Kodi mukupeza ziphuphu zachilendo pakhungu lanu? Kodi izi zingakhale Muir-Torre Syndrome?

Kodi mwadzidzidzi mwayamba kukhala ndi ziphuphu zazing'ono pakhungu lanu? Mungaganize kuti izi ndi zachilendo. Komabe, nthawi zina kusintha kwa khungu kumeneku kungagwirizanenso ndi mavuto amkati. Lero tikambirana za vuto losowa koma lofunika kwambiri lomwe muyenera kulidziwa. Limatchedwa Muir-Torre Syndrome.

Kodi Muir-Torre Syndrome ndi chiyani? Mwachidule...

Muir-Torre Syndrome ndi matenda osowa kwambiri omwe amakula chifukwa cha majini omwe amawonjezera chiopsezo chanu chokhala ndi mitundu yosiyanasiyana ya khansa pamoyo wanu wonse. Anthu omwe ali ndi matendawa nthawi zambiri amakhala ndi zotupa pakhungu, kaya khansa kapena yosaopsa (monga yosaopsa) pakhungu lawo. Akhozanso kukhala ndi khansa imodzi kapena zingapo m'thupi, makamaka m'mimba .

Taganizirani izi, thupi lathu limapangidwa ndi mamiliyoni a maselo ang'onoang'ono. Maselo amenewa akamagawikana, nthawi zina kusintha pang'ono (kusintha kwa majini) kumachitika. Ndicho chimene chimayambitsa kusintha kwa majini kumeneku.

Kodi Muir-Torre Syndrome ndi yofanana ndi Lynch Syndrome?

Nthawi zambiri, inde. Matenda a Moore-Torre amaonedwa ngati mtundu wina wa matenda a Lynch . Matenda a Lynch ndi vuto lomwe limawonjezera chiopsezo cha khansa chifukwa cha kusintha kwa majini angapo. Nthawi zina madokotala amatchanso kuti Hereditary Non-Polyposis Colorectal Cancer (HNPCC). Izi zikutanthauza kuti khansa imakula m'matumbo popanda ma polyps. Chifukwa chake, Moore-Torre ndi gawo la matenda a Lynch omwe amasonyeza mawonekedwe apadera a khungu.

Kodi izi ndi zofala bwanji? Kodi tiyenera kuda nkhawa ndi izi ku Sri Lanka?

Matenda a Moore-Torre ndi matenda osowa kwambiri . Anthu pafupifupi 200 okha ndi omwe apezeka padziko lonse lapansi. Komabe, izi sizikutanthauza kuti sitiyenera kudziwa za matendawa. Anthu pafupifupi 9.2% omwe ali ndi matenda a 'HNPCC' amatha kuwonetsa zizindikiro za Moore-Torre. Zikuonekanso kuti zimakhudza amuna pang'ono kuposa akazi (ndiko kuti, akazi awiri pa amuna atatu aliwonse). Ngakhale palibe ziwerengero zenizeni za kuchuluka kwa anthu ku Sri Lanka, ndikofunikira kudziwa za matendawa.

Kodi zizindikiro za matenda a Moore-Torre ndi ziti? Kodi timazizindikira bwanji?

Izi zimachitika makamaka chifukwa cha kuoneka kwa ziphuphu kapena kusintha kwa khungu komanso zizindikiro za khansa yamkati . Nthawi zina mavuto a khungu amatha kuchitika khansa yamkati isanayambe, nthawi yomweyo, kapena itatha. Komabe, kusintha kwa khungu nthawi zambiri kumakhala chizindikiro choyamba chodziwika . Khansa zina sizingasonyeze zizindikiro zilizonse pachiyambi.

Ndi kusintha kotani komwe mungaone pakhungu?

