Ese uzi FAP (Familial Adenomatous Polyposis), indwara ituma polyps amagana zivuka mu mara?

Hari umuntu wo mu muryango wawe, cyane cyane akiri muto, warwaye kanseri y'amara? Cyangwa se muganga yakubwiye ko ufite polyps nyinshi mu mara yawe? Birashoboka ko ibi biterwa n'indwara y'uturemangingo igaragara mu miryango. Uyu munsi tugiye kuvuga kuri imwe muri izo ndwara zidasanzwe ariko zikomeye cyane. Ni FAP, cyangwa Familyal Adenomatous Polyposis. Nubwo izina rigoye gato, reka tubisobanukirwe mu buryo bworoshye.

Mu magambo make, FAP ni iki?

FAP ni indwara y’uturemangingo ishobora guhererekanywa kuva ku gisekuru kugeza ku kindi. Abantu bafite iyi ndwara bakuramo ibibyimba byinshi byitwa adenomas , bishobora kuvamo kanseri, mu mara no mu nda yabo.

Noneho ushobora kuba urimo kwibaza uti "Ese ni ibisanzwe kugira ikibyimba ku mara yawe?" Yego, ni ibisanzwe ko hari abantu bagira ikibyimba kimwe cyangwa bibiri uko bagenda bakura. Ariko umuntu ufite FAP ashobora kugira ikibyimba amagana, ndetse n'ibihumbi . Kandi bitangira akiri muto cyane, wenda afite imyaka 15 cyangwa 16.

Izi polyps ntabwo ari kanseri mu ntangiriro. Ariko zitwa 'precancerous'. Ibi bivuze ko iyo zitavuwe, hari ibyago byinshi cyane ko imwe cyangwa nyinshi muri izi polyps zizavamo kanseri y'inkondo y'umura .

Iyo hatabayeho ubu buvuzi, abantu benshi bafite FAP bashobora kurwara kanseri mu myaka yo hagati. Nanone, abantu bafite FAP bafite ibyago byo kurwara ibibyimba atari mu mara gusa ahubwo no mu bindi bice by'umubiri (urugero, mu gifu, mu mara mato, mu ruhu no mu magufwa). Kubwibyo, nubwo amara amaze gukurwaho, bazakenera gusuzumwa na muganga buri gihe mu buzima bwabo bwose.

Ni izihe ngaruka mbi zo kurwara kanseri ukoresheje FAP?

Iyo itavuwe, FAP ifite amahirwe hafi 100% yo kurwara kanseri y'amara. Iyi ni indwara ikomeye cyane. Abantu barwaye FAP barwara kanseri bakiri bato cyane kandi ku muvuduko wihuse kurusha umuntu usanzwe. Kubwibyo, niba uzi ko hari amateka y'umuryango wa FAP, umwana wawe agomba gukorerwa isuzuma rya colonoscopy buri mwaka guhera ku myaka 10.

Uretse kanseri y'amara, abantu bafite FAP nabo bafite ibyago byo kurwara izindi kanseri.

Ese hari ubwoko butandukanye bwa FAPs?

Yego, hari ubwoko bw'ingenzi bwa FAP n'ubundi bwoko butandukanye gato kandi budakomeye cyane. Reka turebe ibyo ari byo.

Ni irihe tandukaniro riri hagati ya FAP na Lynch Syndrome?

Indwara ya Lynch ni indi ndwara ishobora guhererekanywa mu bisekuruza no kongera ibyago byo kurwara kanseri y'amara. Ariko hari itandukaniro rikomeye hagati y'izo ndwara. Abantu barwaye Lynch syndrome ntibarwara polyps amagana, nkuko bigenda muri FAP. Hari igihe polyps imwe cyangwa ebyiri zikura, kandi zishobora guhita zihinduka kanseri. Niyo mpamvu Lynch syndrome rimwe na rimwe yitwa "nonpolyposis". Izo ndwara zombi ziterwa n'ubusembwa mu ngirabuzimafatizo zitandukanye.

Ni ibihe bimenyetso bya FAP?

Muri FAP, ibibyimba by'amara bitangira kugaragara kare cyane kurusha mu baturage muri rusange, akenshi mu gihe bakiri bato. Ibi bibyimba akenshi ntibigaragaza ibimenyetso kugeza igihe binini cyane. Niyo mpamvu gusuzuma ari ingenzi cyane.

Ariko, kubera ko umubare wa cysts ari munini cyane kandi zikura vuba, hari igihe ibimenyetso bishobora kugaragara. Ibimenyetso nk'ibi birimo:

• Kuva amaraso mu maraso
• Impiswi idashira
• Ububabare bwo mu nda budakira

Uretse ibi, abantu bafite FAP bashobora no kugira ibimenyetso byo hanze muganga ashobora kubona byoroshye.

