Wakaona here shanduko mumaitiro ako emudumbu, kurwadziwa mudumbu, kana ropa mutsvina yako nguva pfupi yadarika? Usaregeredza zviratidzo izvi, uchifunga kuti zvakajairika. Zvinogona kunge zviratidzo zvekenza yemudumbu. Nhasi, tiri kutaura nezverudzi rwekenza yemudumbu rwakasiyana zvishoma, asi zvakare ine rombo rakanaka. Inonzi MSI-H.
Zvichitaurwa zviri nyore, chii chinonzi gomarara reMSI-H muura?
Kuti tinzwisise izvi, ngatitangei tatarisa DNA iri mukati memasero emuviri wedu. Funga nezveDNA yedu secheni refu. Cheni iyi ine mabhora erudzi rumwe chete akabatanidzwa pairi kakawanda. Izvi zvikamu zveDNA zvinodzokororwa zvinonzi ma microsatellites.
Zvino, kana masero emuviri wedu akapatsanuka uye masero matsva akaumbwa, makopi echeni iyi yeDNA anogadzirwa. Dzimwe nguva zvikanganiso (kuchinja) zvinogona kuitika kana makopi aya akaitwa. Asi musazvidya mwoyo, muviri wedu une sisitimu yakaita se'mapurisa anowana zvikanganiso'. Inonzi sisitimu yeMismatch Repair (MMR) . Inotarisa zvikanganiso mumakopi iwayo eDNA uye inozvigadzirisa nekukurumidza.
Zvisinei, mune mamwe masero egomarara, iyi MMR system haishande nemazvo. Tinoidaidza kuti dMMR (deficient DNA Mismatch Repair). Zvadaro, nekuda kwekuti hapana munhu anogadzirisa zvikanganiso zviri mumakopi eDNA iwayo, zvikanganiso zvinoungana uye DNA inova isina kugadzikana zvakanyanya. Ndiyo mamiriro ezvinhu ane ma microsatellite asina kugadzikana zvakanyanya, atinodaidza kuti MSI-H (Microsatellite Instability-High) .
Zvinoshamisa kuti, "kusagadzikana" uku kweDNA dzimwe nguva chinhu chakanaka. Gomarara reMSI-H rinopindura zviri nani kurapwa kunonzi immunotherapy kupfuura mamwe marudzi egomarara. Pamusoro pezvo, maonero avo akanaka.
Ndezvipi zviratidzo zvingangove zvegomarara reMSI-H?
Zviratidzo zvingasaonekwa nguva dzose, asi kana zvikaonekwa, zvakafanana nekenza yemuura.
| Chikamu chezviratidzo | Zvinhu zvekuona |
|---|---|
| Kuchinja kwekufamba kwemudumbu | Manyoka, kuzvimba, kana kunzwa kuguta mushure mekubvisa tsvina. |
| Ropa muchigaro chetsvina | Tsvina yebrown yakasviba kana nhema, kana kubuda ropa kubva mudumbu. |
| Kusagadzikana kwedumbu | Kurwadziwa kwedumbu, kuzvimba. |
| Zvimwe zvinhu zvemuviri | Kuneta kusingatsananguriki, kudzikira kwehuremu, kurasikirwa nechido chekudya. |
Zvakakosha: Havasi vese vane zviratidzo izvi vane kenza. Zvisinei , kana uine ropa mutsvina yako kana kurwadziwa kwakanyanya mudumbu, enda kuna chiremba nekukasika. Kana zvimwe zviratidzo zvikaramba zviripo kweanopfuura mavhiki maviri, unofanira kutsvaga rubatsiro rwechiremba.
Dzimwe nguva, chiratidzo chekutanga chegomarara iri kuongororwa kweropa kunoratidza huwandu hushoma hwemasero matsvuku eropa (anemia). Izvi zvinokonzerwa nekubuda ropa muura.
Zvinokonzera uye zvinhu zvinokonzera kenza yeMSI-H
Chikonzero chikuru chegomarara reMSI-H inyaya yekusakwana kwemajini eMMR atakataura nezvawo kare. Izvi zvinowanzoitika muhupenyu hwemunhu, pasina chikonzero chaicho.
Asi muvanhu vanosvika 5% vanowana gomarara remuura, chirwere ichi chinopfuudzwa nezvizvarwa nezvizvarwa. Tinochidaidza kuti chirwere cheLynch . Kana mumwe munhu mumhuri yako aine chirwere ichi, iwe uri panjodzi huru yekubatwa negomarara remuura.
Pamusoro pezvo, kune zvinhu mumararamiro edu zvinowedzera njodzi yekubatwa nekenza.
| Zvinhu zvine njodzi zvatisingakwanise kudzora | Zvinhu zvine njodzi zvatinogona kudzora |
|---|---|
| Kuva nemakore anopfuura makumi mashanu | Kufuta |
| Kuva nenhoroondo yemhuri yekenza yekoloni | Chirwere cheshuga cherudzi rwechipiri |
| Zvirwere zvenhaka zvakadai seLynch syndrome | Kusvuta |
| Kuva nezvirwere zvakaita sechirwere cheCrohn | Kunwa doro zvakanyanya |
| Kuva nema polyps muura | Kudya nyama tsvuku yakawandisa nenyama yakagadzirwa |
Nzira yekuziva sei chirwere ichi?