Zotsatirazi zitha kuwoneka pakhungu la munthu amene ali ndi matenda a Moore-Torre:

• Matenda a Sebaceous adenomas: Awa ndi matenda ofala kwambiri pakhungu (80% - 99%). Izi ndi zotupa zomwe sizili ndi khansa (zosavulaza). Zimapezeka m'matenda a sebaceous glands, omwe ndi mafuta omwe ali pakhungu lathu. Nthawi zambiri amapezeka pamutu ndi pakhosi, ndipo mwa anthu omwe ali ndi matenda a Moore-Torre, amapezeka kwambiri pachifuwa, pamimba, m'chiuno, ndi kumbuyo . Amaoneka ngati ziphuphu zazing'ono, zolimba, zachikasu kapena zamtundu wa khungu .
• Sebaceous carcinoma: Ichi ndi chotupa cha khansa (choopsa) chomwe chimayamba m'matenda a sebaceous. Chimawoneka ngati sebaceous adenoma. Koma chimafalikira mwachangu, makamaka kuzungulira zikope . Zotupazi zimatha kutuluka magazi kapena kutulutsa madzi otupa.
• Keratoacanthoma: Uwu ndi mtundu wina wa chotupa cha pakhungu. Chimatha kumera pamutu, pakhosi, m'thupi, ndi m'manja pafupi ndi ma follicle a tsitsi. Chikhoza kukhala khansa kapena chosakhala khansa . Chimawoneka ngati chotupa chaching'ono, chozungulira, nthawi zina chokhala ndi mitsempha yamagazi yooneka pamwamba, ndi mfundo ya keratin pakati . Chimakula mwachangu kwambiri, pafupifupi masentimita atatu kukula kwake m'masabata angapo, kenako chimachepa pang'onopang'ono pakatha miyezi kapena zaka. Pakhoza kukhala chimodzi kapena zingapo.
• Mawanga a Fordyce: Popeza mawanga a sebaceous glands nthawi zambiri amakhala ndi vuto la Moore-Torre syndrome, madokotala ena amaona kuti "mawanga a Fordyce" awa ndi chizindikiro. Awa ndi mawanga a sebaceous okulirapo, okulirapo pang'ono omwe amapezeka m'malo opanda tsitsi, monga kuzungulira milomo . Kafukufuku wasonyeza kuti amapezeka kwambiri mu matenda a Moore-Torre.

Kumbukirani, ngati muwona chotupa chatsopano kapena kusintha kotere pakhungu lanu, makamaka ngati chikukula mofulumira, kusintha mtundu, kapena kutuluka magazi, muyenera kuwonana ndi dokotala.

Ndi khansa ziti zomwe zimagwirizanitsidwa ndi matenda a Moore-Torre?

Mitundu yosiyanasiyana ya khansa imatha kuchitika ndi matendawa. Khansa yodziwika bwino komanso zizindikiro zake ndi izi:

• Khansa ya m'matumbo: Iyi ndi khansa yofala kwambiri . Imakhudza pafupifupi theka la anthu onse. Imayamba chifukwa cha kukula kwa maselo a khansa m'kati mwa matumbo kapena m'matumbo. Mosiyana ndi zimenezi, ndi Moore-Torre, khansa iyi imatha kufalikira zaka 15-20 kale kuposa masiku onse, nthawi zambiri imakhala ndi zaka pafupifupi 50. Imathanso kufalikira mofulumira . Zizindikiro zake ndi monga kupweteka m'mimba, kutupa, kusintha kwa matumbo, ndi magazi m'chimbudzi .
• Khansa ya m'mimba: Iyi ndi khansa yomwe imapezekanso ndi Moore-Torre. Zizindikiro zake zingaphatikizepo kupweteka m'mimba, kudzimbidwa, magazi m'chimbudzi, kuvutika kugaya chakudya, nseru, komanso kusowa chilakolako cha chakudya .
• Khansa ya mkodzo:Amatchedwanso `(Urothelial carcinoma)` kapena `(transitional carcinoma)`. Izi zimakhudza mkati mwa dongosolo la mkodzo. Zingayambitse kupweteka pokodza komanso magazi mu mkodzo .
• Khansa ya m'chiberekero: Iyi ndi khansa yomwe imayamba mu endometrium, mkati mwa chiberekero . Ingayambitse kupweteka m'mimba, kupweteka m'chiuno, komanso kutuluka magazi m'mimba kapena kutuluka magazi mosayembekezereka .

