu oti "biopsy," sichoncho? Ndizachilendo kumva mantha pang'ono akamva mawu oti "biopsy." Koma taganizirani ngati pakanakhala njira yodziwira za maselo a khansa pongotenga dontho limodzi la magazi anu? Ndicho chimene timachitcha ukadaulo wodabwitsa komanso wamakono, "Liquid Biopsy." Izi zabweretsa chiyembekezo chachikulu kwa omwe akulimbana ndi khansa.

Mwachidule, kodi Liquid Biopsy iyi ndi chiyani?

Kuyeza magazi m'thupi ndi njira yapadera yoyezera magazi yomwe imagwiritsidwa ntchito kuzindikira zotupa. Tangoganizirani kuti chotupa chikakula m'thupi mwathu, zidutswa zazing'ono za chotupacho zimasweka ndikulowa m'magazi. Monga momwe zidutswa za pulasitala zimagwera pakhoma lakale. Titha kuzindikira zidutswa za khansa zomwe zimalowa m'magazi ndi njira iyi yoyezera magazi m'thupi.

Pali zinthu ziwiri zazikulu zomwe zimapezeka m'magazi:

• Maselo ozungulira khansa (CTCs): Awa ndi maselo a khansa athunthu omwe achoka pa khansayo ndipo amayenda m'thupi lonse kudzera m'magazi.
• DNA yozungulira khansa (ctDNA): Izi ndi zidutswa zazing'ono za chidziwitso cha majini (DNA) mkati mwa maselo a khansa. DNA ili ngati "chithunzi" chomwe chili ndi malangizo onse omwe selo limafunika kuti ligwire ntchito. Maselo a khansa akafa, zidutswa za DNA zimenezi zimasonkhana m'magazi.

Kukhala ndi ma CTC kapena ctDNA awa m'magazi mwanu ndi chizindikiro chabwino chakuti pali khansa kwinakwake m'thupi lanu. Komanso, mfundo izi zingatipatse chidziwitso chambiri cha majini a khansa. Pogwiritsa ntchito mfundo zimenezo, dokotala wanu angakuthandizeni kusankha chithandizo chomwe chili chabwino kwa inu.

Ukadali ukadaulo watsopano, koma asayansi akukhulupirira kuti ukhoza kusintha kwambiri chithandizo cha khansa. Pali kale mayeso angapo omwe avomerezedwa ndi mabungwe monga US Food and Drug Administration (FDA).

Kodi izi zikusiyana bwanji ndi biopsy yachibadwa?

Pali kusiyana kwakukulu pakati pa ziwirizi. Mu biopsy yokhazikika, chitsanzo cha minofu chimatengedwa mwachindunji kuchokera ku chotupa cha khansa ndikuyesedwa. Komabe, mu biopsy yamadzimadzi, chitsanzo sichitengedwa kuchokera ku chotupacho. M'malo mwake, chimafufuza umboni wa khansa (maselo a khansa kapena zidutswa za DNA) m'magazi.

Tiyeni tiwone tebulo ili kuti timvetse bwino kusiyana pakati pa ziwirizi.

Mu biopsy yamadzimadzi, pali mwayi wochepa wakuti ngakhale pali khansa m'thupi, magazi omwe atengedwa panthawiyo sadzakhala ndi maselo a khansa. Komabe, ngati khansa yapezeka, chidziwitso chomwe chimapereka n'chofunika kwambiri pokonzekera chithandizo.

Kodi ndi nthawi ziti pamene biopsy yamadzimadzi imachitidwa?

Dokotala nthawi zambiri amalimbikitsa mayesowa kwa odwala omwe khansa yawo yakula kwambiri ndipo yafalikira ku ziwalo zina za thupi (khansa yofalikira). Izi zimawathandiza kusankha choti achite kenako, makamaka ngati chithandizo chomwe chilipo sichikugwira ntchito bwino.

Pali zifukwa zingapo zazikulu zochitira mayeso awa:

1. Dziwani nthawi yomwe matenda adzachitike.

Kuchuluka kwa ma CTC (maselo a khansa) m'magazi kungapereke chithunzithunzi cha momwe wodwalayo alili. Kuchuluka kwa ma CTC ochepa m'magazi kumatanthauza kuti munthu ali ndi vuto labwino. Komabe, ngati pali ma CTC ambiri, zikutanthauza kuti matendawa ndi ovuta kwambiri. Mwanjira imeneyi, madokotala amatha kuchita mayesowa nthawi ndi nthawi, kuwona momwe matendawa akuyankhira chithandizo, ndikusintha chithandizocho moyenera.