Kana chiremba wako achifungidzira kuti une kenza zvichibva pazviratidzo zvako, achakutumira kuti unoongororwa kakawanda.
1. Colonoscopy: Chubhu inochinjika ine kamera yakabatanidzwa inopinzwa nepaburi kuti iongorore ura hwese. Panguva iyi, kanyama kadiki kanotorwa kubva panzvimbo inofungidzirwa kuti kaongororwe. Izvi zvinonzi biopsy .
2. Kuongororwa kwemamorekuru: Kuongororwa kwakakosha kunoitwa kuti kuonekwe shanduko dzemajini, kureva mamiriro eMSI-H, musampuli yenyama yakatorwa kubva mu biopsy. Matekinoroji akadai seIHC , PCR , uye NGS anoshandiswa pakuita izvi.
3. Kuongororwa kwemifananidzo: Kuongororwa kwakadai seCT neMRI kunoitwa kuti kuonekwe kana kenza yapararira kune dzimwe nhengo dzemuviri.
Ndeipi mishonga yekurapa gomarara reMSI-H?
Kurapwa kunoenderana nedanho regomarara uye kuti rapararira kusvika papi. Kune nzira mbiri huru dzekurapa.
Kuvhiya
Kana gomarara risati rapararira kune dzimwe nzvimbo, danho rekutanga kubvisa gomarara kuburikidza nekuvhiyiwa. Rudzi rwekuvhiyiwa runogona kusiyana zvichienderana nehukuru hwegomarara.
Mishonga
Apa ndipo panonyanya kukosha kenza yeMSI-H.
- Kurapa nekudzivirira chirwere chegomarara: Uku ndiko kurapa kwakakosha uye kunobudirira kwegomarara reMSI-H.Funga nezvemasero edu ekudzivirira muviri seane switch yekuti 'on'/'off'. Dzimwe nguva masero ekenza anodzima switch iyi nekuchenjera obva ahwanda kubva padziviriro yemuviri wedu. Mishonga yekudzivirira muviri (checkpoint inhibitors) inodzima switch iyoyo, zvichibatsira masoja emuviri kuwana nekuparadza masero ekenza.
- Kurapa nemakemikari: Kupa mishonga ine simba yekuuraya masero ekenza. Dzimwe nguva inoshandiswa usati wavhiyiwa kana kuti mushure mekuvhiyiwa.
- Kurapa Kwakanangana: Kupa mishonga inonanga nekumisa mapuroteni chaiwo kana maitiro anobatsira masero ekenza kukura.
Kurarama negomarara reMSI-H
Zvakakosha zvikuru kuchengetedza hutano hwakanaka hwemuviri nepfungwa panguva yekurapwa kwegomarara.
- Kudya: Mushure mekuvhiyiwa, tevera mirairo yachiremba wako uye idya chikafu chinogayiwa zviri nyore uye chine mapuroteni akawanda. Zvakanakisisa kuderedza kudya chikafu chinogadzira gasi (semuenzaniso, kabichi, bhinzi) nenyama dzakagadzirwa.
- Kurovedza muviri: Kurovedza muviri kuri nyore sekufamba netsoka zvakanyanya kunogona kubatsira zvikuru muviri wako nepfungwa dzako. Asi bvunza chiremba wako usati watanga chero chirongwa chekurovedza muviri.
- Hutano hwepfungwa: Zvakajairika kunzwa kunetseka uye kutya munguva dzakadai. Usavhare manzwiro ako. Taura nemumwe munhu waunovimba naye, kusanganisira nhengo dzemhuri. Tsvaga rubatsiro kubva kumupi wezano wehutano hwepfungwa kana zvichidikanwa.
Kenza yeMSI-H ine mwero wepamusoro wekurapa kana tichienzanisa nedzimwe mhando dzekenza yemuura, kunyanya kana ikaonekwa nekukurumidza, uye kurapwa kwakadai sekurapa nekudzivirira muviri kunogona kupa mhedzisiro yakanaka kwazvo.
Mharidzo Yekuenda Nayo Kumba
- MSI-H imhando chaiyo yegomarara remuura umo masero egomarara ane dambudziko muDNA repair system yavo (MMR).
- Nekuda kwe "kusagadzikana" uku, magomarara aya anopindura zvakanaka pakurapa nekudzivirira muviri.
- Kana uine zviratidzo zvine chekuita nekenza yemuura (kuchinja kwetsvina, kurwadziwa mudumbu, kubuda ropa), usazviregeredza uye enda kuna chiremba wako nekukasika.
- Gomarara reMSI-H rine mukana mukuru wekurapwa kana rikaonekwa nekukasika. Saka, zvakakosha kuti musavhunduke uye musatsvage mazano akakodzera ekurapa.
💬 Comments (0)
Hapana zvakataurwa parizvino. Isa mhinduro yako pano kekutanga.
Wedzera zvaunofunga