Wakambonzwa nezvegomarara remudumbu rinogara nhaka here? (Hereditary Diffuse Gastric Cancer - HDGC) Ngatikurukurei nezveizvi!

Nhasi tichataura nezvechirwere chakakomba chisingazivikanwe nevanhu vazhinji. Iri igomarara remudumbu rinogara nhaka. Vanachiremba vanoriti `(Heroditary Diffuse Gastric Cancer)` kana `(HDGC)` muchidimbu. Kana mumwe munhu mumhuri mako akambova nechirwere ichi, kana kuti uchida kuziva zvakawanda nezvacho, chinyorwa chino chichava chakakosha kwauri. Usazvidya mwoyo, ngatitaure nezvazvo zviri nyore.

Chii ichi chinonzi `(HDGC)`?

Zvichitaurwa zviri nyore, HDGC chirwere chegomarara chinogara nhaka. Izvi zvinoreva kuti njodzi yako yegomarara remudumbu (gastric cancer) muhupenyu hwako hwese inowedzera neinenge 70%. Kwete izvozvo chete, vakadzi vanogara nhaka chirwere ichi vanewo mukana wakawedzera we42% wegomarara rezamu , Lobular Breast Cancer (LBC) .

Vanhu vane chirwere ichi che`(HDGC)` vanogara nhaka gene rakachinja (`(gene rakachinja)`) kubva kune mumwe wevabereki vavo. Kazhinji, iri gene rinonzi `(CDH1)` . Asi dzimwe nguva mamwe majini anogona kusanganisirwa. `(CDH1)` ijini rinodzvinyirira bundu (`(gene rinodzvinyirira bundu)`). Kana izvi zvikachinja, hazvishande zvakanaka kudzora kenza. Funga nezvazvo, jini iri rakafanana nemupurisa mumuviri wedu anomisa masero ekenza kukura. Saka chii chinoitika kana mupurisa iyeye akashaya simba? Ndizvo zvinoitikawo pano.

Chii chinonzi "kenza yemudumbu inopararira"?

Iye zvino ngationei kuti iyi `(Diffuse Gastric Cancer)` chii. Iyi imhando yekenza yemudumbu. Asi pachinzvimbo chekukura panzvimbo imwe chete semamwe makenza, iyi inopararira mumadziro emudumbu mumapoka madiki emasero. Zvakafanana nekudonha kwemvura kunopararira pamadziro. Nekuda kweizvi, madziro emudumbu anokora uye anooma. Zvishoma nezvishoma, inopararira kusvika kumadziro akadzika emadziro emudumbu.

Rudzi urwu rwegomarara remudumbu rwakaoma kuziva nekuti harinyatsoonekwi pakuongorora kwakajairika. Zvakare, zviratidzo zvinowanzoonekwa chete mushure mekunge chirwere chapararira, padanho rekupedzisira. Panguva iyoyo, gomarara rinogona kunge rapararira (rakabva mudumbu) kuburikidza nemadziro emudumbu kuenda kunhengo dziri pedyo, dzakadai sechiropa kana mapfupa.

Dambudziko iri rakajairika zvakadii?

Tichitaura nezvechirwere che `(HDGC)`, zvinofungidzirwa kuti vanhu vanosvika vashanu kusvika gumi kubva pazviuru gumi vanogona kugara nhaka yechirwere ichi pakuzvarwa. Vanhu vanosvika makumi maviri muzana (20%) vegomarara remudumbu ndeverudzi rwe `(diffuse)`. Vanhu vanosvika 2% vegomarara iri rinopararira nderokugara nhaka `(HDGC).` Kunyangwe gomarara remudumbu richiwanzoitika munyika dzeAsia kupfuura munyika dzekumadokero, chirwere ichi che `(HDGC)` chinowanzotaurwa nezvacho munyika dzekumadokero.

Ndezvipi zviratidzo zvechirwere che `(HDGC)`?

