Ukusasaza i-DNA ye-Cancer inokuncedisa iLymphoma Detection
I-Biopsy-ukuthatha isampuli yamathambo asolwayo kuhlalutyo lwebhubhoratri-ngokuqhelekileyo kufuneka ukuba i-diagnostic yokuqala ye-lymphoma. Ulwazi oluvela kwiisisi ezixubileyo luvumela i-oncologists ukuba iqwalasele iimpawu ze-molecule zomhlaza, okanye zonke iindidi ezahlukeneyo zomhlaza weeseli kunye neeprotheni zeeseli zomhlaza, kwaye zivelise olo lwazi ukuphucula unyango.
I-Biopsies ke inikezela oogqirha ulwazi olubalulekileyo ukuze kuxilongwe kwaye unyango. Nangona ixabiso elingenakuqinisekiswa, i-biopsies ayinayo ingozi kunye nemingcele.
Ukongezelela, abantu abaye bafumanisa ukuba bane-lymphomas nabo bafuna ukuba nesifo sabo "sinyuswe" kumaphuzu ahlukeneyo: okokuqala, ukubona indlela esasazeka ngayo ngexesha lokuhamba; kamva, ukuba ubone ukuba iyancipha ekuphenduleni kwonyango; kwaye emva koko, ngokubeka iliso, ukuqinisekisa ukuba oogqirha bakho bangaphezulu kwezinto ukuba umhlaza uphinde ubuye emva kokuba unyango lokuqala. Kwakhona, ukubaluleka kokucatshulwa kwezinto kungenakukhunjulwa, kodwa ukucinga kwimiqathango yazo yokungaphumeleli, njengokubonakaliswa kwimizi. Kungenxa yoko le mvavanyo isetyenziselwa ngokufanelekileyo ukuze inzuzo ibonge ngaphezu kweengozi zokungcola.
Ixesha elizayo: Ukubambisa kwi-Biopsies kunye neengcingo
Namhlanje, indlela esemgangathweni yegolide yokunciphisa umhlaza njengoko kuchazwe ngasentla yi-imaging. Ngokukodwa, ukuhlaziywa kwe-tomography ( CT ) kunye ne-fluorodeoxyglucose (FDG) ye-positron emission tomography (PET) isetyenziswe rhoqo kwisiteji kunye nokufumanisa impendulo yomhlaza kwonyango.
Ngokuqhelekileyo ezi zinto zidibeneyo, kwaye kuthiwa yi-PET / CT. Nangona ezi zifundo eziphambili zengqondo zixabisekileyo kwaye ziphuculise ukunakekelwa kwesigulane kwi-lymphoma, zidibaniswa nokukhutshwa kwemitha, iindleko kunye nakwezinye iimeko, ukungabi nako ngokuchanekileyo.
Zonke ezi zinto ziye zakhuthaza umdla wabaphandi ekufumaneni iindlela ezintsha, ezichanekileyo, ezingaphantsi kunye nezincinci zokusanda umhlaza womntu.
Injongo enye kukufumana amanqaku athile, afana nokulandelana kwemfuza, anokulinganiswa nje ngokuhlolwa kwegazi ukugcina iithebhu kumhlaza ukwenzela ukuba umzekelo ungafanele uhlolwe rhoqo ngexesha lokubeka iliso kwixesha elizayo.
Xa isifo somhlaza sifayo, ezinye zeDNA yazo ziphela egazini. I-DNA kwiiseli zomhlaza ezifile zibizwa ngokuba zijikeleza i-DNA ye-tumor, okanye i-ctDNA. Iingcali zenzululwazi ziye zavelisa iimvavanyo ukuba zifumane iDNA ejikelezayo. Ngaloo ndlela kuthethwa ngale ndlela ngokuthi "i-biopsy yamanzi," kwaye uphando lubhekisela kwizibonelelo ezinokubeka esweni isifo, kunye nokuxela kwangaphambili impendulo yomntu kwiyeza.
Ukujikeleza i-Tumor DNA Study
Kuphando olupapashwe, abaphandi kwiSizwe seCancercer Institute bahlalutye igazi ukusuka kubantu abangama-126 abane-DLBCL ngenxa yobungqina be-DNA ye-tumor. Ukusasaza i-B-cell-cell lymphoma, okanye i-DLBCL, luhlobo oluqhelekileyo lwe-lymphoma, umdlavuza wegazi oqala kwiiseli ezithile ze-immune system.
