Uke waphawula ushintsho emikhubeni yakho yamathumbu, ubuhlungu besisu, noma igazi esitulweni sakho muva nje? Ungazinaki lezi zimpawu, ucabanga ukuthi zivamile. Zingaba izimpawu zomdlavuza wamathumbu amakhulu. Namuhla, sikhuluma ngohlobo lomdlavuza wamathumbu amakhulu olukhethekile kancane, kodwa futhi olunenhlanhla encane. Lubizwa ngokuthi i-MSI-H.
Kalula nje, uyini lo mdlavuza wamathumbu amakhulu we-MSI-H?
Ukuze siqonde lokhu, ake siqale sibheke i-DNA engaphakathi kwamangqamuzana emizimba yethu. Cabanga nge-DNA yethu njengeketanga elide. Leli ketanga linezinhlayiya zohlobo olufanayo ezinamathele kulo ngokuphindaphindiwe. Lezi zingxenye ze-DNA eziphindaphindwayo zibizwa ngokuthi ama-microsatellite.
Manje, lapho amangqamuzana omzimba wethu ehlukana futhi kwakheka amangqamuzana amasha, kwenziwa amakhophi alolu chungechunge lwe-DNA. Ngezinye izikhathi amaphutha (ukuguqulwa kwezakhi zofuzo) angenzeka uma kwenziwa la makhophi. Kodwa ungakhathazeki, umzimba wethu unesimiso esifana 'namaphoyisa athola amaphutha'. Sibizwa ngokuthi uhlelo lwe-Mismatch Repair (MMR) . Luhlola amaphutha kulawo makhophi e-DNA bese luwalungisa ngokushesha.
Kodwa-ke, kwamanye amangqamuzana omdlavuza, lolu hlelo lwe-MMR alusebenzi kahle. Silubiza ngokuthi i-dMMR (ukulungiswa kwe-DNA Mismatch engasebenzi kahle). Ngemuva kwalokho, ngenxa yokuthi akekho olungisa amaphutha kulawo makhophi e-DNA, amaphutha ayaqoqana futhi i-DNA iba engazinzile kakhulu. Leso yisimo esinama-microsatellite angazinzile kakhulu, esiwabiza ngokuthi i-MSI-H (Microsatellite Instability-High) .
Ngokumangazayo, lokhu "kungazinzi" kwe-DNA empeleni ngezinye izikhathi kuyinto enhle. Umdlavuza we-MSI-H usabela kangcono ekwelashweni okubizwa ngokuthi i-immunotherapy kunezinye izinhlobo zomdlavuza. Ngaphezu kwalokho, umbono wabo muhle kakhulu.
Yiziphi izimpawu ezingaba khona zomdlavuza we-MSI-H?
Izimpawu zingase zingaveli njalo, kodwa uma zivela, zifana nezomdlavuza wamathumbu ojwayelekile.
| Isigaba sezimpawu | Izinto okufanele uzibone |
|---|---|
| Izinguquko ekuhambeni kwamathumbu | Uhudo, ukuqunjelwa, noma umuzwa wokugcwala ngemva kokuhamba kwamathumbu. |
| Igazi esitulweni | Indle ensundu noma emnyama, noma ukuphuma kwegazi emiseleni. |
| Ukungakhululeki kwesisu | Ubuhlungu besisu, ukuqunjelwa. |
| Ezinye izici zomzimba | Ukukhathala okungachazeki, ukwehla kwesisindo, ukuphelelwa yisifiso sokudla. |
Okubalulekile: Akuwona wonke umuntu onalezi zimpawu onomdlavuza. Kodwa-ke , uma unegazi esitulweni sakho noma ubuhlungu obukhulu besisu, bona udokotela ngokushesha. Uma ezinye izimpawu ziqhubeka isikhathi esingaphezu kwamasonto amabili, kufanele nakanjani ufune iseluleko sezokwelapha.
Ngezinye izikhathi, uphawu lokuqala lwalo mdlavuza ukuhlolwa kwegazi okubonisa inani eliphansi lamaseli abomvu egazi (i-anemia). Lokhu kungenxa yokopha emathunjini.
Izimbangela kanye nezici eziyingozi zokuthuthukisa umdlavuza we-MSI-H
Imbangela eyinhloko yomdlavuza we-MSI-H yizinkinga ezitholakala ku-MMR genes esikhulume ngazo ngaphambili. Lokhu kuvame ukwenzeka ngesikhathi sokuphila komuntu, ngaphandle kwesizathu esithile.
Kodwa cishe kubantu abangu-5% abathola umdlavuza wamathumbu amakhulu, lesi sici sofuzo sidluliselwa ezizukulwaneni ngezizukulwane. Lokhu sikubiza ngokuthi i -Lynch syndrome . Uma othile emndenini wakho enalesi simo, nawe usengozini enkulu yokuthola umdlavuza wamathumbu amakhulu.
Ngaphezu kwalokho, kunezinto endleleni yethu yokuphila ezandisa ingozi yomdlavuza.
| Izici eziyingozi esingenakuzilawula | Izici eziyingozi esingazilawula |
|---|---|
| Ukuba neminyaka engaphezu kwengu-50 ubudala | Ukukhuluphala ngokweqile |
| Ukuba nomlando womndeni womdlavuza wamathumbu amakhulu | Isifo sikashukela sohlobo 2 |
| Izifo ezidluliselwa ngofuzo njenge-Lynch syndrome | Ukubhema |
| Ukuba nezifo ezifana nesifo sikaCrohn | Ukusetshenziswa kotshwala ngokweqile |
| Ukuba nama-polyps ku-colon | Ukudla inyama ebomvu kakhulu nenyama ecutshunguliwe |
Ungasithola kanjani lesi sifo?