Sezvatakambotaura, zviratidzo zverudzi urwu rwegomarara remudumbu zvinogona kusaonekwa kusvika chirwere chapararira (metastasized). Ndosaka zvichikosha kuziva njodzi yekuti chirwere ichi chinogona kuitika mumhuri. MuHDGC, gomarara rinokura pazera diki zvishoma pane mune mamwe magomarara. Vanhu vazhinji vanoonekwa vasati vasvitsa makore makumi mana.

Zviratidzo zvikuru zvinogona kuva:

• Kurwadziwa kwemudumbu (kunyanya muchikamu chepamusoro chekuruboshwe chedumbu)
• Dumbu rinozvimba, flatulence
• Kusvotwa nekurutsa
• Kuda kudya
• Kuderedza huremu
• Kuneta kwakanyanya, kuneta
• Kuoma kumedza chikafu
• Ropa riri mutsvina (`(Ropa riri mutsvina)`)
• Kurutsa ropa (`(Kurutsa ropa)`)
• Jaundice (kutsvuka kwemaziso neganda)

Dzimwe nguva, chirwere chekuzvarwa chinonzi cleft lip kana cleft palate chinogonawo kuva chiratidzo chekutanga chechirwere ichi. Izvi zvinokonzerwa nekuti kuchinja kwemajini uku kunogona kukonzera chirwere ichi chekuzvarwa. Zvisinei, kazhinji, cleft lip haina chekuita neHDGC. Zvisinei, kana wakazvarwa uine chirwere chakadaro chekuzvarwa uye mumwe munhu mumhuri mako akambova nekenza dzemhando idzi, unogona kunge uchifungidzira zvishoma.

Chii chakaita kuti pave nekuumbwa kweizvi `(HDGC)`?

HDGC chirwere chemajini . Chinoitika kana shanduko mune rimwe remajini anoderedza bundu ratakataura nezvaro kare ikachinja hurongwa hweDNA yako. Majini anoderedza bundu anoudza masero kuti adzore kupatsanurwa nekukura kwemasero. Saka kana majini aya asingashande nemazvo, kenza inogona kukura.

Unogara nhaka jini iri rakachinja kubva kuna amai vako kana baba vako. Kuchinja kunogarwa nhaka nenzira iyi kunonzi germline mutation . Kunokanganisa kodhi yemajini emasero ako ekubereka.

Izvi `(HDGC)` zvinogara nhaka sei?

HDGC chirwere chinotonga autosomal . Izvi zvinoreva kuti unongoda kopi imwe chete yejini rakachinja kuti ugare nhaka chirwere ichi. Chinogona kugarwa nhaka kubva kuna amai vako kana baba vako. Kana mumwe wevabereki vako aine mutation, iwe kana vanun'una vako mune mukana we50% wekuchigara nhaka. Funga nezvazvo semukana wekuti mari inobuda misoro kana miswe.

Munhu wese anogara nhaka yekuchinja kwemajini anowana kenza here?

Kwete. Kuchinja kwemajini kwaunogara nhaka kubva kuvabereki vako kunokanganisa kopi imwe chete yejini rinodzvinyirira kenza musero rega rega. Asi sero rega rega rine makopi maviri ejini iri, rimwe kubva kuna amai vako nerimwe kubva kuna baba vako. Saka kunyangwe kana usingagare nhaka kuchinja kumwe chete kubva kuvabereki vese, uchiri nekopi yejini rinoshanda zvakanaka.

Kuti kenza itange, shanduko yechipiri (`(somatic mutation)`)Zvinofanira kuitika munyama inoumbwa kenza (kureva, mukati medumbu kana muzvikamu zvezamu) muhupenyu hwako hwese. Kuchinja uku kwechipiri kunodzimawo imwe kopi yejini. Ndipo panotanga kukura kenza.

Chii chinokonzera kuchinja kwechipiri uku?

