Ngaba wakha weva ngohlobo lomhlaza wesisu oluzuzwa njengelifa? (Umhlaza Wesisu Osasazekileyo Obangelwa Yimfuza - HDGC) Masithethe ngale nto!

Namhlanje siza kuthetha ngesimo esinzima abantu abaninzi abangasaziyo. Olu luhlobo lomhlaza wesisu oludluliselwa kwilifa. Oogqirha balubiza ngokuba yi -'(Heroditary Diffuse Gastric Cancer)' okanye `(HDGC)` ngamafutshane. Ukuba kukho umntu kusapho lwakho oye waba nale meko, okanye ukuba ufuna ukwazi okungakumbi ngayo, eli nqaku liza kuba baluleke kakhulu kuwe. Ungakhathazeki, masithethe ngayo ngokulula.

Yintoni le `(HDGC)`?

Ngamafutshane, i-HDGC yimeko yomngcipheko womhlaza wesisu. Oku kuthetha ukuba umngcipheko wakho wokufumana umhlaza wesisu (umhlaza wesisu) ubomi bakho bonke uyanda malunga nama-70%. Akuphelelanga apho, abafazi abafumana esi sifo bakwanayo nengozi eyonyukileyo yama-42% yokufumana uhlobo oluthile lomhlaza webele , iLobular Breast Cancer (LBC) .

Abantu abanesi simo `(HDGC)` bazuza ilifa le-gene eguquliweyo (`(i-gene eguquliweyo)`) komnye wabazali babo. Ngokuqhelekileyo, le yi-gene ebizwa ngokuba yi -`(CDH1)` . Kodwa ngamanye amaxesha ezinye ii-genes zinokubandakanyeka. `(CDH1)` yi-gene ethintela i-tumor (`(i-tumor ethintela i-tumor)`). Xa oku kuguqulwa, akusebenzi kakuhle ukulawula umhlaza. Cinga ngayo, le gene ifana nepolisa emzimbeni wethu elithintela iiseli zomhlaza ukuba zingakhuli. Ngoko ke kwenzeka ntoni ukuba elo polisa liba buthathaka? Yiloo nto eyenzekayo nalapha.

Yintoni umhlaza wesisu "osasazekileyo"?

Ngoku masibone ukuba yintoni le `(umhlaza wesisu osasazekayo)`. Olu luhlobo lomhlaza wesisu. Kodwa endaweni yokuba ukhulele kwenye indawo njengezinye iintlobo zomhlaza, lo usasazeka kudonga lwesisu ngamaqoqo amancinci eeseli. Kufana nokuvuza kwamanzi okusasazeka eludongeni. Ngenxa yoku, udonga lwesisu luyaqina kwaye luqine. Kancinci kancinci, lusasazeka luye kwiindawo ezinzulu zodonga lwesisu.

Olu hlobo lomhlaza wesisu kunzima ukulufumanisa kuba alubonakali ngokucacileyo kwiimvavanyo eziqhelekileyo zomfanekiso. Kwakhona, iimpawu zihlala zibonakala kuphela emva kokuba isifo sisasazekile, kumanqanaba okugqibela. Ngelo xesha, umhlaza usenokuba usasazeke (ususele kwi-metastasized) ngodonga lwesisu ukuya kwizicubu ezikufutshane, njengesibindi okanye amathambo.

Ixhaphake kangakanani le meko?

Xa sithetha ngemeko ethi `(HDGC)`, kuqikelelwa ukuba malunga nabantu abahlanu ukuya kwabalishumi kwabalishumi lamawaka banokuyifumana le meko xa bezalwa. Malunga nama-20% azo zonke iintlobo zomhlaza wesisu ziluhlobo lwe `(diffuse)`. Malunga nama-2% ezo ntlobo zomhlaza zisasazekayo zifuzo `(HDGC). Nangona umhlaza wesisu uqheleke kakhulu kumazwe aseAsia kunakumazwe aseNtshona, le meko `(HDGC)` ixelwa rhoqo kumazwe aseNtshona.

Zithini iimpawu zemeko ye-`(HDGC)`?

