Uwu ndi mtundu wapadera wa khansa ya m'matumbo: Tiyeni tingophunzira za MSI-H! (Microsatellite Instability-High Colon Cancer)

Kodi mwaona kusintha kwa machitidwe anu a m'mimba, kupweteka m'mimba, kapena magazi m'chimbudzi chanu posachedwapa? Musanyalanyaze zizindikiro izi, poganiza kuti ndi zachilendo. Zingakhale zizindikiro za khansa ya m'matumbo. Lero, tikulankhula za mtundu wa khansa ya m'matumbo yomwe ndi yapadera pang'ono, komanso yamwayi pang'ono. Imatchedwa MSI-H.

Mwachidule, kodi khansa ya m'matumbo ya MSI-H iyi ndi chiyani?

Kuti timvetse izi, choyamba tiyeni tiwone DNA mkati mwa maselo a thupi lathu. Taganizirani za DNA yathu ngati unyolo wautali. Unyolo uwu uli ndi mikanda yamtundu womwewo yolumikizidwa nawo mobwerezabwereza. Magawo obwerezabwereza a DNA awa amatchedwa ma microsatellites.

Tsopano, pamene maselo a thupi lathu agawanika ndipo maselo atsopano amapangidwa, makope a unyolo wa DNA uwu amapangidwa. Nthawi zina zolakwika (kusintha) zimatha kuchitika makope awa akapangidwa. Koma musadandaule, thupi lathu lili ndi dongosolo ngati 'apolisi omwe amapeza zolakwika'. Limatchedwa dongosolo la Mismatch Repair (MMR) . Limayang'ana zolakwika m'makope a DNA amenewo ndikuwongolera nthawi yomweyo.

Komabe, m'maselo ena a khansa, dongosolo la MMR siligwira ntchito bwino. Timalitcha kuti dMMR (kukonza zolakwika za DNA). Kenako, chifukwa palibe wokonza zolakwika m'makope a DNA amenewo, zolakwika zimasonkhana ndipo DNA imakhala yosakhazikika kwambiri. Umenewo ndi mkhalidwe wa ma microsatellite osakhazikika kwambiri, omwe timawatcha MSI-H (Microsatellite Instability-High) .

Kodi zizindikiro zomwe zingachitike chifukwa cha khansa ya MSI-H ndi ziti?

Zizindikiro sizingawonekere nthawi zonse, koma ngati zizindikirozo ziwonekera, zimakhala zofanana ndi za khansa ya m'matumbo wamba.

Chofunika: Si aliyense amene ali ndi zizindikirozi amene ali ndi khansa. Komabe , ngati muli ndi magazi m'chimbudzi chanu kapena mukumva kupweteka kwambiri m'mimba, pitani kwa dokotala nthawi yomweyo. Ngati zizindikiro zina zikupitirira kwa milungu iwiri, muyenera kufunsa upangiri kwa dokotala.

Nthawi zina, chizindikiro choyamba cha khansa iyi ndi kuyezetsa magazi komwe kumasonyeza kuchuluka kwa maselo ofiira m'magazi (anemia). Izi zimachitika chifukwa cha kutuluka magazi m'matumbo.

Zomwe zimayambitsa khansa ya MSI-H komanso zoopsa zake

Chifukwa chachikulu cha khansa ya MSI-H ndi zolakwika zomwe zili m'majini a MMR zomwe takambirana kale. Izi nthawi zambiri zimachitika munthu akamakalamba, popanda chifukwa chenicheni.

Koma pafupifupi 5% ya anthu omwe ali ndi khansa ya m'matumbo, vuto la majini limeneli limafalikira kwa mibadwomibadwo. Timatcha kuti Lynch syndrome . Ngati wina m'banja mwanu ali ndi vutoli, mulinso pachiwopsezo chachikulu chotenga khansa ya m'matumbo.