Kutaura chokwadi, hatizivi chikonzero chaicho cheizvi. Asi zvinhu zvakasiyana-siyana zvinogona kuita basa. Kusangana nemamiriro ezvinhu akapoteredza kunowanzoita basa mu "kukonzera" zvirwere zvemajini. Mamwe majini anogonawo kunge aripo. Dzimwe mhuri dzine gene reHDGC dzine huwandu hwakawanda hwekenza kupfuura dzimwe.

Zvimwe zvinhu zvinokonzera njodzi dzezvakatipoteredza zvinoparira kukura kwekenza yemudumbu ndeizvi:

• Kusvuta
• Kushandisa doro zvakanyanya
• Kudya nyama tsvuku yakawandisa (senge nyama yemombe, yegwayana)
• (H. pylori) hutachiona (iyi ibhakitiriya inokonzera maronda emudumbu)

Maitiro ekuyedza `(HDGC)` akaita sei?

Kunyangwe usati wava nezviratidzo, kana paine chikonzero chekufunga kuti uri panjodzi (semuenzaniso, kana mumwe munhu mumhuri mako akambova nerudzi urwu rwekenza, kana kuti wakamboongororwa majini akawana shanduko mujini rekuti '(CDH1)'), chiremba anogona kukutumira kunoongororwa `(HDGC)`.

Chiremba wako achaverenga njodzi yako zvichienderana nenhoroondo yemhuri yako uye/kana mhedzisiro yekuongororwa kwemajini. Vanogonawo kutsvaga zviratidzo zvegomarara munyama yako. Semuenzaniso, vanogona kutsvaga chirwere chinonzi Lobular Carcinoma In Situ (LCIS) muzamu kana masero erudzi rwesignet-ring mudumbu. Idzi shanduko dzekutanga dzinogona kuva gomarara.

HDGC inoonekwa sei?

Kana uine zviratidzo zvegomarara remudumbu rakapararira, chiremba wako achatsvaga humbowo hwegomarara mudumbu mako. Vachatora masampuli enyama voaongorora pasi pemaikorosikopu. Kana gomarara remudumbu rakapararira rikawanikwa, uye kana mumwe munhu mumhuri mako akambova negomarara rerudzi urwu, chiremba wako anogona kukukurudzira kuti uedze majini .

Parizvino, vanhu vanosvika 40% vane HDGC vakawanikwa vaine chirwere ichi cheCDH1 mutation. Dzimwe shanduko dzingangove dziripo, asi CDH1 ndiyo huru yatinoziva uye yatinogona kuziva. Kana uine chirwere ichi, inzira yechokwadi yekuongorora HDGC. Zvisinei, kana uine nhoroondo yemhuri yerudzi urwu rwekenza yemudumbu inopararira, unogona kuonekwa uine HDGC kunyangwe usina chirwere cheCDH1 mutation.

Ndezvipi zviedzo zvinoshandiswa kuongorora `(HDGC)`?

Kuongororwa uku kunogona kuitwa kuti uongorore chirwere ichi:

• Kuongororwa kwemajini:Uku kuongororwa kweropa. Muenzaniso weropa rako unotorwa woongororwa kuti uone kana paine shanduko dzemajini dzine chekuita nezvirwere zvemajini. Vamwe vanhu vanoongororwa izvi nekuti vane nhoroondo yemhuri yavo yezvirwere zvemajini. Vamwe vanoongororwa rudzi urwu rwemajini nekuti havazivi nhoroondo yehutano hwemhuri yavo, kuti vawane ruzivo rwavo, kana kuti nekuti vari kuronga kuva nevana.
• Endoscopy yepamusoro (EGD test): Iyi bvunzo yekutarisa mukati menzira yako yepamusoro yekugaya (kureva, gumbo, dumbu) uye kutora sampuli dzenyama. Izvi zvakakosha pakuongorora kenza yemudumbu, kunyanya rudzi urwu rwekenza rwakapararira. Chiremba wezvekudya (chiremba anonyanya kubata zvirwere zvemudumbu) anoita izvi. Anoisa chubhu refu (endoscope) ine kamera diki kuburikidza nemuromo wako uye pasi pegumbo rako mudumbu mako. Sampuli dzenyama dzinogonawo kutorwa kuburikidza nechubhu. Zvisinei, kunyangwe nenzira idzi, zvinogona kuoma kuwana kenza yemudumbu yakapararira. Nekuti yakapararira zvakanyanya, chiremba angasakwanise kuiona kana kuiwana musampuli dzenyama. Saka, chiremba anotsvaga rudzi urwu rwekenza anofanira kunge aine kudzidziswa kwakakosha uye ruzivo.
• MRI yezamu: Nekuti kenza yezamu yemukona haionekwi nekuongororwa kwemazamu nguva dzose, vanachiremba vanokurudzira kuti MRI iongororwe. Kana MRI ikaona chimwe chinhu chisingawanzoitiki, inoiswa chiratidzo uye mumwe chiremba anotora sampuli yenyama.
• Kuongororwa kwemuviri: Chiremba anotora sampuli yenyama oitumira kurabhoritari kuti iongororwe nemaikorosikopu. Kuongororwa uku kunogona kusimbisa kana sampuli yenyama yacho ine masero ekenza.

Chii chinoitika mushure mekunge yaonekwa seine `(HDGC)`?

Kana uchitova nekenza, chiremba wako achataura newe nezvenzira dzekurapa. Kunyangwe usati wava nekenza, kana uine chirwere ichi, chiremba wako angangokurudzira kuongororwa kenza nguva dzose, sezvambotaurwa pamusoro apa. Kuvhiyiwa kwekudzivirira ndeimwe nzira yaunogona kutaura nachiremba wako nezvayo.

Kenza yemudumbu yakapararira inorapwa sei?

Kuvhiyiwa kazhinji ndiyo nzira yekutanga yekurapa kenza inogona kubviswa nekuvhiyiwa. Kana uine HDGC, chiremba wako anowanzo kurudzira kubviswa kwegastrectomy zvachose . Izvi zvinodaro nekuti HDGC ine njodzi huru yekupararira kure isati yaonekwa.

Mukuvhiyiwa kwegastrectomy yese, chiremba anobvisa dumbu rako rese uye anosanganisa magumo egurokuro zvakananga kuura hwako hudiki. Zvinokwanisika kurarama usina dumbu, asi pane zvimwe zvinokanganisa. Mushure mekuvhiyiwa, unogona kupiwa mamwe marapirwo (adjuvant therapy) akadai seradiation therapy kana chemotherapy.

Nekuti vakadzi vane `(HDGC)` vari panjodzi yekubatwa nekenza yemazamu yelobular (`(LBC)`), vanofanirwa kugara vachiziva zviratidzo zve`(LBC)` panguva yekurapwa. Kana uine `(LBC)`, kurapwa kunowanzo tanga nekuvhiyiwa kwekenza yemazamu. Mamwe marapirwo anobva apihwa.

Ndeipi nguva yekurarama kana uine chirwere che `(HDGC)`?

Nguva yekurarama inoenderana nekuwana nekurapa kenza nekukurumidza. Kunyangwe nekuongororwa nguva dzose, izvi zvinogona kuoma. Kana kenza yemudumbu ikabatwa uye ikarapwa nekukurumidza, huwandu hwekurarama kwemakore mashanu hunopfuura 90%. Zvisinei, kana ikawanikwa yanonoka, mushure mekunge yapinda mudumbu, huwandu hwayo hunoderera kusvika pasi pe30%.

Ndosaka tichiti zvakakosha kuziva nhoroondo yemhuri uye kutsvaga mazano ekurapa kana uri panjodzi.

Pane nzira yekudzivirira `(HDGC)` here?

Kana uine `(CDH1)` gene mutation (iyo inobatanidzwa nekuwedzera kwenjodzi yekubatwa nekenza), kune matanho akati wandei ekudzivirira aunogona kutora. Kune vanhu vasina gene mutation iyi chaiyo, njodzi nematanho hazvina kunyatsotsanangurwa. Unogona kutaura nachiremba wako nezvenjodzi dzako uye sarudzo dzako.

