Ziziphi iindlela eziKhusela iiKhansela zaBafazi ngeLynch Syndrome
Yintoni ongayenza ukukhusela umdlavuza kwimizimba yabasetyhini (i-gynecologic cancers) ukuba unayo i-Lynch syndrome?
Ngethuba ngethuba asinalo iindlela zokuthintela umdlavuza kubantu abaneLynch Syndrome-okanye ngaphandle kwe-Lynch syndrome malunga naloo nto-siyazi ngezinto ezithile onokukwazi ukuzenza ezinokunciphisa umngcipheko wakho wokuphucula umdlavuza wee-ovari okanye isisu .
Siyazi kwakhona iindlela zokuvavanya iintsholongwane zeesetyhini, kwaye ngokwenza njalo, nethemba lokufumana ezi ngxaki zamachiza kumanyathelo angaphambili angaphilisi.
Sibanzi
I-Lynch syndrome yaziwa nangokuthi i- non-poystis i-coloredal syndrome (i-HNPCC) . Yimeko ezuze ilifa apho ukungaqhelekanga kwiijethi kungadlulelwa kwisizukulwana kwisizukulwana.
Isifo sihlobene nokutshintshwa kweengqimba ezine: MLH1, MSH2, MSH6, kunye ne-PMS2. Olu tshintsho lwemizimba luzuze ifa le-autosomal, elithetha ukuba kufuneka uzuze ifa lomzimba ovela kumnye wabazali bakho ukuba ubhekane nobungozi be-syndrome. I-Lynch syndrome ixanduva lwee-2 ukuya kweesibhozo zeepesenti zee-cancer zekoloni, kwaye umyinge ophakathi wokwenza umdlavuza wekolon ungama-45 kumntu onesifo se-Lynch.
Iingozi zengozi
Ingozi yomdlavuza jikelele kubantu abaneLynch syndrome ziquka:
- Umhlaza weColon - iipesenti ezingama-80
- Umhlaza wesisu - i-18 ukuya kwe-18
- Umhlaza kunye nomhlaza we-bile duct - i-2 ukuya kwi-7 ekhulwini
- Umdlavuza kunye nomhlaza wesifo - 4.5 ukuya kuma-5 ekhulwini
- Umhlaza wamathumbu emathunjini - 1 ukuya kwi-4 ekhulwini
- Umhlaza weBrain - 1 - 3 ekhulwini
Umngcipheko weengcambu zengqungquthela zowesifazane zibandakanya:
- Umhlaza wesibeleko - ama-20 ukuya kuma-60 ekhulwini kwabasetyhini
- Umhlaza we-Ovarian - i-9 ukuya kwi-12 ekhulwini yabasetyhini
Le meko ibeka abantu kwezinye i-cancer, ngokunje, njengomhlaza wesisu .
Ukunciphisa Ingozi yeCancer
Xa uthetha ngokunciphisa umngcipheko, kubalulekile ukuba uqale ukuhlula. Uninzi lweemvavanyo zokuvavanya ozakuva ngazo luhlobo lokufumanisa kwangaphambili. Ezi mvavanyo azivimbele umhlaza, okanye zinciphise umngcipheko wokuba uhlakulele umhlaza. Kunoko, banyusela ithuba lokuba umhlaza uza kufunyanwa xa uncinci. Kwaye ininzi kanomdla iyaphiliswa, kwaye mhlawumbi iyaphiliswa, xa ilula.
Ngokwahlukileyo, kukho izinto abantu abangayenza ukuze banciphise umngcipheko wokuba nomhlaza kuqala. Ukutya ukutya okunempilo nokusebenzisa ukuwela kweli candelo. Ukuhlolwa komhlaza weColon , nangona kunjalo, kuyinto ekhethekileyo kwimvavanyo yokuhlola umdlavuza. Inika ithuba lokufumana umhlaza ekuqaleni-ukufumanisa kwangaphambili-kodwa kunokukunceda ekukhuseleni, xa kutholakala izicubu ezinqabileyo , kwaye zisuswe, ngaphambi kokuba zibe ngumhlaza.