Kuphatikiza apo, mitundu ina ingapo ya khansa ingakhale yogwirizana ndi matendawa, kuphatikizapo:

• Khansa ya m'chiberekero
• Khansa ya prostate
• Khansa ya chikhodzodzo
• Khansa ya impso
• Khansa ya m'matumbo ang'onoang'ono
• Khansa ya chiwindi
• Khansa ya m'mapapo
• Khansa ya magazi
• Pali khansa ya muubongo ndi mitundu ina.

Mndandandawu ungawoneke woopsa. Koma chofunika ndichakuti si khansa yonseyi yomwe ingayambire aliyense. Ndipo, ngati yapezeka msanga, imatha kuchiritsidwa .

N’chifukwa chiyani matenda a Moore-Torre amachitika? Kodi chifukwa chake n’chiyani?

Mwachidule, matenda a Moore-Torrell amayamba chifukwa cha kusintha kwa majini anu . Kusintha kwa majini ndi kusintha kwa DNA yathu. DNA iyi imakopedwa pamene maselo athu amagawanika ndikupanga maselo atsopano. Nthawi zina zolakwika zimatha kuchitika. Ngati selo losazolowereka lotere likupitiriza kugawanika, lingayambitse matenda osiyanasiyana, kuphatikizapo khansa.

Ndi kusintha kotani kwa majini komwe kumakhudza izi?

Pali mitundu iwiri makamaka:

• Matenda a mtundu woyamba wa Moore-Torre (Mtundu woyamba wa MTS): Izi zimachitika chifukwa cha kusintha kwa majini omwe amalakwitsa mu DNA yanu . Majini amenewa akalephera kukonza zolakwikazo, maselo osazolowereka amasonkhana m'maselo. Mu 90% ya milandu, jini yotchedwa MSH2 imakhudzidwa. Komabe, majini ena angapo, monga MLH1, MSH6, ndi PMS2, akhoza kukhala nawo.
• Matenda a Moore-Torrell a Mtundu Wachiwiri (MTS): Izi zimachitika chifukwa cha kusintha kwa majini a MUTYH. Jini iyi imayambitsa kukonzanso kuwonongeka kwa okosijeni ku DNA yathu. Pafupifupi gawo limodzi mwa magawo atatu a anthu omwe ali ndi MTS ali ndi mtundu uwu. Kusungunuka kwa okosijeni kumayambitsa kusintha kwa molekyulu ya DNA, zomwe zingayambitse kukula kosalamulirika kwa maselo (monga khansa). Pamene jini yosinthikayo ikulephera kukonza kuwonongeka kumeneku, kuwonongekako kumapitirira.

Kodi izi ndi zinthu zomwe zimachokera ku mibadwomibadwo?

Mwina, inde, ndi cholowa . Komabe, nthawi zina munthu amatha kukhala ndi kusintha kwa majini atsopano popanda aliyense m'banjamo kukhala nako kale. Pafupifupi 60% ya odwala amatha kupeza mbiri ya banja la Moore-Torre syndrome. Komabe, chifukwa si aliyense amene ali ndi kusintha kwa majini kumeneku amene amakhala ndi zizindikiro, kulumikizana kwa banjali sikuonekera nthawi zonse.

Anthu ena akhoza kukhala ndi vutoli popanda zizindikiro, ndipo mwina sakudziwa nkomwe. Komanso, nthawi zina chitetezo cha mthupi chikafooka, 'MTS' yobisika iyi imatha kuyatsidwa. Anthu ena adwala matendawa atapatsidwa 'chiwalo cholimba' ndikumwa mankhwala oletsa chitetezo chamthupi.

Kodi izi zimadutsa bwanji m'mibadwomibadwo?

• Mtundu 1 wa MTS ndi vuto la ``autosomal dominant''. Izi zikutanthauza kuti muyenera kukhala ndi kopi imodzi yokha ya jini yosinthika kuti mulandire vutoli. Ngati m'modzi mwa makolo anu ali ndi kusintha kwa majini kumeneku, muli ndi mwayi wa 50% wolandiranso. Komabe, momwe mumakhalira ndi zizindikiro zingakhale zosiyana ndi zomwe kholo lanu linatengera jiniyo.
• Mtundu wachiwiri wa MTS ndi vuto la ``autosomal recessive``. Izi zikutanthauza kuti kuti mulandire matendawa, makolo anu onse awiri ayenera kukhala ndi kusintha kwa majini komweko. Izi sizichitika kawirikawiri. Komabe, makolo omwe ali ndi kopi imodzi yokha ya jini ya ``autosomal recessive`` iyi sangakhale ndi zizindikiro zilizonse, kotero sangadziwe kuti ali nayo.

