I-Estrogen kunye neProgesterone efanelekileyo ye-Cancer Breast
Ukuba unesibeleko sebele okanye utyando lomhlaza wesifuba (mhlawumbi i-mastectomy okanye i-lumpectomy), enye yezinto zokuqala ezenziwayo kukuqinisekisa imeko ye-hormone receptor ye-tumor yakho. I-hormone receptor status, kwakhona, kubaluleke kakhulu ekukhetheni ukhetho olungcono lwempilo yomhlaza wakho. Makhe sijonge kwiimvavanyo ze-hormone ezahlukeneyo, yintoni isimo esichaphazelekayo okanye esichaphazelekayo sithetha, kwaye oku kuchaphazela njani amanyathelo akho alandelayo ekuxilongeni nasekunyangeni.
Uvavanyo lwe-Estrogen kunye neProgesterone Receptor Test
Uvavanyo lwe-Estrogen kunye ne-progesterone receptor ziyi-"biomarker" iimvavanyo ezenziwa kuzo zonke iisomhlaza zebele. Ezi ziza kubonakala kwiingxelo zakho zezilwanyana emva kokubili kwe-biopsy nangemva kokuhlinzwa. Ama-Receptors aphinde abuyiselwe xa unakho ukuphindaphinda, njengoko unokutshintsha ukuba i-tumor iqhubekela phambili okanye isasazeka. Ama-hormone receptors anqunywe ngokusetyenziswa kwe-microscope kwisampuli ye-biopsy.
Ukuqonda iRommone Receptors
I-Estrogen kunye ne-progesterone receptors ziyi-protein ezitholakala kwiindawo zeeseli zebele. I-Estrogen kunye neprogesterone idibanisa kula ma-receptors (njengenkikhi kunye nencoko) ukubonisa ukuba iseli ikhule kwaye ihlule. Zonke iiseli zesifuba zinama-receptors, kodwa zifumaneka kwinani elikhulu kakhulu kwieseli zomhlaza zesifuba ezibhekwa njengento enhle.
Ukuze uvalise umqondiso owenziwe xa i-estrogen okanye i-progesterone ibopha kule milambo, kuyimfuneko ukwenza enye yezinto ezimbini.
Unokunciphisa inani le-estrogen emzimbeni (ngokusebenzisa unyango lwe-ovarian unyango ngaphambi kokumisa umva okanye ukusebenzisa i-aromatase inhibitor emva kokumisa umva) okanye uvimbele i-receptor ukuze i-estrogen ekhoyo emzimbeni ayikwazi ukubopha nge-receptor.
Kubaluleka kwe-Estrogen kunye neNkqubo yeProgesterone kunye neCanscer Breast
Amanomdla okubeleka ase-estrogen (kunye / okanye i-progesterone) enhle "aqhutyelwa" yi-estrogen.
Akunjalo onke amangqamuzana omhlaza wesisu aqhutywa yi-estrogen. Ezinye i-cancer zebele zikhundleni esikhundleni se-HER2 enhle. Ngala ma-cancer, izinto zokukhula emzimbeni zibophelela kwi-HER2 receptors kummandla wamaseli omhlaza ukuqhuba ukukhula kwe-tumor. Ezinye iintsholongwane zebele zisenayo nayiphi na yale milambo kwaye zibizwa ngokuba yi "cancer" ezintathu.
Ezinye izifo zomhlaza zentlungu zine-hormone receptor ezintle kunye ne-HER2 enhle. Ngala ma-cancer, iiseli zingakhuthazwa ukuba zikhule nge-estrogen / progesterone ebophayo kwi-estrogen okanye i-progesterone receptors, okanye ngokukhula okubambisana ne-HER2 receptors. Ezi khansa ziyakuthi zibhekiswe "njengezintathu ezinomhlaza". (Funda kabanzi malunga nendima ye-estrogen kumdlavuza webele).
Isimo esilungileyo kunye neNigative Estrogen
Amanqaku e-Estrogen Receptor positive (ER +) ithetha ukuba i-estrogen ibangela ukuba i-tumor yakho ikhule, kwaye umhlaza kufuneka uphendule kakuhle unyango lokunyanzelisa i-hormone. Ukuba amanqaku yi-Estrogen Receptor negative (ER-), ngoko i-tumor yakho ayiqhutyelwa yi-estrogen, kwaye iziphumo zakho ziya kufuneka zihlolwe kunye nezinye iimvavanyo, njenge- HER2 isimo sakho , ukufumanisa unyango ophezulu.
Ufanele Ucele nini i-Numerical Score?
Ukuba iimvavanyo zakho zeemeyimu ze-hormone zithathwa njengento engalunganga, kulungile ukucela ugqirha wakho ngenani elibonisa amanqaku okwenene.
Nangona inani liphantsi, umhlaza ungaphathwa kakuhle ngonyango lwe-hormone.
Izikolo zeHormone Receptor Status
Kwi ingxelo yakho yokukhubazeka, ungabona amanqaku eHormone Status. Oku kuboniswa njengenombolo phakathi kwe-0 no-3. Nazi indlela zokuqonda amanani:
- 0 ayikho i-receptors efunyenweyo,
- 1+ inombolo encinci,
- I-2+ inamba ephakathi, kwaye
- I-3+ yinani elikhulu lama-receptors.
Unokufumana kwakhona inani lamaseli ngaphandle kweeseli ezili-100 ezivavanywe kakuhle kwiimitholampi ze-hormone. Oku kubhaliwe njengenombolo phakathi kweepesenti ezingama-0 (akukho-receptors) kunye neepesenti eziyi-100 (zonke iiseli zifumana i-receptors).