Uma udokotela wakho esola ukuthi unomdlavuza ngokusekelwe ezimpawini zakho, uzokudlulisela ezivivinyweni eziningana.
1. I-Colonoscopy: Ipayipi eligobekayo elinekhamera enamathiselwe lifakwa nge-anus ukuze kuhlolwe wonke umathumbu. Ngalesi sikhathi, kuthathwa ingxenye encane yezicubu endaweni esolisayo ukuze ihlolwe. Lokhu kubizwa ngokuthi i-biopsy .
2. Ukuhlolwa kwama-molecule: Kwenziwa ukuhlolwa okukhethekile ukuthola izinguquko zofuzo, okungukuthi isimo se-MSI-H, kusampula yezicubu ezithathwe ku-biopsy. Ubuchwepheshe obufana ne -IHC , i-PCR , kanye ne-NGS busetshenziselwa lokhu.
3. Ukuhlolwa kwezithombe: Kwenziwa ama-scan afana ne-CT ne-MRI ukuze kubonakale ukuthi umdlavuza ususakazekele kwezinye izitho zomzimba.
Yiziphi izindlela zokwelapha umdlavuza we-MSI-H?
Ukwelashwa kuncike esigabeni somdlavuza nokuthi ususakazeke kangakanani. Kunezindlela ezimbili zokwelapha eziyinhloko.
Ukuhlinzwa
Uma umdlavuza ungakasabalali kwezinye izindawo, isinyathelo sokuqala ukususa isimila ngokuhlinzwa. Uhlobo lokuhlinzwa lungahluka kuye ngobukhulu bomdlavuza.
Imithi
Yilapho ukucaciswa komdlavuza we-MSI-H kuqala khona.
- Ukwelashwa nge-immunotherapy: Lokhu kuyindlela yokwelapha ebaluleke kakhulu nephumelelayo yomdlavuza we-MSI-H.Cabanga ngamaseli ethu omzimba njengokushintsha 'ukuvula'/'ukuvala'. Amaseli omdlavuza ngezinye izikhathi ayawuvala ngobuhlakani lo mshini futhi afihle izivikelo zomzimba wethu. Imithi yokwelapha ngezifo (izivimbeli zokuhlola) iyawuvula futhi lowo mshini 'wokuvala', isiza isimiso somzimba sokuzivikela ukuthola nokubhubhisa amaseli omdlavuza.
- Ukwelashwa ngamakhemikhali: Ukunikeza imithi enamandla yokubulala amangqamuzana omdlavuza. Ngezinye izikhathi isetshenziswa ngaphambi noma ngemva kokuhlinzwa.
- Ukwelashwa Okuqondiwe: Ukunikeza imithi eqondisa futhi imise amaprotheni noma izinqubo ezithile ezisiza amangqamuzana omdlavuza ukuba akhule.
Ukuphila nomdlavuza we-MSI-H
Kubaluleke kakhulu ukugcina impilo enhle yomzimba neyengqondo ngesikhathi sokwelashwa komdlavuza.
- Ukudla: Ngemva kokuhlinzwa, landela imiyalelo kadokotela wakho bese udla ukudla okulula ukugayeka futhi okuneprotheni eningi. Kungcono ukunciphisa ukudla okukhiqiza igesi (isib. iklabishi, ubhontshisi) kanye nenyama ecutshunguliwe.
- Ukuzivocavoca: Ukuzivocavoca okulula njengokuhamba ngangokunokwenzeka kungaba usizo kakhulu emzimbeni nasengqondweni yakho. Kodwa xhumana nodokotela wakho ngaphambi kokuqala noma yiluphi uhlelo lokuzivocavoca.
- Impilo yengqondo: Kuvamile ukuzizwa ukhathazekile futhi wesaba ngezikhathi ezinjengalezi. Ungagcini imizwa yakho ivaliwe. Khuluma nomuntu omethembayo, okuhlanganisa namalungu omndeni. Funa usizo kumeluleki wezempilo yengqondo uma kudingeka.
Umdlavuza we-MSI-H unezinga eliphezulu lokuphulukiswa uma kuqhathaniswa nezinye izinhlobo zomdlavuza wamathumbu amakhulu, ikakhulukazi uma utholakala kusenesikhathi, futhi ukwelashwa okufana nokwelashwa nge-immunotherapy kungaletha imiphumela emihle kakhulu.
Umlayezo Wokuya Nawe Ekhaya
- I-MSI-H uhlobo oluthile lomdlavuza wamathumbu amakhulu lapho amangqamuzana omdlavuza enesici ohlelweni lwawo lokulungisa i-DNA (i-MMR).
- Ngenxa yalokhu "ukungazinzi", lezi zinhlanzana zisabela kahle kakhulu ekwelashweni nge-immunotherapy.
- Uma unezimpawu ezihlobene nomdlavuza wamathumbu amakhulu (ushintsho lwendle, ubuhlungu besisu, ukuphuma kwegazi), ungazinaki futhi ubone udokotela wakho ngokushesha.
- Umdlavuza we-MSI-H unethuba elikhulu kakhulu lokwelashwa uma utholakala kusenesikhathi. Ngakho-ke, kubalulekile ukungesabi futhi ufune iseluleko nokwelashwa okufanele kwezokwelapha.
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