Kodi madokotala amazindikira bwanji matenda a Muir-Torre?

Ngati muli ndi zotupa pakhungu monga zomwe tatchula pamwambapa, makamaka pa thunthu lanu, kapena ngati zawonekera muli aang'ono, dokotala angaganize kuti muli ndi matenda a Moore-Torrell. Adzakufunsaninso za zizindikiro zina zomwe zingasonyeze khansa yamkati, komanso ngati pali aliyense m'banja mwanu amene ali ndi mbiri ya khansa.

Ndi mayeso amtundu wanji omwe amachitidwa pa izi?

Dokotala wanu angachite mayeso angapo oyambirira asanakulimbikitseni kuyezetsa majini. Mwachitsanzo:

• Immunohistochemistry (IHC): Chitsanzo chaching'ono cha chotupa pakhungu lanu chimatengedwa, chimapakidwa utoto wapadera, ndikuwunikidwa pansi pa maikulosikopu kuti muwone ngati chitsanzocho chili ndi kusintha kwa majini.

Ndi zotsatira za mayesowa ndi zina, dokotala wanu angakulangizeni kuti muyesere majini kuti muwone ngati pali kusintha kwa majini komwe kumakhudzana ndi matenda a Moore-Torre. Kenako adzatenga chitsanzo cha magazi anu ndikuyang'ana kusintha kwa majini okonzanso osafanana MSH2, MLH1, MSH6, PMS2, kapena jini lokonzanso loyambira MUTYH.

Kodi munthu amene ali ndi matenda a Moore-Torre ayenera kuyezedwa khansa yamtundu wanji nthawi zonse?

Ndikofunikira kwambiri kuti anthu omwe ali ndi vutoli aziyezetsa khansa nthawi zonse , chifukwa kuzizindikira msanga kumawonjezera mwayi wopeza chithandizo chabwino. Mayeso omwe madokotala angalimbikitse angaphatikizepo:

• Colonoscopy: Kufufuza matumbo akuluakulu.
• Endoscopy Yapamwamba (EGD): Kuwunika m'mero, m'mimba, ndi gawo loyamba la matumbo ang'onoang'ono.
• Kuyezetsa prostate ( kwa amuna)
• Mammogram:Kuyezetsa khansa ya m'mawere (kwa akazi)
• Kuyezetsa m'chiuno ( kwa akazi)
• Kuyezetsa khansa ya pachibelekero (kwa akazi)
• Cytology ya mkodzo: Kwa khansa ya mkodzo.
• Mayeso a ntchito ya chiwindi
• Kuchuluka kwa magazi (CBC)
• Kuyezetsa thupi
• Kuyezetsa khungu
• X-ray pachifuwa

Dokotala wanu adzasankha nthawi yomwe muyenera kuchita mayesowa.

Kodi mankhwala a Moore-Torre syndrome ndi ati?

Cholinga chachikulu chothandizira matenda a Moore-Torre ndikupeza ndikuchotsa khansa ngati yachitika . Muyenera kuyesedwa khansa nthawi zonse ndikuyesa minofu iliyonse yokayikitsa. Ngati dokotala wanu apeza khansa, adzaichiza malinga ndi mtundu wake ndi gawo lake. Opaleshoni yochotsa khansa nthawi zambiri ndiyo njira yoyamba yothandizira .

Mankhwala ena a khansa angaphatikizepo:

• Mankhwala a Chemotherapy
• Chithandizo cha radiation
• Chithandizo cha mahomoni
• Chithandizo cha Immunotherapy
• Chithandizo cholunjika
• Kusamutsa mafuta a m'mafupa

Kuphatikiza apo, retinoid yopangidwa pakamwa yotchedwa isotretinoin ingathandize kupewa zilonda zatsopano pakhungu. Ngati colonoscopy yanu yapeza ma polyps ambiri a m'matumbo (omwe ali pachiwopsezo chachikulu chotenga khansa), dokotala wanu angakulangizeni kuti muchotsedwe mbali ina ya m'matumbo kapena m'matumbo onse.

