Abantu abaningi bayesaba uma bezwa igama elithi "biopsy," akunjalo? Kuvamile ukuzizwa wesaba kancane uma bezwa igama elithi "biopsy." Kodwa cabanga ukuthi ngabe ikhona indlela yokuthola ulwazi ngamaseli omdlavuza ngokuthatha nje iconsi legazi lakho? Yilokho esikubiza ngokuthi lobu buchwepheshe obumangalisayo, obusezingeni eliphezulu, "Liquid Biopsy." Lokhu kulethe ithemba elikhulu kulabo abalwa nomdlavuza.
Kalula nje, iyini le Liquid Biopsy?
I-Liquid Biopsy ukuhlolwa kwegazi okukhethekile okusetshenziselwa ukuthola izimila. Cabanga ukuthi lapho isimila sikhula emzimbeni wethu, izingcezu ezincane zesimila ziyaqhekeka zingene egazini. Njengezingcezu zeplasta eziwela odongeni oludala. Singathola izingcezu zomdlavuza ezingena egazini ngalolu vivinyo lwe-Liquid Biopsy.
Kunezinto ezimbili eziyinhloko ezingaba khona egazini:
- Amaseli esimila ajikelezayo (ama-CTC): Lawa amangqamuzana omdlavuza aphelele aphumile esimila futhi ahamba emzimbeni wonke ngegazi.
- I-DNA yesimila esijikelezayo (ctDNA): Lezi yizingcezu ezincane zolwazi lwezakhi zofuzo (i-DNA) ngaphakathi kwamangqamuzana omdlavuza. I-DNA ifana "nohlelo" oluqukethe yonke imiyalelo iseli eliyidingayo ukuze lisebenze. Lapho amangqamuzana omdlavuza efa, lezi zingcezu ze-DNA ziyaqongelela egazini.
Ukuba nala ma-CTC noma i-ctDNA egazini lakho kuyisibonakaliso esihle sokuthi kukhona umdlavuza endaweni ethile emzimbeni wakho. Futhi, lezi zingcezu zolwazi zingasinika ukuqonda okukhulu ngolwazi lwezakhi zofuzo lomdlavuza. Esebenzisa lolo lwazi, udokotela wakho angakusiza ukuthi unqume ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.
Lokhu kusese ubuchwepheshe obusha kakhulu, kodwa ososayensi bakholelwa ukuthi bungashintsha ukwelashwa komdlavuza. Sekuvele kunezilingo eziningana ezivunyelwe yizikhungo ezifana ne-US Food and Drug Administration (FDA).
Lokhu kuhluke kanjani ku-biopsy evamile?
Kunomehluko omkhulu phakathi kwalokhu okubili. Ku-biopsy evamile, isampula yezicubu ithathwa ngqo esigaxeni somdlavuza bese ihlolwa. Kodwa-ke, ku-biopsy yoketshezi, isampula ayithathwa esigaxeni. Kunalokho, ibheka ubufakazi bomdlavuza (amangqamuzana omdlavuza noma izingcezu ze-DNA) egazini.
Ake sibheke leli thebula ukuze sicacise kabanzi umehluko phakathi kwalokhu okubili.