Izinketho zokwelapha kwi-Estrogen Receptor ezifanelekileyo ezinomhlaza webele
Ukuba i-tumor yakho i-ER + kunye / okanye i-PG +, ityrafu ye-hormone ivame ukucetyiswa.
Ukukhethwa kwamachiza, nangona kunjalo, kuxhomekeka kwiimeko zakho ze-menopausal.
Ngaphambi kokumiswa kwexesha, ii-ovari zivelisa isixa esikhulu se-estrogen. Ukuthintela le-estrogen ekuhlanganiseni iiseli zomhlaza ukuze zikhulise, imithi ebizwa ngokuba yi-modro-receptor modulator ekhethiweyo isetyenzisiweyo. Ezi zi yobisi, njenge- tamoxifen , zibophelela kwi-estrogen receptor ukuze i-estrogen ingakwazi ukubopha.
Emva kokumisa umva imeko ihlukile. Kukho i-estrogen encinane emzimbeni. Esikhundleni samathambo amaqanda okuvelisa i-estrogen, umthombo oyintloko we-estrogen emzimbeni kukuguqulwa kwe-androgens (i-hormone yamadoda) kwi-estrogen. Le mpendulo ishukunyiswa yi-enzyme eyaziwa njenge-aromatase. Imithi ebizwa ngokuthi i- aromatase inhibitors inokuvimbela le enzyme ukuze i-estrogen ingabonakali, kwaye ayikwazi ukubophelela kumaseli omhlaza ukwenzela ukuba bakhule.
Kukho ezintathu i-aromatase inhibitors ezikhoyo ngoku:
- Arimidex (anastrozole)
- Aromasin (exemestane)
- Femara (letrozole)
I-Aromatase inhibitors ngamanye amaxesha ingasetyenziselwa kubafazi be-premenopausal emva kwonyango lokunciphisa i-ovarian. Okokuqala, kusetyenziswa imichiza ekhusela ii-ovari ukusenza i-estrogen. (Enye inketho, nangona kungenakuqala kokukhetha, ukususa ii-ovari). Emva koko, ibhinqa linokutshintshwa ukusuka ku-tamoxifen ukuya kwenye ye-aromatase inhibitors. Ukwenza njalo kubonakala kunenzuzo yokuphila kwabanye abafazi abanomdlavuza wesibele.
Kukho ezinye iindlela zokwelapha ezingasetyenziswa ngamanye amaxesha. I-Faslodex (fulvestrant) yi-receptor-control regulator (SERD). Ingasetyenziselwa abafazi abaqhuba umhlaza wabo ngelixa be-tamoxifen okanye i-aromatase inhibitor. Ukongezelela, kukho ezinye iindlela zokwelapha ze-hormonal zesifo somhlaza wesifo se-metastatic esinokuthi sicingelwe kwabanye abantu.
Iimvumi zeHormone kunye ne-Breast Breast Recerrence okanye iMastastases
Ngethuba lokusasa i-esrogen, i-hormonal therapies inokunciphisa ukuphindaphinda malunga nesiqingatha, nokuba itamoxifen isetyenziselwa abafazi be-premenopausal okanye i-aromatase inhibitors esetyenziselwa abo bangama-postmenopausal.
I-Estrogen Receptor Iimvumi ezifanelekileyo kunye ne-Bisphosphonates
Kungekudala, i- bisphosphonates yongezwe kunye ne-aromatase inhibitors kwi-postmenopausal isifo se-postmenopausal esiswini se-receptor. Xa zisetyenziselwa kunye ne-aromatase inhibitors zibonakala zinciphisa umngcipheko wokuphindaphinda, ngokukodwa ukusasazeka komhlaza wesifuba kumathambo.
Ubude bonyango
Kwixesha elidlulileyo, unyango kunye ne-tamoxifen okanye i-aromatase inhibitors lalivame ukuqhubeka iminyaka emi-5. Ngoku kucinga ukuba ukusebenzisa i-aromatase inhibitor iminyaka engaphezu kwe-5 kunciphisa umngcipheko wokuphindaphinda kubasetyhini abanomdlavuza webele. Kubalulekile ukuthetha nodokotela wakho malunga neengcomo zangoku malunga nobude bonyango ngokubhekiselele kwezi zifundo ezintsha.
Ngaphantsi kweeHormone Receptor Test with Cancer
I-hormone receptor imeko yinto ebaluleke kakhulu yokuxilongwa komhlaza webele. Ukuba i-tumor is receptor positive (ER +) ithetha ukuba i-estrogen "ngumqhubi" ekukhuleni komhlaza. Ngokufanayo, i-tumor e-progesterone receptor positive (PG +) iqhutyelwa ubukho beprogesterone. Ngokuqhelekileyo, kodwa kungekho rhoqo, i-tumor iya kuba i-ER + ne-PG + okanye i-ER- ne-PG-.
Kubafazi be-premenopausal, ukuvimbela i-estrogen receptor kwiiseli zomhlaza zesisu ngumsebenzi oqhelekileyo. Kubafazi besimo se-postmenopausal, ukuvimbela ukubunjwa kwe-estrogen kumathambo e-peripheral nge-aromatase inhibitors yindlela eqhelekileyo. Ukusebenzisa imithi ye-hormonal kulabo abanomdla wokufumana i-estrogen okanye iipresitone receptor positives kunokunciphisa kakhulu umngcipheko wokuphindaphinda. Kwabesetyhini abanomdlavuza webele weemetastatic, i-hormonal therapies inokunyusa ixesha lokuphila kwaye kaninzi linciphise iimpawu zesifo.
> Umthombo:
> INational Cancer Institute. Ukwelashwa kweNtsholongwane kaBestile (PDQ) -Ingxelo yeNgcali yezobuNtu. Ukuhlaziywa 10/13/17. https://www.cancer.gov/types/breast/hp/breast-treatment-pdq