Njengoko besitshilo ngaphambili, iimpawu zolu hlobo lomhlaza wesisu osasazekayo zisenokungabonakali de isifo sisasazeke (i-metastasized). Yiyo loo nto kubalulekile ukuqaphela umngcipheko wokuba esi sifo sinokusasazeka kwiintsapho. Kwi-HDGC, umhlaza ukhula usemncinci kancinci kunakweminye imidlaza. Uninzi lwabantu lufunyaniswa lunaso ngaphambi kokuba lufikelele kwiminyaka engama-40.

Iimpawu eziphambili zinokuba zezi:

• Intlungu yesisu (ingakumbi kwinxalenye ephezulu yasekhohlo yesisu)
• Ukudumba kwesisu, ukurhawuzelela
• Isicaphucaphu nokuhlanza
• Umnqweno wokutya
• Ukuhla ukusinda
• Ukudinwa kakhulu, ukudinwa
• Ubunzima bokuginya ukutya
• Igazi elikwindle (`(Igazi elikwindle)`)
• Ukuhlanza igazi (`(Ukuhlanza igazi)`)
• I-Jaundice (ukutyheli kwamehlo nolusu)

Ngamanye amaxesha, isiphene sokuzalwa esibizwa ngokuba yi-cleft lip okanye i-cleft palate sinokuba luphawu lokuqala lwesi sifo. Oku kungenxa yokuba olu tshintsho lwemfuza lunokubangela esi siphene sokuzalwa. Nangona kunjalo, uninzi lwexesha, i-cleft lip ayinxulumananga ne-HDGC. Nangona kunjalo, ukuba wazalwa unesiphene sokuzalwa esinjalo kwaye umntu kusapho lwakho ebenale ntlobo yomhlaza, usenokuba nomdla wokukrokra kancinci.

Yintoni isizathu sokwenziwa kwale `(HDGC)`?

I-HDGC sisifo semfuza . Kwenzeka xa utshintsho kwenye yezakhi zofuzo ezithintela ithumba esithethe ngazo ngaphambili lutshintsha inkqubo kwi-DNA yakho. Izakhi zofuzo ezithintela ithumba zixelela iiseli ukuba zilawule ukwahlukana nokukhula kweeseli. Ngoko ke xa ezi zakhi zofuzo zingasebenzi kakuhle, umhlaza unokuvela.

Ufumana eli jini liguquliweyo kumama wakho okanye kutata wakho. Utshintsho oluzuzwe ngolu hlobo lubizwa ngokuba yi-germline mutation . Luchaphazela ikhowudi yejini yeeseli zakho zokuzala.

Le `(HDGC)` izuzwe njani njengelifa?

I-HDGC yimeko elawulayo ye-autosomal . Oku kuthetha ukuba udinga ikopi enye yejini eguquliweyo ukuze ufumane i-syndrome. Ingafunyanwa kumama wakho okanye kutata wakho. Ukuba omnye wabazali bakho une-mutation, wena okanye abantakwenu ninethuba lama-50% lokuyifumana njengelifa. Cinga ngayo njengethuba lokuba ingqekembe ivele iintloko okanye imisila.

Ngaba wonke umntu ozuze ilifa lokuguqulwa kwezakhi zofuzo uba nomhlaza?

Hayi. Utshintsho lwemfuza oluvela kubazali bakho luchaphazela ikopi enye kuphela yemfuza ethintela umhlaza kwiseli nganye. Kodwa iseli nganye ineekopi ezimbini zale mfuza, enye evela kumama wakho nenye evela kutata wakho. Ngoko ke nokuba awuzuzisi tshintsho olufanayo kubazali bobabini, usenayo ikopi yemfuza esebenza ngokuqhelekileyo.

Ukuze umhlaza ukhule, kuza kubakho utshintsho lwesibini (`(uguquko lwe-somatic)`)Kufuneka kwenzeke kwizicubu apho umhlaza uvela khona (oko kukuthi, ulwelo lwesisu okanye ii-lobules zebele) ngexesha lobomi bakho. Olu tshintsho lwesibini lukwacima enye ikopi yejini. Kulapho umhlaza uqala ukukhula khona.

Yintoni unobangela wolu tshintsho lwesibini?