| Isici | Ukuhlolwa Kwegazi Okuwuketshezi | Ukuhlolwa Kwegazi Kwendabuko |
|---|---|---|
| Indlela yokukwenza | Kulula kakhulu. Ngokuvamile kuthathwa igazi elincane kuphela. | Ngezinye izikhathi kwenziwa ukuhlinzwa okuncane ukuze kususwe ingcezu yezicubu esimila somdlavuza. |
| Ubuhlungu kanye nengozi | Kukhona ubuhlungu obuncane obuvela enalitini. Ingozi iphansi kakhulu. | Kungaba buhlungu. Kufanele unikezwe i-anesthesia. Kungaba nezingozi ezifana nokutheleleka. |
| Okufanele ukuthole | Izingcezu zamaseli omdlavuza (ama-CTC) kanye ne-DNA yomdlavuza (ama-ctDNA) egazini. | Amaseli esimila somdlavuza ngokwawo ahlolwa ngqo. |
| Ukusetshenziswa okuyinhloko | Bona ukuthi isiguli sisabela kanjani ekwelashweni bese ukhetha ukwelashwa okufanele kakhulu. | Okokuqala, qinisekisa ukuthi ukhona yini umdlavuza noma cha. |
Kodwa kubalulekile ukukhumbula lokhu: Indlela ejwayelekile nengcono kakhulu emhlabeni yokuqinisekisa ngokunembile ukuthi umdlavuza ukhona noma cha yi-biopsy yendabuko.
Ku-biopsy yolwelo, kunethuba elincane lokuthi noma ngabe kukhona umdlavuza emzimbeni, isampula yegazi elithathwe ngaleso sikhathi ngeke libe namaseli omdlavuza. Kodwa-ke, uma umdlavuza utholakala, ulwazi olunikezayo lubaluleke kakhulu ekuhleleni ukwelashwa.
Kukuziphi izimo lapho kwenziwa khona i-liquid biopsy?
Udokotela uvame ukuncoma lokhu kuhlolwa kweziguli ezinomdlavuza osuthuthuke kakhulu futhi osusakazekele kwezinye izingxenye zomzimba (umdlavuza osakazekile). Lokhu kubasiza ukuthi banqume ukuthi benzeni ngokulandelayo, ikakhulukazi uma ukwelashwa kwamanje kungasebenzi kahle.
Kunezizathu eziningana eziyinhloko zokwenza lokhu kuhlolwa:
1. Thola ukuthi kuzokwenzekani uma kwenzeka ingozi.
Inani lama-CTC (amangqamuzana omdlavuza) egazini linganikeza umbono oqondile ngesimo sesiguli. Inani eliphansi lama-CTC egazini lisho isimo esihle. Kodwa-ke, uma kune-CTC eningi, kusho ukuthi lesi sifo sibi kakhulu. Ngale ndlela, odokotela bangenza lokhu kuhlolwa ngezikhathi ezithile, babone ukuthi lesi sifo sisabela kanjani ekwelashweni, futhi bashintshe ukwelashwa ngokufanele.
2. Yenza izinqumo zokwelashwa
Lokhu kungenye yezinzuzo ezibaluleke kakhulu ze-Liquid Biopsy. Amanye amangqamuzana omdlavuza anamaphutha athile ezakhi zofuzo. Kunemithi ethile ehlose kuphela lezo zinguquko. Lokhu sikubiza ngokuthi "ukwelashwa okuqondiwe". Kalula nje, kufana nokukhiya okungavulwa kuphela ngokhiye othize. I-Liquid Biopsy ingakutshela ukuthi hlobo luni "lokukhiya" amangqamuzana akho omdlavuza analo. Ngemuva kwalokho udokotela wakho angakunikeza "ukhiye" ofanele (umuthi) walokho.
3. Uma i-biopsy evamile ingenakukwazi ukwenziwa
Ngezinye izikhathi isiguli singase sibe buthaka kakhulu ukuba sihlolwe njalo. Noma isimila singase sibe yingxenye yesitho ebucayi kakhulu futhi okunzima ukuyifinyelela, njengobuchopho noma amaphaphu. Uma ucezu lusikwa endaweni enjalo, kunengozi yokulimaza izicubu ezinempilo ezizungezile. Ezimweni ezinjalo, ukuhlolwa koketshezi okungenangozi kuyasiza kakhulu.
Yiziphi izivivinyo ze-Liquid Biopsy ezivunyelwe njengamanje?