Kodi munthu amene ali ndi matenda a Moore-Torre angayembekezere chiyani?

Kuyembekeza kwanu kumadalira kuchuluka kwa khansa zomwe mungakhale nazo komanso momwe zimafalikira. Ziwerengero zikusonyeza kuti pafupifupi theka la anthu omwe ali ndi matenda a Moore-Torre amakhala ndi khansa yoposa imodzi. Oposa theka amakhala ndi khansa yofalikira m'thupi (khansa yomwe yafalikira mbali zina za thupi ndipo ndi yovuta kuchiza).

Khansa zomwe zili ndi matenda a Moore-Torre nthawi zambiri zimawonekera ali ndi zaka pafupifupi 50. Khansa zimenezi zimatha kukula ndikuipiraipira mofulumira kuposa anthu ambiri. Chifukwa chake, kuzizindikira msanga ndikofunikira . Komanso, pali mwayi waukulu woti khansa ibwererenso ngakhale itachotsedwa. Chifukwa chake, kuyezetsa nthawi zonse mukatha kulandira chithandizo ndikofunikira.

Kodi pali njira yopewera izi?

Kawirikawiri sizili choncho. Izi zili choncho chifukwa ndi vuto lomwe mumabadwa nalo. Komabe, si aliyense amene amakhala ndi zizindikiro. Ngakhale amene amakhala ndi zizindikiro akhoza kukhala ndi matendawa pang'ono kapena pang'ono kuposa makolo awo. Asayansi sakudziwabe chifukwa chake izi zimachitika. Komabe, zawonedwa kuti vutoli likhoza kuipiraipira ngati chitetezo cha mthupi chifooka .

Kudziwa kuti muli ndi kusintha kwa majini kungakuthandizeni kupanga zisankho zina zodzitetezera. Mwachitsanzo, kuyezetsa majini ndi upangiri wa majini kungakuthandizeni kupewa kupatsira matendawa kwa ana anu. Komanso, kudziwa izi kungakuthandizeni kuzindikira khansa msanga ndikuyamba kulandira chithandizo, kupewa zotsatirapo zoyipa.

Ngakhale kuti matenda a Moore-Torre ndi osowa, sikophweka kuthana ndi matenda ngati amenewa. Zingaoneke zovuta kulimbana ndi chinthu chomwe chili mu DNA yathu. Koma, chidziwitso ndi mphamvu . Mukazindikira ndi kulandira chithandizo nthawi yake, inu ndi dokotala wanu mutha kukumana ndi vutoli.

Pomaliza, uthenga wopita nawo kunyumba

Chabwino, tiyeni tifotokoze mwachidule zina mwa zinthu zomwe muyenera kukumbukira kuchokera pa zomwe takambirana:

• Muir-Torre Syndrome ndi matenda a majini omwe amawonjezera chiopsezo chokhala ndi zotupa pakhungu ndi khansa yamkati (makamaka m'mimba).
• Ngati muwona chotupa chatsopano, chachilendo pakhungu lanu, makamaka pa thunthu lanu, funsani upangiri wa dokotala nthawi yomweyo. Sizingakhale kanthu, koma ndi bwino kukayezetsa.
• Iyi ndi njira yosiyana ya matenda a Lynch. Ngati wina aliyense m'banja mwanu ali ndi mbiri ya khansa, uzani dokotala wanu za iyo.
• Kuzindikira msanga ndi kuyezetsa nthawi zonse n'kofunika kwambiri. Izi zingathandize kuzindikira khansa msanga ndikuchiza bwino.
• Kuyezetsa majini ndi uphungu kungathandize kudziwa ngati vutoli lilipo komanso ngati likukhudza achibale.
• Musachite mantha, koma dziwani. Simuli nokha, ndipo madokotala alipo kuti akuthandizeni.

Ndikukhulupirira kuti izi zikuthandizani. Khalani ndi thanzi labwino!

Muir -Torre Syndrome, Lynch Syndrome, Khansa ya Khungu, Matenda a Majini, Khansa ya M'mimba, Kuwunika Khansa, Kusintha kwa Majini