Ukuba sithetha inyani, asazi isizathu esichanekileyo soku. Kodwa izinto ezahlukeneyo zinokudlala indima. Ukuvezwa kwendalo kudla ngokuba nendima "ekubangeleni" izifo zemfuza. Ezinye iimfuza nazo zinokuba negalelo. Ezinye iintsapho ezinemfuza ye-HDGC zinokwanda komhlaza kunezinye.

Ezinye izinto ezibangela umngcipheko kwindalo ezibangela umhlaza wesisu zezi:

• Ukutshaya
• Ukusetyenziswa kotywala ngokugqithisileyo
• Ukutya inyama ebomvu kakhulu (njengenyama yenkomo, yegusha)
• (H. pylori) usulelo (le yintsholongwane ebangela izilonda zesisu)

Injani inkqubo yokuvavanya i-`(HDGC)`?

Nokuba awukabi nazo iimpawu okwangoku, ukuba kukho isizathu sokucinga ukuba usemngciphekweni (umzekelo, ukuba umntu kusapho lwakho ukhe waba nezi ntlobo zomhlaza, okanye ukuba ukhe wenza uvavanyo lwemfuza olufumene utshintsho kwi-`(CDH1)` gene), ugqirha unokukuthumela ukuze uvavanyelwe i-`(HDGC)`.

Ugqirha wakho uza kubala umngcipheko wakho ngokusekelwe kwimbali yosapho lwakho kunye/okanye kwiziphumo zovavanyo lwemfuza. Basenokukhangela nezinto ezibangela umhlaza kwizicubu zakho. Umzekelo, banokukhangela imeko ebizwa ngokuba yiLobular Carcinoma In Situ (LCIS) kwiiseli zebele okanye uhlobo lwendandatho yesandla kwingaphakathi lesisu. Ezi ziinguqu zakuqala ezinokuba ngumhlaza.

Ifunyaniswa njani i-HDGC?

Ukuba uneempawu zomhlaza wesisu osasazekayo, ugqirha wakho uza kukhangela ubungqina bomhlaza eludongeni lwesisu sakho. Baza kuthatha iisampuli zezicubu baze bazihlole phantsi kwe-microscope. Ukuba ufunyenwe umhlaza wesisu osasazekayo, kwaye ukuba kukho umntu kusapho lwakho okhe waba nolu hlobo lomhlaza, ugqirha wakho unokucebisa ukuba wenze uvavanyo lwemfuza .

Okwangoku, malunga nama-40% ezigulana ezine-HDGC zifunyenwe zine-mutation ye-CDH1. Ezinye ii-mutations zinokuba zibandakanyeka, kodwa i-CDH1 yeyona iphambili esiyaziyo nesinokuyichonga. Ukuba unayo, yindlela eqinisekileyo yokuxilonga i-HDGC. Nangona kunjalo, ukuba unembali yosapho lwakho yolu hlobo lomhlaza wesisu osasazekayo, unokufunyanwa une-HDGC nokuba awunayo i-mutation ye-CDH1.

Zeziphi iimvavanyo ezisetyenziselwa ukuxilonga `(HDGC)`?

Ezi mvavanyo zingenziwa ukuze kufunyaniswe isifo:

• Uvavanyo lwemfuza:Olu luvavanyo lwegazi. Isampulu yegazi lakho iyathathwa ize ihlolwe ukuze kubonwe ukuba kukho na utshintsho lwezakhi zofuzo oluhambelana nezifo zezakhi zofuzo. Abanye abantu bafumana olu vavanyo kuba benembali yezakhi zofuzo kusapho lwabo. Abanye bafumana olu hlobo lovavanyo lwezakhi zofuzo kuba bengayazi imbali yempilo yentsapho yabo, ukuze bafumane ulwazi lwabo, okanye kuba beceba ukuba nabantwana.
• I-endoscopy ephezulu (uvavanyo lwe-EGD): Olu luvavanyo lokujonga ngaphakathi kwendlela yakho ephezulu yesisu (oko kukuthi, umphimbo, isisu) kunye nokuthatha iisampuli zezicubu. Oku kubalulekile ekuxilongeni umhlaza wesisu, ingakumbi olu hlobo lomhlaza olusasazekileyo. Ingcali yesifo sesisu (ugqirha ogxile kwizifo zesisu) wenza oku. Ufaka ityhubhu ende (i-endoscope) enekhamera encinci ngomlomo wakho aze ehle aye esiswini sakho. Iisampuli zezicubu nazo zinokuthathwa ngetyhubhu. Nangona kunjalo, nangona kunjalo, nangona kukho ezi ndlela, kunokuba nzima ukufumana umhlaza wesisu osasazekayo. Ngenxa yokuba usasazeke kakhulu, ugqirha usenokungakwazi ukuwubona okanye ukuwufumana kwiisampuli zezicubu. Ke ngoko, ugqirha okhangela olu hlobo lomhlaza kufuneka abe noqeqesho olukhethekileyo kunye namava.
• I-MRI yamabele: Ngenxa yokuba umhlaza wamabele we-lobular awubonwa nge-mammogram eqhelekileyo, oogqirha bacebisa i-MRI. Ukuba i-MRI ibonisa into engaqhelekanga, iyaphawulwa kwaye omnye ugqirha uthatha isampuli yezicubu.
• I-Biopsy: Ugqirha uthatha isampuli yezicubu aze azithumele kwilebhu ukuze zihlolwe phantsi kwe-microscope. Le biopsy inokuqinisekisa ukuba isampuli yezicubu inazo na iiseli zomhlaza.

Kwenzeka ntoni emva kokuba ichongiwe njenge-`(HDGC)`?

Ukuba sele unomhlaza, ugqirha wakho uza kuthetha nawe malunga neendlela zonyango. Nokuba awukabi nawo umhlaza, ukuba unale sifo, ugqirha wakho uya kucebisa ukuba uhlolwe rhoqo umhlaza, njengoko kukhankanyiwe apha ngasentla. Utyando lokuthintela lolunye ukhetho onokuthetha ngalo nogqirha wakho.

Unyangwa njani umhlaza wesisu osasazekayo?

Utyando ludla ngokuba lolona nyango lokuqala lomhlaza olunokususwa ngotyando. Ukuba une-HDGC, ugqirha wakho uya kucebisa ukuba utyando lwesisu lugqitywe ngokupheleleyo . Oku kungenxa yokuba i-HDGC inomngcipheko omkhulu wokusasazeka kude ngaphambi kokuba ifunyanwe.

Kwi-gastrectomy epheleleyo, ugqirha otyandayo ususa isisu sakho sonke aze adibanise isiphelo somqala wakho ngqo kumathumbu akho amancinci. Kunokwenzeka ukuba uphile ngaphandle kwesisu, kodwa kukho iziphumo ebezingalindelekanga. Emva kotyando, unokufumana unyango olongezelelweyo (unyango oluncedisayo) olufana nonyango lwemitha okanye i-chemotherapy.

Ngenxa yokuba abafazi abane-`(HDGC)` nabo basengozini yokuba nomhlaza webele we-lobular (`(LBC)`), kufuneka bahlale beqaphela iimpawu ze-`(LBC)` ngexesha lonyango. Ukuba une-`(LBC)`, unyango ludla ngokuqala ngotyando lomhlaza webele. Emva koko kunikwa unyango olongezelelweyo.

Ingakanani ixesha lokuphila xa unemeko ye-`(HDGC)`?

Ulindelo lobomi luxhomekeke ekufumaneni nasekunyangeni umhlaza kwangethuba. Nokuba kuhlolwe rhoqo, oku kunokuba nzima. Ukuba umhlaza wesisu osasazekayo ufunyenwe kwaye unyangwa kwangethuba, izinga lokusinda leminyaka emihlanu lingaphezulu kwama-90%. Nangona kunjalo, ukuba ufunyenwe emva kwexesha, emva kokuba ungenele udonga lwesisu, izinga liyehla liye ngaphantsi kwama-30%.

Yiyo loo nto sithi kubaluleke kakhulu ukuba nolwazi ngembali yosapho lwakho kwaye ufune iingcebiso zonyango ukuba usengozini.

Ngaba ikho indlela yokuthintela `(HDGC)`?

Ukuba une-`(CDH1)` ye-gene mutation (enxulunyaniswa nomngcipheko ophezulu wokuba nomhlaza), kukho amanyathelo okuthintela aliqela onokuwathatha. Kubantu abangenalo olu tshintsho lwe-gene, iingozi kunye namanyathelo achazwe ngokucacileyo. Ungathetha nogqirha wakho malunga neengozi zakho kunye neendlela onokukhetha kuzo.