Nangona zibonakala ngendlela efanayo phantsi kwe-microscope, ii-subset ezahlukeneyo ze-DLBCL zinokuthi zihluke. Ngokwe-American Cancer Society, ngokubanzi, malunga nabantu abathathu kwababane abayi kuba nezibonakaliso zesifo emva kokunyanga kokuqala, kwaye abaninzi baphiliswa ngonyango.
Nangona kunjalo, umhlaza uphindaphindwa kuma-40 ekhulwini labantu, nangona kunjalo, kwaye ngoku azinakho ukuphilisa, ngokukodwa xa ubuya kusasa kunye / okanye xa amanqanaba eeseli zesisu egazini aphezulu, ngokweNational Cancer Institute.
Wonke umntu kulo uphando lwangoku ufumene unyango lwe-DLBCL ngokwemiqathango e-3 eyahlukeneyo, kunye neziyobisi ezifana ne-etoposide, prednisone, vincristine, cyclophosphamide, kunye ne-doxorubicin, eyaziwa nge-EPOCH, okanye ngaphandle kwe-rituximab, kwiimvavanyo zonyango phakathi kukaMeyi 1993 noDisemba 2013.
Ukuhlolwa kwegazi kwenziwa ngaphambi komjikelezo ngamnye wekhemotherapy, ekupheleni kokonyango, kwaye rhoqo ixesha lokuhlolwa kweesiteji.
Abantu balandelwa iminyaka emininzi emva kokunyanga, kwaye ii-CT zenziwa ngelo xesha kunye nokuhlolwa kwegazi. Abantu abakulesi sifundo balandelwa ukuba babe ngumlambo kwiminyaka engama-11 emva kokunyanga-oko kukuthi, inamba ephakathi kwimixholo yayineminyaka eyi-11, kodwa abantu balandelwa ukuba babe ngamaxesha amancinci nangaphezulu.
Ukunyuka kwegazi, ukuphindaphinda
Kwabantu abangama-107 abanokuxolelwa ngokupheleleyo komhlaza, abo bahlakulele i-CD ebonakalayo kwiisampulu zegazi babekho ngaphezu kwama-200 amathuba okuba isifo sabo siphumelele kunabo abangenayo i-ADN ebonakalayo.
Uvavanyo lwegazi lwalukwazi ukuxela ukuba ngubani abantu abangazange baphendule kwonyango emva komjikelo wesibini wonyango lolwa nomhlaza.
Ukuvavanywa kwegazi kwaye kwenza ukuba kutholakale umhlaza wesifo seminyaka engama-3.4 ngaphambi kokuba kukho nawuphi na ubungqina bezonyango zesifo, ngaphambi kokufunyanwa nge-CT scan.
Okwangoku, i-biopsies yamanzi kwi-DLBCL yiphando kwaye ayiyi kuvunyelwa i-FDA okanye iphakanyiswe izikhokelo ze-NCCN. Ingcaciso enikezelwe yi-biopsy yamanzi ayifanele isetyenziswe ukukhokela unyango kwi-DLBCL.
Izikhokelo zexesha elizayo
Kukho imibuzo eninzi engaphendulwanga kunye nemingeni echaphazelekayo ekugcineni iithebhu kwiisifo zamanqamzana ngokusebenzisa amanqaku amachiza kwiimvavanyo zegazi, kodwa isiseko solwazi siyaqhubeka kwaye siphucula.
Kwimeko ye-lymphoma, kwaye ngokukodwa zonke iintlobo ezahlukeneyo ze- non-Hodgkin lymphoma , ukuhlukahluka kobugqwetha obunzima kubangela umsebenzi onzima. Nangona xa sicinga ukuhlaselwa okufanayo, okufana ne-DLBCL, kunokwenzeka ukuba umakishi omnye makangasebenzi kakuhle kuzo zonke iimeko.
Ekugqibeleni ke, ithemba, kukuba ezinye zeziganeko, iinaliti kunye nezicatshulwa eziqhelekileyo kwizigulane zomhlaza zanamhlanje zingagwenywa kwaye zitshintshwe iimvavanyo ezifumanisa aba makishi kwaye zilinganise amanqanaba emzimbeni.
> Imithombo:
> I-American Cancer Society. B-cell cell lymphomas. Ukuhambisa i-cell-cell lymphoma enkulu.
> Melani C, Roschewski M. Ukuqapha kwe-Molecular ye-cell-free free circulation of DNA kwi-non-Hodgkin lymphoma. I-Oncology (Williston Park). 2016; 30 (8). pii: 218406.
> NIH. Ukujikeleza i-DNA ye-tumor kwigazi kunokuqikelela ukuphindaphinda uhlobo oluqhelekileyo lwe-lymphoma.