2. Pangani zisankho za chithandizo

Ichi ndi chimodzi mwa zabwino kwambiri za Liquid Biopsy. Maselo ena a khansa ali ndi zolakwika zinazake za majini. Pali mankhwala enaake omwe amangoyang'ana kusintha kumeneko. Timatcha izi kuti "njira yochiritsira yolunjika". Mwachidule, zili ngati loko yomwe ingatsegulidwe ndi kiyi inayake. Liquid Biopsy ingakuuzeni mtundu wa "loko" lomwe maselo anu a khansa ali nalo. Kenako dokotala wanu angakupatseni "kiyi" yoyenera (mankhwala) ya zimenezo.

3. Ngati biopsy yachibadwa singathe kuchitidwa

Nthawi zina wodwala angakhale wofooka kwambiri kuti achite biopsy nthawi zonse. Kapena chotupacho chingakhale mbali yovuta kwambiri komanso yovuta kufikako ya chiwalo, monga ubongo kapena mapapo. Ngati chidutswa chadulidwa pamalo otere, pamakhala chiopsezo chowononga minofu yathanzi yozungulira. Pazochitika zotere, biopsy yamadzi yopanda chiopsezo ndi yothandiza kwambiri.

Kodi mayeso a Liquid Biopsy omwe avomerezedwa pano ndi ati?

Pali kafukufuku wambiri womwe ukuchitika padziko lonse lapansi. Pakadali pano pali mayeso akuluakulu angapo omwe avomerezedwa ndi FDA ku United States, zomwe zikutanthauza kuti ayesedwa bwino kuti aone ngati ali otetezeka komanso olondola:

• Mayeso a Cell Search® Circulating Tumor Cell (CTC): Izi zimayesa kuchuluka kwa ma CTC (maselo a khansa) m'magazi. Amagwiritsidwa ntchito poyang'anira momwe odwala alili ndi khansa ya m'mawere, prostate, ndi m'matumbo omwe afalikira m'thupi lonse.
• Mayeso a kusintha kwa EGFR a cobas® v2: Izi zimayesa ctDNA (zidutswa za DNA za khansa). Zimazindikira kusintha kwa majini a EGFR, komwe kumachitika kawirikawiri mu khansa ya m'mapapo (khansa ya m'mapapo yopanda maselo ang'onoang'ono - NSCLC). Chifukwa chake, 'mankhwala ofunikira' oyenera kwambiri angasankhidwe.
• Guardant360® CDx: Izi zimayang'ananso ctDNA. Zimazindikira kusintha kwa majini komwe kumachitika m'mitundu ingapo ya khansa ndipo zimathandiza madokotala kusankha chithandizo chothandiza kwambiri.
• FoundationOne® Liquid CDx: Iyi ndi njira yoyezera ya ctDNA yomwe imagwiritsidwa ntchito kuzindikira kusintha kwa majini mu mitundu yosiyanasiyana ya khansa, zomwe zingathandize kudziwa mankhwala othandiza kwambiri.

Kodi mayesowa ndi opweteka? Zimatenga nthawi yayitali bwanji kuti mupeze zotsatira zake?

Chinthu chabwino kwambiri pa Liquid Biopsy ndichakuti ndi njira yosavuta komanso yopanda ululu. Zili ngati kupereka magazi kuti ayezedwe magazi nthawi zonse. Palibe ululu wina kupatulapo kupweteka pang'ono pamene singano yalowetsedwa.

Magazi anu amatumizidwa ku labu, komwe akatswiri a matenda amasiyanitsa plasma ndi magazi ndikuyesa CTC kapena ctDNA. Nthawi zambiri zimatenga milungu iwiri kapena itatu kuti mupeze zotsatira.

Zotsatira zake zimakuuzani ngati magazi anu ali ndi maselo a khansa kapena zidutswa za DNA (zabwino) kapena ayi (zoipa). Ngati zili ndi khansa, mayeso ena amathanso kudziwa mtundu wa khansa yomwe amachokera komanso kusintha kwa majini komwe ali nako.