Kunocwaningo oluningi oluqhubekayo emhlabeni jikelele. Okwamanje kunezivivinyo eziningana ezinkulu ezivunyelwe yi-FDA e-United States, okusho ukuthi zihlolwe ngokuphelele ukuphepha nokunemba:
- Ukuhlolwa kwe-Cell Search® Circulating Tumor Cell (CTC): Lokhu kulinganisa inani lama-CTC (amangqamuzana omdlavuza) egazini. Kusetshenziselwa ukuqapha isimo seziguli ezinomdlavuza webele, we-prostate, kanye nowe-colon osakazeke emzimbeni wonke.
- Ukuhlolwa Kokuguquka Kwe-EGFR kwe-cobas® v2: Lokhu kuhlola i-ctDNA (izingcezu ze-DNA yomdlavuza). Kukhomba izinguquko ku-gene ye-EGFR, ezivame kakhulu kumdlavuza wamaphaphu (umdlavuza wamaphaphu ongewona amaseli amancane - i-NSCLC). Ngakho-ke, 'ukwelashwa okuqondisiwe' okufanele kakhulu kungakhethwa.
- I-Guardant360® CDx: Lokhu kubheka ne-ctDNA. Ikhomba izinguquko zofuzo ezivamile ezibonakala ezinhlotsheni eziningana zomdlavuza futhi isiza odokotela ukukhetha ukwelashwa okusebenza kahle kakhulu.
- I-FoundationOne® Liquid CDx: Lokhu futhi ukuhlolwa kwe-ctDNA okusetshenziselwa ukuhlonza izinguquko zofuzo ezinhlotsheni ezahlukene zomdlavuza, okungasiza ekunqumeni ukwelashwa okuphumelelayo kakhulu.
Ingabe lokhu kuhlolwa kubuhlungu? Kuthatha isikhathi esingakanani ukuthola imiphumela?
Into engcono kakhulu nge-Liquid Biopsy ukuthi inqubo elula kakhulu, engenabuhlungu. Kufana nokunikeza igazi ukuze kuhlolwe igazi njalo. Abukho ubuhlungu ngaphandle kokuzwa okuncane okuhlabayo lapho kufakwa inaliti.
Isampula yegazi lakho lithunyelwa elabhorethri, lapho odokotela bezifo behlukanisa khona i-plasma egazini bese beyihlola ukuze bathole ama-CTC noma i-ctDNA. Ngokuvamile kuthatha amasonto amabili kuya kwamathathu ukuthola imiphumela.
Imiphumela ikutshela ukuthi isampula yakho yegazi inamangqamuzana omdlavuza noma izingcezu ze-DNA (ezinhle) noma cha (ezimbi). Uma zinhle, ezinye izivivinyo zingathola nokuthi zivela kuluphi uhlobo lomdlavuza nokuthi yiziphi izinguquko zofuzo ezinazo.
Umlayezo Wokuya Nawe Ekhaya
- I-biopsy yoketshezi akuyona inqubo ehilela ukusika ingcezu yezicubu emzimbeni njenge-biopsy evamile. Kwenziwa ngokuhlolwa kwegazi okulula.
- Lokhu kuhlola izingcezu ezincane zamaseli omdlavuza aphukile (ama-CTC kanye ne-ctDNA) aqongeleleke egazini.
- Lokhu kusetshenziselwa kakhulu ukukhetha ukwelashwa okungcono kakhulu kweziguli ezinomdlavuza osakazeke kakhulu kanye nokuqapha impendulo yomzimba ekwelashweni.
- Lokhu akubuhlungu kakhulu futhi akunangozi kakhulu kunokuhlolwa njalo kwe-biopsy.
- Okubaluleke kakhulu: Indlela engcono kakhulu yokuqinisekisa ukuthi umdlavuza ukhona noma cha (izinga elifanele) ukuhlolwa kwe-biopsy yendabuko.
- Kungcono ukukhuluma nodokotela wakho mayelana nokuthi lolu vivinyo luyadingeka futhi lufanelekile yini kuwe.
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