Ngaba ukhe waphawula utshintsho kwindlela oziphatha ngayo amathumbu akho, iintlungu zesisu, okanye igazi eliphuma esitulweni sakho kutshanje? Musa ukuzityeshela ezi mpawu, ucinga ukuba ziqhelekile. Zisenokuba ziimpawu zomhlaza wamathumbu amakhulu. Namhlanje, sithetha ngohlobo lomhlaza wamathumbu amakhulu olukhethekileyo kancinci, kodwa olunethamsanqa elincinci. Lubizwa ngokuba yi-MSI-H.
Kalula nje, yintoni le mhlaza wamathumbu amakhulu i-MSI-H?
Ukuze siqonde oku, masiqale sijonge i-DNA engaphakathi kwiiseli zomzimba wethu. Cinga nge-DNA yethu njengekhonkco elide. Eli khonkco lineentsimbi zohlobo olufanayo ezinamathele kulo ngokuphindaphindiweyo. Ezi nxalenye ze-DNA eziphindaphindwayo zibizwa ngokuba zii-microsatellites.
Ngoku, xa iiseli zomzimba wethu zahlukana kwaye kwakheka iiseli ezintsha, kwenziwa iikopi zale khonkco le-DNA. Ngamanye amaxesha iimpazamo (iinguqu) zinokwenzeka xa kwenziwa ezi kopi. Kodwa ungakhathazeki, umzimba wethu unenkqubo efana 'nepolisa elifumana iimpazamo'. Ibizwa ngokuba yinkqubo yokulungisa i-Mismatch (MMR) . Ijonga iimpazamo kwezo kopi ze-DNA kwaye izilungise ngoko nangoko.
Nangona kunjalo, kwezinye iiseli zomhlaza, le nkqubo ye-MMR ayisebenzi kakuhle. Siyibiza ngokuba yi-dMMR (ukulungiswa kwe-DNA Mismatch engafanelekanga). Emva koko, ngenxa yokuba akukho mntu wokulungisa iimpazamo kwezo kopi ze-DNA, iimpazamo ziyaqokelelana kwaye i-DNA iba yinto engazinzile kakhulu. Leyo yimeko ene-microsatellites ezingazinzanga kakhulu, esiyibiza ngokuba yi-MSI-H (Microsatellite Instability-High) .
Okumangalisayo kukuba, oku "kungazinzi" kwe-DNA ngamanye amaxesha kuyinto elungileyo. Umhlaza we-MSI-H usabela ngcono kunyango olubizwa ngokuba yi -immunotherapy kunezinye iintlobo zomhlaza. Ukongeza, umbono wabo ulungile.
Ziziphi iimpawu ezinokubakho zomhlaza we-MSI-H?
Iimpawu zisenokungabonakali rhoqo, kodwa ukuba ziyabonakala, ziyafana nezo zomhlaza wamathumbu aqhelekileyo.
| Udidi lweempawu | Izinto onokuzibona |
|---|---|
| Utshintsho kwiintshukumo zamathumbu | Urhudo, ukuqhinwa, okanye ukuziva ugcwele emva kokuphuma kwesisu. |
| Igazi esitulweni | Indle emnyama okanye emnyama, okanye ukopha okuphuma kwi-rectum. |
| Ukungonwabi kwesisu | Intlungu yesisu, ukudumba. |
| Ezinye iimpawu zomzimba | Ukudinwa okungachazekiyo, ukwehla kobunzima, ukungabi namdla wokutya. |
Kubalulekile: Asinguye wonke umntu onezi mpawu onomhlaza. Nangona kunjalo , ukuba unegazi esitulweni sakho okanye isisu sakho sibuhlungu kakhulu, bona ugqirha ngokukhawuleza. Ukuba ezinye iimpawu ziyaqhubeka kangangeeveki ezingaphezu kwezimbini, ngokuqinisekileyo kuya kufuneka ufune ingcebiso kagqirha.
Ngamanye amaxesha, uphawu lokuqala lwalo mhlaza luvavanyo lwegazi olubonisa ukuba inani leeseli ezibomvu zegazi liphantsi (i-anemia). Oku kungenxa yokopha emathunjini.
Izizathu kunye nemingcipheko yokuphuhlisa umhlaza we-MSI-H
Eyona nto iphambili ebangela umhlaza we-MSI-H ziziphene kwiijini ze-MMR esithethe ngazo ngaphambili. Ezi zidla ngokuvela ngexesha lobomi bomntu, ngaphandle kwesizathu esithile.
Kodwa malunga ne-5% yabantu abafumana umhlaza wamathumbu amakhulu, esi siphene semfuza sidluliselwa kwizizukulwana ngezizukulwana. Sibiza esi sifo ngokuba yiLynch syndrome . Ukuba kukho umntu kusapho lwakho onale meko, nawe usengozini enkulu yokuba nomhlaza wamathumbu amakhulu.
Ukongeza, kukho izinto kwindlela esiphila ngayo ezinyusa umngcipheko wokuba nomhlaza.
| Izinto ezinobungozi esingenakuzilawula | Izinto ezinobungozi esinokuzilawula |
|---|---|
| Ukuba neminyaka engaphezu kwama-50 ubudala | Ukutyeba kakhulu |
| Ukuba nembali yosapho yomhlaza wamathumbu amakhulu | Uhlobo lwesibini lweswekile |
| Izifo ezidluliselwa kwilifa ezifana neLynch syndrome | Ukutshaya |
| Ukuba nezifo ezifana nesifo sikaCrohn | Ukusela utywala ngokugqithisileyo |
| Ukuba neepolyps kwikholoni | Ukutya inyama ebomvu kakhulu kunye nenyama ecutshungulweyo |
Indlela yokuxilonga esi sifo?