Iingqungquthela zokuLungisa umdlavuza
Kubalulekile ukuba uqaphele ukuba abafazi abane-syndrome ye-Lynch, ngaphezu kweminye imilinganiselo eya kuxoxwa ngayo, kufuneka bafumane iimvavanyo zokuhlola iimvavanyo ezibangelwa ngabafazi abangenayo i-Lynch syndrome. Enyanisweni, oku kubaluleke kakhulu ukukhumbula, njengoko kubalulekile ukunyamekela imiba yempilo enokwenzeka xa ungenayo i-Lynch syndrome.
Ngokomzekelo, abafazi abanomdlavuza wesibeleko ngezinye iinkqubo banokugxininiswa ekukhuseleni umdlavuza webele, ukuba bayakulibala ukulandela ukukhutshwa komdlavuza wekoloni njengoko kubonakala "kungabalulekanga."
Ukukhumbula oku kubalulekile kubasetyhini abane-syndrome ye-Lynch ukuthetha nodokotela wabo malunga neengxaki zonyango ezingahambelani ne-Lynch syndrome. Ngokomzekelo, kubalulekile ukuthetha ngesithintelo sesifo senhliziyo nangona le syndrome ayifaki ingozi yesifo senhliziyo, kuba wonke umntu usemngciphekweni.
Amanyathelo okukhusela okongezelelweyo kwabasetyhini abane-Lynch Syndrome
Ukuze ubone ukuba yeyiphi imilinganiselo enokuthi ithathelwe ukunciphisa amathuba okuchaphazeleka komngcipheko wobomi be-Lynch syndrome, abaphandi baye bajonga iingenelo ezinokwenzeka zokuhlola iimvavanyo eziliqela.
Ukunciphisa Ingozi ye-Ovarian kunye ne-Uterine Cancer
Kukho iindlela ezahlukeneyo zokunciphisa umngcipheko wokufa kwintsholongwane ye-ovari okanye isifo se-uterine kubasetyhini abane-Lynch syndrome.
Kuphando olwenziwe ngo-2006 olupapashwe kwi- New England Journal of Medicine , abaphengululi baphetha i-prophylactic hysterectomy kunye ne-salpingo-oophorectomy yamazwe ngamazwe isicwangciso esilungileyo sokuthintela i-endometrial (uterine) kunye nomhlaza wesibeleko kubasetyhini abane-Lynch syndrome. Uphononongo olwenziwa ngo-2011 olubhekiselele kuhlalutyo lweendleko zeendlela ezahlukeneyo ezifunyenweyo, ukuphuculwa komngcipheko wokungcipheka komngcipheko kube yindlela echanekileyo yokusebenza.
Ukususela ekubeni ube ngummeli wakho kubaluleke kakhulu ekufumaneni unyango olungcono, kunokuba luncedo ukwazi apho ezinye zezi ngcebiso zivela khona. Emva koko, kwaye emva kokuthelekisa ukhetho oluthile kunye nezifiso zakho, unokwenza isigqibo esilungele wena ngokwakho.
Abaphandi baye bajonga iindlela ezahlukahlukeneyo zokunciphisa umngcipheko wokufa kula ma-cancer. Ezinye izinto eziye zazanywa ziquka:
- Iimviwo zonyaka zonyango
- Ukuhlolwa kwonyaka ngokusebenzisa i- biopsy ye-endometrial , i-ultrasonography yangaphandle, kunye ne- serum CA 125
- Ukutshitshiswa kwe-uterus, ii-ovaries, kunye nama-tublopian tubes eneminyaka engama-30 (okanye ubuncinane ngaphambi ko-35 ubudala)
Abaphandi banqume ukuba ukhetho olukhulu (ukuhlinzwa) lube nomngcipheko wesifo somdlavuza ophantsi kakhulu kwaye ukhetho oluncinci (iimviwo zonyaka) lubangele ingozi enkulu yomhlaza. Oku kwakukho okwenyaniso kwimiba yesibini ye-ovari kunye ne-uterine. Kodwa, ukusinda ngokubanzi akuzange kutshintshe kakhulu. Ngokomyinge, abafazi abanamaqanda abo, ama-ovari, kunye nama-fallopian tubes abasuswe kwiminyaka engama-30 bahlala iminyaka emithathu kunamalungu abo babenemviwo zonyaka zonyango.