Kuphatikiza apo, pali zinthu zina zomwe timachita zomwe zimawonjezera chiopsezo cha khansa.

Kodi mungazindikire bwanji matendawa?

Ngati dokotala wanu akukayikira kuti muli ndi khansa kutengera zizindikiro zanu, adzakutumizani kuti mukayesedwe kangapo.

1. Colonoscopy: Chubu chosinthasintha chokhala ndi kamera yolumikizidwa chimayikidwa kudzera mu anus kuti chione m'mimba wonse. Panthawiyi, chidutswa chaching'ono cha minofu chimatengedwa kuchokera pamalo okayikitsa kuti chikafufuzidwe. Izi zimatchedwa biopsy .

2. Mayeso a mamolekyu: Mayeso apadera amachitidwa kuti azindikire kusintha kwa majini, mwachitsanzo momwe MSI-H ilili, mu chitsanzo cha minofu chomwe chatengedwa kuchokera ku biopsy. Zipangizo zamakono monga IHC , PCR , ndi NGS zimagwiritsidwa ntchito pa izi.

3. Mayeso ojambulira: Ma scan monga CT ndi MRI amachitidwa kuti awone ngati khansa yafalikira ku ziwalo zina.

Kodi mankhwala a khansa ya MSI-H ndi ati?

Chithandizo chimadalira gawo la khansa komanso momwe yafalikira. Pali njira ziwiri zazikulu zochiritsira.

Opaleshoni

Ngati khansayo sinafalikire kumadera ena, choyamba ndi kuchotsa chotupacho kudzera mu opaleshoni. Mtundu wa opaleshoni ungasiyane malinga ndi kukula kwa khansayo.

Mankhwala

Apa ndi pomwe kudziwika kwa khansa ya MSI-H kumayamba kugwira ntchito.

• Chithandizo cha Immunotherapy: Ichi ndi chithandizo chofunikira kwambiri komanso chopambana cha khansa ya MSI-H.Ganizirani za maselo athu oteteza thupi ngati kuti ali ndi switch ya 'open'/'off'. Maselo a khansa nthawi zina amatseka switch iyi mwanzeru ndikubisala ku chitetezo cha thupi lathu. Mankhwala oletsa matenda a immunotherapy (checkpoint inhibitors) amatsekanso switch ya 'open', kuthandiza chitetezo cha mthupi kupeza ndikuwononga maselo a khansa.
• Chemotherapy: Kupereka mankhwala amphamvu ophera maselo a khansa. Nthawi zina amagwiritsidwa ntchito opaleshoni isanachitike kapena itatha.
• Chithandizo Cholunjika: Kupereka mankhwala omwe amaletsa mapuloteni kapena njira zinazake zomwe zimathandiza maselo a khansa kukula.

Kukhala ndi khansa ya MSI-H

Ndikofunikira kwambiri kukhala ndi thanzi labwino la thupi ndi maganizo panthawi yolandira chithandizo cha khansa.

• Zakudya: Mukamaliza opaleshoni, tsatirani malangizo a dokotala wanu ndipo idyani zakudya zomwe zimagayidwa mosavuta komanso zokhala ndi mapuloteni ambiri. Ndi bwino kuchepetsa kudya zakudya zomwe zimapanga mpweya (monga kabichi, nyemba) ndi nyama zokonzedwa.
• Maseŵero Olimbitsa Thupi: Maseŵero osavuta monga kuyenda momwe mungathere angathandize kwambiri thupi lanu ndi malingaliro anu. Koma funsani dokotala wanu musanayambe kuchita masewera olimbitsa thupi.
• Thanzi la maganizo: N'zachibadwa kukhala ndi nkhawa komanso mantha nthawi ngati izi. Musabise zomwe mukumva. Lankhulani ndi munthu amene mumamukhulupirira, kuphatikizapo achibale anu. Funsani thandizo kwa mlangizi wa zaumoyo wamaganizo ngati pakufunika kutero.