Ngokuthuthuka komphakathi, izindinganiso zokuphila zabantu abaningi ziye zaba ngcono, kodwa ngenxa yezizathu zomsebenzi noma zomkhaya baye bazishaya indiva izinkinga zabo zempilo, bavumela izifo ezithile ukuba zisizakale. Phakathi kwabo, umdlavuza we-colorectal uyisibonelo esijwayelekile. Umdlavuza we-Colorectal awenzeki ngokuphazima kweso. Ngokwezibalo, isikhathi esithatha ingqamuzana eliguquguqukayo ukuze likhule libe isimila esiyingozi empeleni singaphezu kweminyaka engama-30 ngokwesilinganiso. Futhi ngokungaqondile, umkhuba omncane wokuphila ungase ubambe iqhaza ku-carcinogenesis, futhi akunakwenzeka ukuwuvimbela. Eminyakeni yamuva nje, umdlavuza we-colorectal usulandele eduze umdlavuza wamaphaphu futhi usuphenduke umdlavuza wesibili ngobukhulu, okumele udonse ukunaka kwabantu.
Ukwelashwa okunembayo kuletha ithemba elisha ezigulini ezinomdlavuza we-colorectal
Ngokujula kocwaningo ngokusebenza ngempumelelo kokwelashwa okuhlosiwe kanye ne-genotyping, izidakamizwa ezihlosiwe seziphenduke inketho entsha yokwelashwa komuntu ngamunye kanye nokwelashwa okuphelele kweziguli ezinomdlavuza we-colorectal. Ukwelashwa komugqa wokuqala. Ukuvela kwezidakamizwa okuhlosiwe kuye kwathuthukisa okulindelwe ukwelashwa kweziguli ezinomdlavuza we-colorectal, futhi ukuhlanganiswa kwayo nezidakamizwa ze-chemotherapy kuye kwandisa isikhathi sokusinda seziguli.
Izidakamizwa ezivame ukusetshenziswa ekwelapheni umdlavuza we-colorectal ikakhulukazi zihlanganisa izinhlobo ezimbili zezidakamizwa eziqondise i-epidermal growth factor receptor (EGFR) kanye ne-vascular endothelial growth factor (VEGF), njenge-cetuximab yangaphambili kanye ne-panib Monoclonal antibodies, eyokugcina okuyi-ramucirumab. , i-bevacizumab ne-regorafenib. Izidakamizwa ezihlosiwe ezifana ne-KRAS, BRAF, PIK3CA, MSI kanye ne-PD-L1 nazo sezingenile ezivivinyweni zomtholampilo, futhi kukholakala ukuthi izidakamizwa eziningi ezihlosiwe zizotholakala esikhathini esizayo esiseduze ukuze kusizakale iziguli ezinomdlavuza we-colorectal.
Ukubhekana nomehluko ngamunye womdlavuza we-colorectal Ukuhlolwa kwe-Gene kubalulekile
Mayelana nokwelashwa komdlavuza we-colorectal, abantu bakhathazeke kakhulu ngokuthi yiziphi izindlela zokwelapha ezisetshenziswayo njengamanje? Ukwelashwa komdlavuza we-colorectal kuhlobene nesiteji sesimila, futhi ukwelashwa kufanele kulandele isimiso sokwelashwa komuntu ngamunye. Indlela yokufeza ukwelashwa komuntu ngamunye? Impendulo, yiqiniso, ukuhlolwa kofuzo. Kuphela ngokuhlolwa kofuzo ukuqonda izici zamangqamuzana omdlavuza lapho singaselapha lesi sifo. Njengoba kushiwo ngaphambili, kunezidakamizwa ezimbalwa ezihlosiwe kakade ezitholakalayo, kodwa ingabe kwanele ukuthola kuphela okuhlosiwe okuhambisanayo komuthi? vele akunjalo.
Isibonelo, nakuba ungekho umuthi ohlosiwe wokuguqulwa kwe-RAS kumdlavuza we-colorectal, kubalulekile futhi ukuthola ufuzo lwe-RAS ezigulini ezinomdlavuza we-colorectal. Ucwaningo lwango-2008 lwabonisa ukuthi ezigulini zohlobo lwasendle lwe-KRAS, i-cetuximab monotherapy ingandisa kakhulu i-OS yeziguli (izinyanga ezingu-9.5 vs 4.8 izinyanga) uma kuqhathaniswa nokwelashwa okusekela okungcono kakhulu, kodwa iziguli eziguquguqukayo ze-KRAS Kodwa zehlulekile ukuzuza kukho. Lokhu kuphakamisa ukuthi ukusetshenziswa kwe-cetuximab ne-EGFR njengoba okuqondiwe nakho kudinga ukuthola ukuguqulwa kwe-KRAS ezigulini, futhi ukuhlolwa kofuzo kudlale indima engenakuthathelwa indawo.