Ngokukodwa, umdlavuza we-ovari wenziwa ngeepesenti ezisibhozo zabasetyhini abafumana iimviwo zonyaka, ezine iipesenti ezazibekwe ukuhlolwa kwonyaka, kwaye zingaphantsi kwe-1/10 yepesenti yabasetyhini ababehlinzwa. Umhlaza wesifo sangasemva kwenzeke kuma-49 ekhulwini kwabasetyhini abafumana iimviwo zonyaka, i-18 ekhulwini ababenokuhlolwa kwonyaka, nangaphantsi kwe-1/10 yepesenti yabasetyhini ababehlinzwa. Nangona kubonakala kungenakuphikisa, kusenokwenzeka ukuba abasetyhini bafumane umdlavuza we-ovari okanye umdlavuza we-uterine xa ezo zitho zisuswe. Umzekelo yi-peritoneal carcinoma.
Abafazi ababenemiviwo yonyaka babehlala malunga nama-77, abo babenokuhlola i-year bahlala malunga ne-79, kwaye abo baphethwe unyango baba malunga nama-80.
Ukunciphisa Ubungozi bezinye iCancer
Kukho ezininzi iingcamango zokujonga abantu abane-Lynch syndrome ukufunyanwa kwangaphambili kwezinye i-cancer. Umzekelo, iikhooloncopy zonyaka okanye ze-biyearly zinconywa ziqala ukususela kwiminyaka engama-20 kuya kwe-25 okanye kwiminyaka emihlanu ngaphantsi kwexesha apho isihlobo saphuhlise eso sifo. Thetha ugqirha wakho malunga nale mivavanyo yokuhlola ukufumana oko kukulungele.
Imithombo:
I-American Society ye-Clinical Oncology. Cancer.Net Lynch Syndrome. 12/2004. http://www.cancer.net/cancer-types/lynch-syndrome
Bonis, P., Ahnen, D., noL. Axell. I-Lynch syndrome (umhlaza wesifo esingenalo i-popolyposis). Ukuhlola nokuphathwa. UpToDate . Ukuhlaziywa 05/12/16.
Chen, L., Yang, K., Little, S., Cheung, M., no-A. Caughey. I-Gynecologic Cancer Prevention kwiLynch Syndrome / i-Hereditary Nonpolyposis I-Colorectal Cancer Families. I-Obstetrics kunye neGynecology . 2007. 110 (1): 18-25.
Schmeier, K., Lynch, J., Chen, L. et al. I-Prophylactic Surgery yokunciphisa ingozi yeChancer's Cancers kwiLynch Syndrome. I-New England Journal of Medicine . 2006. 354 (3): 261-9.
Vasen, H., Ignacio, B., Aktan-Collan, K. et al. Izikhokelo ezihlaziyiweyo zokulawulwa kweekliniki ze-Lynch syndrome (i-HNPCC): iingcebiso yiqela leengcali zaseYurophu. Gut . 2013. 62 (6): 812-23.
Yang, K., Caughey, A., Little, S., Cheung, M., noL. Chen. Uhlalutyo lweNdleko-Impumelelo ye-Prophylactic Surgery ne-Gynecologic Surveillance kwabesifazane abavela kwi-Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Imindeni. ICatal Cancer . 2011. 10 (3): 535-43.