Ukuba ugqirha wakho urhanela ukuba unomhlaza ngokusekelwe kwiimpawu zakho, uza kukuthumela kwiimvavanyo ezininzi.
1. I-Colonoscopy: Ityhubhu eguquguqukayo enekhamera eqhotyoshelweyo ifakwa nge-anus ukuze kuhlolwe lonke ikholoni. Ngeli xesha, iqhekeza elincinci lesicwili lithathwa kwindawo erhanelekayo ukuze lihlolwe. Oku kubizwa ngokuba yi-biopsy .
2. Uvavanyo lweemolekyuli: Uvavanyo olukhethekileyo lwenziwa ukuze kufunyanwe utshintsho lwemfuza, oko kukuthi imeko ye-MSI-H, kwisampuli yezicubu ethathwe kwi-biopsy. Ubuchwepheshe obufana ne -IHC , i-PCR , kunye ne-NGS busetyenziselwa oku.
3. Uvavanyo lwemifanekiso: Iiskeni ezifana ne-CT kunye ne-MRI zenziwa ukuze kubonwe ukuba umhlaza usasazeke na kwamanye amalungu omzimba.
Ziziphi iindlela zonyango lomhlaza we-MSI-H?
Unyango luxhomekeke kwinqanaba lomhlaza kunye nokuba usasazeke kangakanani. Kukho iindlela ezimbini eziphambili zonyango.
Utyando
Ukuba umhlaza awukasasazeka kwezinye iindawo, inyathelo lokuqala kukususa ithumba ngotyando. Uhlobo lotyando lunokwahluka ngokuxhomekeke kubukhulu bomhlaza.
Amayeza
Kulapho ke ukuchazwa ngqo komhlaza we-MSI-H kuqala khona.
- Unyango lwe-Immunotherapy: Olu lolona nyango lubalulekileyo noluphumeleleyo lomhlaza we-MSI-H.Cinga ngeeseli zethu zomzimba ezikhusela umzimba njengeswitshi 'yokuvula'/'yokucima'. Iiseli zomhlaza ngamanye amaxesha ziyayicima le switshi ngobuchule kwaye zifihle kwizokhuselo zomzimba wethu. Amayeza e-immunotherapy (i-checkpoint inhibitors) ayayicima kwakhona loo switshi 'yokucima', enceda inkqubo yomzimba yokuzikhusela ukuba ifumane kwaye itshabalalise iiseli zomhlaza.
- Unyango lweKhemotherapy: Ukunika amayeza anamandla okubulala iiseli zomhlaza. Ngamanye amaxesha asetyenziswa ngaphambi okanye emva kotyando.
- Unyango olujoliswe kulo: Ukunika amayeza ajolise kwaye ayeke iiproteni okanye iinkqubo ezithile ezinceda iiseli zomhlaza zikhule.
Ukuphila nomhlaza we-MSI-H
Kubaluleke kakhulu ukugcina impilo entle yomzimba nengqondo ngexesha lonyango lomhlaza.
- Ukutya: Emva kotyando, landela imiyalelo kagqirha wakho kwaye utye ukutya okulula ukugaywa kwaye okuneproteni eninzi. Kungcono ukunciphisa ukutya okuvelisa igesi (umz. ikhaphetshu, iimbotyi) kunye nenyama ecutshungulweyo.
- Ukuzilolonga: Ukuzilolonga okulula njengokuhamba kangangoko unako kunokuba luncedo kakhulu emzimbeni nasengqondweni yakho. Kodwa qhagamshelana nogqirha wakho ngaphambi kokuba uqalise naluphi na uhlobo lokuzilolonga.
- Impilo yengqondo: Kuqhelekile ukuba nexhala kwaye uloyiko ngamaxesha anje. Musa ukugcina iimvakalelo zakho zivaliwe. Thetha nomntu omthembayo, kuquka amalungu osapho. Funa uncedo kumcebisi wezempilo yengqondo ukuba kuyimfuneko.
Umhlaza we-MSI-H unezinga eliphezulu lokunyanga xa kuthelekiswa nezinye iintlobo zomhlaza wamathumbu amakhulu, ingakumbi ukuba ufunyenwe kwangethuba, kwaye unyango olufana nonyango lwe-immunotherapy lunokuvelisa iziphumo ezilungileyo kakhulu.
Umyalezo Wokuya Ekhaya
- I-MSI-H luhlobo oluthile lomhlaza wamathumbu amakhulu apho iiseli zomhlaza zinesiphako kwinkqubo yazo yokulungisa i-DNA (MMR).
- Ngenxa yoku "ngazinzi", ezi cancer zisabela kakuhle kakhulu kwi-immunotherapy.
- Ukuba uneempawu ezinxulumene nomhlaza wamathumbu amakhulu (utshintsho kwindle, iintlungu zesisu, ukopha), musa ukuzityeshela kwaye bonana nogqirha wakho ngoko nangoko.
- Umhlaza we-MSI-H unethuba eliphezulu lokunyangwa ukuba ufunyenwe kwangethuba. Ke ngoko, kubalulekile ukuba ungoyiki kwaye ufune iingcebiso zonyango ezifanelekileyo kunye nonyango.
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