• Dermatofibromas: Utubyimba dukomeye, tumeze nk'inkovu tuba munsi y'uruhu.
• Udukoko two mu bwoko bwa epidermal cysts: Udusimba twuzuyemo keratin tuba munsi y'uruhu.
• Amagufwa yo mu bwonko:Ibibyimba bitari kanseri biba mu magufwa. Ibi bikunze kugaragara mu gahanga cyangwa mu kibuno.
• Amenyo y'inyongera cyangwa amenyo yangiritse: Ibi bishobora kugaragara hakoreshejwe X-ray y'amenyo.
• Utudomo tw’amaso dufite ibara ry’umuhondo (CHRPE): Ibi bishobora kugaragara mu gihe cyo gusuzuma amaso. Ariko, akenshi ntibigira ingaruka ku kureba.

Ni iyihe mpamvu nyamukuru ya FAP?

Nkuko twabivuze mbere, FAP iterwa n'impinduka mu ngirabuzimafatizo. Ingirabuzimafatizo igira ingaruka kuri ibi yitwa APC (Adenomatous Polyposis Coli) .

Umuntu urwaye FAP aba afite gene ya APC yahinduwe, bivuze ko ifite inenge. Hanyuma, nk'imodoka ifite feri yacitse, uturemangingo twigabanyamo ibice mu buryo butunguranye tugakora ibibyimba amagana.

Iyi nenge y’uturemangingo iragwa. Iyo umwe mu babyeyi afite iyi nenge y’uturemangingo twa APC, umwana afite amahirwe ya 50% yo kuyirwara . Ibi bivuze ko buri mwana ashobora kuyirwara cyangwa atayirwara. Ariko, abantu bagera kuri 30% basanzwe barwaye FAP nta mateka y’umuryango baba bafite. Ibi bivuze ko iyi nenge y’uturemangingo yavutse mu mubiri wabo vuba aha (mutation y’umwimerere).

Ni izihe ngorane zishobora guterwa na FAP?

Ingorane ikomeye kandi iteje akaga yo guhangana na FAP ni kanseri y'inkondo y'umura . Ibi byago biragabanuka cyane iyo umara uvuyemo. Ariko, hari ingorane zimwe na zimwe zo kubaho udafite umara utari mu nda. Uburyo bwo kugenda mu mara burahinduka. Kuri ibi, ushobora gukoresha ipaki ya ileostomy cyangwa ipaki ya ileal .

Kubera ko ikibazo cya APC gene kigaragara muri buri turemangingo mu mubiri, ibibyimba bishobora no kuvuka hanze y'amara. Bimwe muri byo bifite ibyago byo kurwara kanseri.

• Polyps zo mu gifu: Izi zikura hafi ya buri wese ufite FAP. Umubare muto muri zo ushobora gukuramo kanseri ya duodenum, biliary duct, cyangwa pancreas duct.
• Polyps zo mu nda: Nubwo zigaragara ku bantu bagera kuri 90%, ni bake cyane, hafi 1%, bahinduka kanseri.
• Ibibyimba bya Desmoid: Ibi si kanseri. Ariko bishobora kuba bibi cyane kandi bishobora gukwirakwira mu ngingo no mu mitsi y'amaraso yegereye, bikangiza. Biragoye kubikuraho kandi bishobora kugaruka.
• Kanseri ya tiroyide: Ibi bishobora kubaho ku bantu bagera kuri 2% bafite FAP. Akenshi ibi birakira burundu.
• Kanseri y'umwijima: hepatoblastoma, cyane cyane ku bana bafite FAPHari ibyago bike byo kurwara kanseri y'umwijima idakunze kugaragara yitwa.

Bivurwa bite kandi bigacungwa bite?

Gahunda yo kuvura FAP igabanyijemo ibice bibiri: kubaga no gupima ubuzima bwose.

1. Kubagwa

Abantu benshi bafite FAP ya kera bazakenera gukorerwa colectomy yuzuye, ikubiyemo gukuraho amara yose, bari mu kigero cy'imyaka 20 cyangwa 30. Muganga wawe ni we uzagena igihe n'uburyo bwo kubaga, bitewe n'uburwayi bwawe.

2. Gusuzuma buri gihe

Ugomba gukorerwa ibizamini bitandukanye mbere na nyuma yo kubagwa, ndetse no mu buzima bwawe bwose. Ubu ni bwo buryo bwiza bwo kurinda ubuzima bwawe.

Ubuzima bumeze bute hamwe na FAP?

Ni ibisanzwe kumva ubabaye kandi ugatangara iyo umenye ko ufite indwara nk'iyi mu maraso. Ariko, kumenya iyi ndwara hakiri kare ni bwo buryo bwiza bwo guhangana n'ibyago byo kurwara kanseri.

Iyo umuntu ufite FAP yitabwaho neza kandi agasuzumwa buri gihe, ashobora kubaho ubuzima busanzwe, burambye kandi bufite ubuzima bwiza . Nyuma yo gukuraho amara, ibyago byinshi bituruka ku zindi kanseri zo mu nzira y'igifu cyangwa kanseri ya desmoid. Ariko izi ni nke cyane kurusha kanseri y'amara.

Nubwo kubagwa ari impinduka ikomeye mu buzima, hamwe n'ikoranabuhanga rigezweho muri iki gihe, kubagwa hakoreshejwe laparoscopic bishobora kugufasha gukira vuba.