Ukuhlolwa kofuzo okusekelwe ekulandeleni kwesizukulwane sesibili akusakwazi ukuhlangabezana nezidingo zeziguli
Uma kuziwa ekuhlolweni kofuzo, into yokuqala wonke umuntu acabanga ngayo ukulandelana kwesizukulwane sesibili ukuthola ukuguqulwa kwe-DNA. Ngokuhlaziywa kofuzo, thola izidakamizwa ezihlosiwe ezinezimpawu zokuhloswe kokuguqula ukuqondisa ukwelashwa kweziguli. Kodwa zingaki iziguli ezinomdlavuza ezingazuza ngempela ngokulandelana kwesizukulwane sesibili? Ngokwezibalo, ngaphansi kuka-10% weziguli zingakwazi ukubona okuhloswe ukuguqula, futhi iziguli ezimbalwa nakakhulu ezingaqhubeka nokusebenzisa izidakamizwa ezihlosiwe futhi zizuze. Iningi leziguli lisathembele ekwelashweni kwemithi ye-chemotherapeutic ukuze ziphile isikhathi eside. Kunezinketho eziqondile zokukhetha umuthi we-chemotherapeutic. Esikhundleni sokukopisha iziqondiso ngobumpumputhe, i-United States inobuchwepheshe obungakwazi ukuqondisa kuphela ukwelashwa okuhlosiwe kodwa futhi nokuqondisa iziguli ekukhetheni ukwelashwa ngamakhemikhali Ngokuqondile, ngokuhlolwa, kungenza u-95% weziguli zithole isiqondiso sokwelashwa futhi zizuze kukho.
Ukuhlaziywa kwamangqamuzana e-Caris multi-platform kuyisinqumo sokuqala seziguli
Ngokungeziwe ekuqondiseni izidakamizwa eziqondisiwe, futhi ingaqondisa ukukhethwa kwemithi yokwelapha i-chemotherapeutic. Lesi isici esikhulu kunazo zonke sokuhlaziywa kwephrofayili yamangqamuzana ezingxenyekazi eziningi ze-United States Keris, futhi kuyindawo lapho iziguli zingazuza khona kakhulu. Ukuhlaziywa kwamangqamuzana e-Kerais multi-platform multi-platform, kuzo zonke izinhlobo zeziguli ezinomdlavuza, kuhlaziya ngokuphelele izici zebhayoloji yamangqamuzana avela ku-DNA, i-RNA kanye namazinga amaprotheni, kunganikeza amathuba angaphezu kwama-60 okukhetha izidakamizwa agunyazwe yi-FDA, futhi sekuqedele ukuhlaziywa kwemephu yesimila eyi-127,000. , u-95% weziguli ezinomdlavuza zingazuza ngokomtholampilo.
Ngokusho kwedatha esemthethweni kaKeruisi, ucwaningo olukhulu lwesimila oluqinile olubhalisa iziguli eziyi-1180, ngemuva kokuqondiswa ukuhlaziya kwamangqamuzana e-Keruisi multi-platform, ukusinda isikhathi eside kweziguli ngezinsuku ezingama-422. Isilinganiso senani lemithi esetshenziswa iziguli ezifundiswayo sasingu-3.2, futhi inani lemithi esetshenziswa iziguli ngaphandle kokuqondiswa lalingu-4.2. Imithi eminingi yayisho ukuthi iziguli zingase zidinge ukuba nemiphumela engemihle kakhulu kanye nokulahlekelwa kwezomnotho okungadingekile. Iziguli ezingakucabangeli ukuthi ngaphezu kokuqondisa ukukhethwa kwemithi eqondiwe, u-Keruisi angabuye ahlaziye ukuthi yimiphi imithi ye-chemotherapeutic elungele iziguli. Abantu abaningi bayazi ukuthi ukwelapha okuhlosiwe kusekelwe ekuguqulweni kofuzo ukuze kukhethwe izidakamizwa eziqondiwe Ukwelashwa okunembile, kodwa empeleni, ukukhethwa kwemithi yokwelapha ngamakhemikhali nakho kudinga ukuqondiswa, futhi akukwazi ukukopishwa ngokuhambisana neziqondiso zokwelashwa. Ukuhlaziywa kwamangqamuzana e-Keris okunezinkundla eziningi kuwubuchwepheshe bokuhlaziya obuphelele, obunikeza iziguli izinketho zokwelashwa ezinembe kakhulu nezifaneleka kakhulu.
Umdlavuza ohlomule kakhulu wokuhlaziywa kwamangqamuzana e-Keruis umdlavuza wamaphaphu, umdlavuza wesikhumba nomdlavuza webele. Iziguli zingazuza ekuhlaziyweni kwamangqamuzana e-Keruis ezimeni ezilandelayo, njengokwelashwa okujwayelekile komdlavuza we-metastatic onokumelana nezidakamizwa: njengomdlavuza we-colorectal, umdlavuza wamaphaphu, umdlavuza webele, nomdlavuza wesibeletho; umdlavuza ongavamile onezindlela ezimbalwa zokwelapha: njenge-sarcoma, i-glia Stromal tumors, i-metastatic carcinoma yokugxila okungaziwa okuyinhloko; cishe azikho izindlela zokukhetha izimila eziyingozi: njenge-melanoma, umdlavuza we-pancreatic.
Iziguli ezinomdlavuza we-Colorectal kumele zilazise leli thuba. Ngokuhlaziywa kwamangqamuzana ezingxenyekazi eziningi ze-Keruis, bangathola ngokuphelele izici zemephu yomdlavuza. Ngisho noma kungekho okuhlosiwe kokuguqulwa kwezakhi zofuzo, u-Keruisi angaveza ukuthi yimiphi imithi engazuza emtholampilo futhi engakwazi ukuzuza emithini ye-chemotherapy Ukusiza iziguli zigweme imiphumela emibi engadingekile.
