Indima ekuqaphelweni kweKhemotherapy Response and Prognosis
I-Ki-67 ingumdlavuza we-antigen (iprotheni) efunyenwe ekukhuleni, ehlula iiseli kodwa engekho kwisigaba sokuphumla sokukhula kweseli (xa amaseli engakhuliyo). Inyaniso yokuba i-Ki-67 itholakala ekuhlukaniseni iiseli yenza ukuba kube ngummakishi omhle (kuba iseli lomhlaza likhula ngokukhawuleza kwaye lahlula) ukulandela inkqubela yomhlaza wesifuba, nangona inendima yayo ekwenzeni okwamanje ingqubuzana.
Xa kufike kumhlaza webele, uvavanyo lwe-Ki-67 lunokwenziwa kwisampula yeengxube zomhlaza zesifuba ukunceda ukuqikelela ukutshatyalaliswa komhlaza. Uvavanyo, olwenziwa kwaye luchazwa ngugqirha obizwa ngokuba ngu- pathologist , ulinganisa inqanaba le-Ki-67 ibonakaliso kumaseli omhlaza ngokusebenzisa inkqubo yokuqhawula.
Nangona uvavanyo lwama-marker proliferation marker olwandisa kakhulu luyalelwe ngabagqirha, asiqinisekanga ngokuxhamla ngokubanzi, ngokukodwa xa kuziwa kukwenza izigqibo malunga nophatho.
Ukuqonda iziphumo zakho ze-Ki-67
Ugqirha wakho unokuyalela uvavanyo lwe-Ki-67 njengendlela yokujonga ngokukhawuleza ukuba iintsholongwane zakho zentsholongwane zihlula njani kwaye zenza iiseli ezintsha. Umphumo wokuvavanywa kweepesenti ezingaphantsi kwe-10 uthathwa njengezantsi ngelixa umphumo wokuvavanya ama-20 ekhulwini okanye ngaphezulu uphathwa njengophakamileyo. Amanqaku "aphakamileyo" athetha ukuba i-tumor isifuba sinomdla kwaye isasazeka ngokukhawuleza.
Nangona kunjalo, akubona bonke oogqirha abaya kuhlola uvavanyo lwe-Ki-67, ngoko musa ukukothuka xa ungayiboni kwingxelo yakho yokugula.
Ukongezelela, kubalulekile ukuba uqaphele ukuba ezinye iimvavanyo zenziwa ukufikelela kwi-tumor yakho, kwaye ezi ziphumo, kunye ne-Ki-67 Labeling Index (amanqaku okuvavanya) anokuchaphazela isicwangciso sonyango. Ngamanye amagama, ugqirha wakho uvame ukufumana iziphumo ezininzi zokuvavanya xa ezama ukuqonda umhlaza wakho ohlukile.
Ngokomzekelo, olunye uvavanyo olwenziwe ukufikelela ukukhula komhlaza wakho webele ngumqhezu wesigaba seS. Olu vavanyo luchazwa njengepesenti kwaye litsho ukuba mangaphi amangqamuzana omhlaza ekusebenzeni ukukopisha iDNA yabo. Ipesenti ephezulu kuneepesenti ezili-10 ithathwa njengophakamileyo.
Iziphumo ze-Ki-67 kunye nokuqikelela ukuphendula ngeKhemotherapy
Ukubona amanqaku akho e-Ki-67 kukunceda ugqirha wakho uqaphele umhlaza wakho wesifo somhlaza okanye ithuba lokubuyisela. Enyanisweni, uphando lufumene ukuba izicubu ezinamazinga aphezulu ase-Ki-67 zihlaselwa ngokusondeza ngokusondeza ngokuphathelele izicubu ezinamazinga aphantsi.
Kwiphepha elincomekayo, uphando lufumene ukuba izicubu ezinezinga eliphezulu ze-Ki-67 zingaphendula ngokukodwa kwi-chemotherapy. Ekubeni i-chemotherapy yenzelwe ukuhlasela zonke iiseli ezikhula ngokukhawuleza (kubandakanya "iiseli eziqhelekileyo" ezifana neentlobo zezinwele), izicubu ezinamandla kakhulu (ukwahlula ngokukhawuleza ngakumbi) zingaphendula ngokukodwa kule mijelo. Enyanisweni, okokuba kutheni ezinye iintsholongwane ezinomdla (ezifana ne-acute lymphocytic leukemia) eziye zafa ngokukhawuleza, ngoku ziyakuthi zinyango nge-chemotherapy. Oko kwathiwa, ukusebenzisa i-Ki-67 njengommakishi wokugqibela weempendulo ze-chemotherapy kusekhona impikiswano.