Kuvhiyiwa kwekudzivirira

Kana wave nemakore angangoita makumi maviri uchionekwa uine HDGC uye usina mamwe matambudziko makuru ehutano, chiremba wako anogona kukurudzira kuti ubviswe zvachose . Kunyangwe kurasikirwa nedumbu kuchigona kukanganisa kugaya kwako, migumisiro iyi iri nyore kugadzirisa pane kubata nekenza yemudumbu yakakwira.

Kune avo vasati vagadzirira kutora matanho aya, nzira yekuti "mirirai uye mutarise" inogona kushandiswa, inosanganisira endoscopy yepamusoro yemudumbu kakawanda uye sampuli dze biopsy dzisingatarisirwi. Zvisinei, kunyangwe paine kutarisisa kwakadaro, HDGC inogona kusaonekwa nguva dzose nekukurumidza (kana kurapwa kwacho kuchinyatsobudirira).

Migumisiro yekubvisa zvachose gastrectomy:

• Dumping syndrome: Kana chikafu chikapfuura zvakananga kubva mugurokuro chichipinda muura hudiki, chinopfuura nemuura hudiki nekukurumidza kupfuura zvakajairika. Izvi zvinogona kukonzera shanduko huru mumahormone mudumbu, zvichikonzera zviratidzo zvakaita sekusvotwa, manyoka, uye shuga shoma muropa. Zviratidzo izvi zvinogona kudzorwa nekuchinja maitiro ako ekudya. Zviratidzo izvi zvinopera nekufamba kwenguva.
• Kusanyorovesa uye kushaya chikafu: Kana dumbu rabviswa, chikamu chedumbu chine maasidhi nema enzyme anobatsira kugaya chikafu chinorasika. Izvi zvinogona kudzivirira chikafu kuti chisaputswe zvakanaka uye kudzivirira muviri kuti usatore zvinovaka muviri. Izvi zvinogona kukonzera kushaya chikafu. Izvi zvinogona kubatsirwa nekuchinja kudya kwako uye kutora zvinovaka muviri.

Mazano ezvemajini uye kuronga mhuri

Kune vanhu vane CDH1 gene mutation, mazano ezvemajini anogona kubatsira zvikuru mukukurukura nezvekuronga mhuri. Izvi zvinogona kukubatsira kunzwisisa njodzi yekuti mwana wako agare nhaka chirwere cheHDGC. Kana uchironga kuva nevana, imwe sarudzo yekugadzirisa njodzi iyoyo ndeyekusarudza In Vitro Fertilization (IVF) .

MuIVF, mazai nembeu zvinotorwa kubva kuna amai nababa zvoiswa murabhoritari. Mushure mekunge mazai akura, sero rimwe chete kubva mudumbu rega rega rinogona kutorwa roongororwa kuti harina CDH1 mutation here. Vabereki vanogona kusarudza mazai asina mutation voaisa mudumbu raamai.

Chekupedzisira, zvekurangarira

Kuziva kuti une Hereditary Diffuse Gastric Cancer Syndrome (HDGC) kunogona kuva chiitiko chinoshungurudza zvikuru, uye ungatofanira kuita zvisarudzo zvikuru. Izvi zvinogona kukanganisa iwe nemhuri yako. Tora nguva yako yekufunga zvinhu pasina kutya. Bvunza mibvunzo yakawanda sezvaunoda. Chikwata chako chekurapa chiripo kuti chikubatsire kuwana nzira yakanakisisa yekufamba rwendo urwu. Yeuka, kuziva ndicho nhanho yekutanga. Hausi wega.

HDGC , kenza yenhaka, kenza yemudumbu, jini reCDH1, kenza yemudumbu, kenza yemazamu, kuyedzwa kwemajini, endoscopy, gastrectomy, kudzivirira kenza