Utyando lokuthintela

Ukuba ubukhe wafunyaniswa une-HDGC ubuncinane iminyaka engama-20 kwaye awunazo ezinye iingxaki ezinkulu zempilo, ugqirha wakho unokucebisa ukuba utyando lwe-total gastrectomy luthintelwe . Nangona ukulahlekelwa sisisu kunokuba nemiphumo ethile kwinkqubo yakho yokugaya ukutya, ezi ziphumo bezingalindelekanga kulula ukuzilawula kunokujongana nomhlaza wesisu oqhubekileyo.

Kwabo bangekakulungeli ukuthatha la manyathelo, indlela "yokulinda nokubukela" inokusetyenziswa, equka i-endoscopy yamathumbu aphezulu rhoqo kunye neesampuli ze-biopsy ezingacwangciswanga. Nangona kunjalo, nangona kujongwa ngokusondeleyo, i-HDGC isenokungabonwa rhoqo kwangethuba (xa unyango lusebenza kakhulu).

Iziphumo ebezingalindelekanga zokususwa kwesisu ngokupheleleyo:

• I-Dumping syndrome: Xa ukutya kudlula ngqo kwi-esophagus ukuya kwi-small intestine, kudlula kwi-small intestine ngokukhawuleza kunesiqhelo. Oku kunokubangela utshintsho olukhulu kwii-hormones kwinkqubo yokugaya ukutya, okukhokelela kwiimpawu ezifana nokucaphuka, urhudo, kunye neswekile ephantsi yegazi. Ezi mpawu zinokulawulwa ngokutshintsha indlela otya ngayo. Ezi mpawu ziya kuphela ngokuhamba kwexesha.
• Ukungafunxwa kokutya kunye nokungondleki kakuhle: Xa isisu sisusiwe, inxalenye yesisu equlethe ii-asidi kunye nee-enzymes ezinceda ekugayweni kokutya iyalahleka. Oku kunokuthintela ukutya ukuba kungaphuki kakuhle kwaye kuthintele umzimba ekufunxeni izondlo. Oku kunokukhokelela ekungondlekini kakuhle. Oku kungancedwa ngokutshintsha indlela otya ngayo kunye nokuthatha izongezo zesondlo.

Ingcebiso ngemfuza kunye nocwangciso losapho

Kubantu abane-CDH1 gene mutation, ingcebiso nge-genetic inokuba luncedo kakhulu ekuxoxeni ngocwangciso losapho. Oku kunokukunceda uqonde umngcipheko wokuba umntwana wakho afumane i-HDGC njengelifa. Ukuba uceba ukuba nabantwana, enye indlela yokulawula loo mngcipheko kukukhetha i-In Vitro Fertilization (IVF) .

Kwi-IVF, amaqanda kunye nesidoda zithathwa kumama notata zize zivundiswe kwilebhu. Emva kokuba iimbumba zikhule, iseli enye kwimbumba nganye ingathathwa ize ivavanywe ukuba ayinayo na i-CDH1 mutation. Abazali banokukhetha iimbumba ezingenayo le nguqu baze bazifake kwisibeleko sikamama.

Okokugqibela, yintoni ekufuneka uyikhumbule

Ukufumanisa ukuba uneHereditary Diffuse Gastric Cancer Syndrome (HDGC) kunokuba ngamava achukumisayo kakhulu, kwaye kusenokufuneka wenze izigqibo ezinkulu. Ezi zinokukuchaphazela wena nosapho lwakho. Zinike ixesha lokucinga ngezinto ngaphandle kokukhathazeka. Buza imibuzo emininzi kangangoko ufuna. Iqela lakho lezonyango lilapha ukukunceda ufumane eyona ndlela ilungileyo yokuhamba kolu hambo. Khumbula, ukuqonda linyathelo lokuqala. Awuwedwa.

I- HDGC, umhlaza wofuzo, umhlaza wesisu, i-CDH1 gene, umhlaza wesisu, umhlaza webele, uvavanyo lwemfuza, i-endoscopy, i-gastrectomy, uthintelo lomhlaza