Ngexesha langoku, mhlawumbi ukusetyenziswa okuqhelekileyo kwesi sifo kukuxela impendulo kwi-chemotherapy ye-neoadjuvant kubantu abanomdlavuza wesibeleko.
I-neoadjuvant chemotherapy yikhemotherapy eyenziwa ngaphambi kokuhlinzwa ukuba ilahle i-tumor kunye / okanye i-lymph nodes ukuze kwenziwe utyando. Umhlaza wesifuba esisekuhlaleni ubhekiselele kwiisondo zomhlaza ezisasazela eludongeni lwesifuba, isikhumba sesifuba, okanye kwi-lymph node ezininzi (ngokuqhelekileyo isigaba se-3A okanye isigaba se-3B izihlamba).
Ekugqibeleni, ukuba izinga lakho le-Ki-67 libuyele phezulu, unokuba uziva uxhalabile kakhulu. Kwakhona, isiphumo sokuhlola se-Ki-67 sisinye isiqephu se-puzzle, ngoko kuzama ukungazifundeli kakhulu. Kunoko, xela ugqirha malunga nendlela ongayichaza ngayo iziphumo zakho zokuvavanya, kunye nendlela enokuthi (okanye angenayo) zichaphazele isicwangciso sakho soonyango.
ILizwi
Imfundo malunga nomhlaza wesibele iyakunika amandla kwaye ikuncede ufumane ukulawula okunye kwiimeko zakho ezisengozini. Ngelixa uba ngummeli wakho wokhathalelo lomhlaza wakho , qiniseka ukuba uyazinyamekela kwaye ufumane inkxaso yemoya, njengoko uhamba nezihloko ezinzima, izigqibo, kunye neyeza.
Ekugqibeleni, ngelixa ufunda yindlela enhle kakhulu yokufumana ulwazi ngomdlavuza webele, cinga ukujoyina iqela lokuxhaswa ngumdlavuza webele emphakathini wakho, okanye uluntu lwesifo somhlaza wesibeletho . Ngokuqhelekileyo, la maqela ayongezelelekileyo iindlela zokuhlala phezu kophando olutsha malunga nomhlaza. Kungathuthuzela 'ukuthetha' nabanye abaye bajamelana nokungaqiniseki kunye nokuphikisana okujikeleze ukuhlolwa kwe-Ki-67 ephakamileyo.
> Imithombo
> Kontzoglou, K., Palla, V., Karaolanis, G. et al. Ulungelelaniso phakathi kwe-Ki67 kunye nomhlaza wesifuba. Oncology . 2013. 84 (4): 219-25.
> Koz, Z., kunye noD.Dabbs. Uvavanyo lwe-Biomarker kunye noVavanyo lweMeleki yoNgcaciso kwiCancer Breast. Ubomi bakhe . 2016. 68 (1): 70-85.
> Luporsi, E., Andre, F., Spyratos, F. et al. I-Ki-67: ubungakanani bokuba nobungqina kunye neendlela zokwenza inxaxheba kwintlupheko yokulawulwa komhlaza wesifuba: ukuhlalutya nokuhlaziywa okubalulekileyo. Uphando lwe-Cancer noPhando . 2012. 132 (3): 895-915.
> Perez-Lopez, M., Garcia-Gomez, J., Alves, M. et al. I-Ki-67 ingummemezeli wokuxela ukufumana iimvumi ezithatha i-hormone receptor. I-Clinical & Translational Oncology. 2016. 18 (10): 996-1002.
> Yagi, T., Inoue, N, Yanai, A. et al. Ukubaluleka kokubaluleka kweeGeminin Izinga lokuchaza kwi-Ki67-High Subset ye-Estrogen Receptor-Positive and HER2-Negative Breast Cancers. Ngomhlaza webele . 2016. 23 (2): 224-30.