Umhlahlandlela Weziguli Ezibhekene Nezifo Ezifuywayo Ezixhunywe Ngomdlavuza Wezikhumba Ze-Melanoma
Ukuqonda umdlavuza wezakhi zofuzo nokuthi udlala kanjani ingxenye e- melanoma kungase kuzwakale njengomsebenzi onzima. Kodwa ukuthatha isikhathi sokwenza lokho kungakusiza ukuba uqonde kangcono ingozi yakho - nokuthi yini ongayenza ngakho.
I-Cancer Genetics
I-Cancer iqala lapho eyodwa noma ngaphezulu izakhi zofuzo zingena kumakhalekhukhwini (zishintsha kusuka kwifomu yazo evamile). Lokhu kungakha iphrotheni engavamile noma akukho amaprotheni nhlobo, kokubili okubangelwa ukuthi amangqamuzana aguquliwe angene ngokungalawuleki.
Inani elikhulu lezakhi zofuzo ziphenywa ngendima yazo ku-melanoma, kufaka phakathi izakhi zofuzo ezizuze njengefa kanye nezifo ezingokwemvelo ezitholakala ngenxa yezimo zemvelo, njengokungcola kwelanga ngokweqile. Kuze kube manje, ukuhlukahluka kohlobo lwe-genetic kubangelwa u-1% kuphela wezo zonke izifo zokuxilongwa kwe-melanoma, nakuba u-2009 ucwaningo lwamawele ane-melanoma lubonisa ukuthi ingozi engama-55% yengozi yomuntu yengozi ye-melanoma ingaba ngenxa yezifo zofuzo. Ukucwaninga kule ndawo eyinkimbinkimbi kusencane, kodwa ithemba lokuthi esikhathini esizayo esiseduze, ukuhlolwa kofuzo kuzokusiza ukuhlola ukuhlolwa kwe-melanoma, ukuxilongwa , nokwelashwa .
Ukuguqulwa kwe-Gene ku-Melanoma
Izibonelo zezakhi zofuzo ezidluliselwa kumzali kuya komntwana zihlanganisa okulandelayo:
I-CDKN2A - Izinguquko kulo mlawuli we-cell division yizimbangela ezivame kakhulu ze-melanoma enefa. Lezi zinguquko zisajwayelekile kakhulu jikelele futhi zingabonakala nasezintweni ezingenalo i-melanoma.
Abantu abane-melanoma yomndeni bavame ukuba neningi elikhulu le-moles engavamile (i-dysplastic nevi) futhi kuthiwa bane-melanoma esencane (iminyaka engu-35 kuya kwengu-40 ubudala). Njengoba abantu abangamaphesenti angu-70 abaguqule isakhi se-CDKN2A bazokhipha i-melanoma ngesikhathi sokuphila kwabo, ukuhlolwa kwezamabhizinisi kuye kwasungulwa i-CDKN2A, nakuba kungacacile uma ukwazi imiphumela yokuhlolwa kuyobazuzisa abantu abathwele isakhi.
Ukuguquguquka okuhlobene kodwa ngisho nokuhlukumezeka kusegeni le-CDK4, elilawula futhi lapho amaseli ehlukanisa futhi ekwandisa ingozi yokuthuthukisa i-melanoma.
I-MC1R - Ubufakazi obandayo bukhombisa ukuthi inani elikhulu lokuhluka kwegesi okuthiwa i-MC1R (melanocortin-1 receptor), ingozi enkulu ye-melanoma. Izakhi zidlala indima ebalulekile ekunqumeni ukuthi umuntu unenwele ebomvu, isikhumba esilungile, nozwela emisebeni ye-UV. Abantu abanesikhumba somnqumo nomnyama futhi abathwala isisindo esisodwa noma ngaphezulu kunesisindo esingaphezu kwesilinganiso se-melanoma. Noma kunjalo, ukuguquguquka kwe-MC1R kuthatha ingozi elinganiselayo kunezinguquko ze-CDKN2A noma ze-CDK4. Muva nje, ezinye izakhi zofuzo ezibandakanya isikhumba sesikhumba sezitholakale ezingase zenze ukwanda kwe-melanoma, kufaka phakathi i-TYR (i-tyrosinase), i-TYRP1 (iprotheni ehlobene ne-TYR 1), kanye ne-ASIP (agouti ukusayina amaprotheni).
I-MDM2 - Ukuhlukahluka kofuzo lwe-MDM2 kuvela "kumgqugquzeli" wesigcawu, uhlobo lokushintsha kwamandla olukhomba ukuthi isakhi sivuliwe nokuthi zingaki amakhophi akhiqizwa ngaphakathi kweseli. Ucwaningo olushicilelwe ngo-2009 lubonise ukuthi lubeka phambili abesifazane - kodwa hhayi amadoda - ukuthuthukisa i-melanoma esemncane (engaphansi kweminyaka engama-50 ubudala). Ukuba nalesi shintsho singase sibe namandla kakhulu kunezinye izici ezinobungozi be-melanoma ezifana nomlando wokushisa kwelanga, isikhumba esilungile, nokukhanda.
Uma unomzali noma umntakwabo onomama we-melanoma, ingozi yakho yokudala i-melanoma ikhulu kunomuntu ojwayelekile. Kodwa-ke, ingozi isasencane, kanti ezimweni eziningi, isakhi sofuzo asitholakali. Noma kunjalo, ochwepheshe abaningi batusa kakhulu ukuthi abantu abathintekayo ngomlando wabo womndeni we-melanoma baxoxisane nomeluleki wezakhi zofuzo futhi babuze udokotela wakho mayelana nokuhlanganyela ekuhloleni kocwaningo lwezofuzo ukuze ezinye zifunde ngokuthi ukuguquka kwezakhi zofuzo kuthonya ingozi ye-melanoma. Empeleni, abantu abasengozini yokuthola i-melanoma yokuzalwa kufanele bavikele ukukhanya kwelanga futhi bahlolisise isikhumba sabo ngokucophelela inyanga ngayinye kusukela ekuqaleni kweminyaka engu-10 ukufuna izinguquko ekubukeni kwe-moles.
Ukuguqulwa Kwezakhi Okungeyona Ifa
Izinguquko ze-Gene ezingazuzwa njengefa kodwa zitholakala ngenxa yezici zemvelo ezifana nelanga ezibandakanya:
I-BRAF - Izifundo zithole ukuguqulwa okungewona ifa ku-gene ye-BRAF ebonakala sengathi iyisenzakalo esivamile kakhulu enkambeni eholela ku-melanoma; kuye kwabonakala ku-66% we-melanomas ebulalayo. Abacwaningi banethemba lokuthi izidakamizwa ezivimbela le geni zingase zibe yindlela yokwelapha ephumelelayo esikhathini esizayo.
I-P16 iyinzalo yesondlo esondayo engahle ibe yinto engavamile kwezinye izimo ezingenalo ifa le-melanoma. Izinguquko zomzimba ezilawula i-Ku70 ne-Ku80 amaprotheni zingaphazamisa izinqubo ezilungisa izinhlamvu ze-DNA.
I-EGF - Abacwaningi bacwaninga ukuguqulwa kwegciwane esakhiweni esenza into ebizwa nge-epidermal growth factor (EGF). I-EGF idlala indima ekukhuleni kwamaseli esikhumba nokuphulukiswa okulimazayo, futhi ingase ilandele amacala amaningi angewona ifa le-melanoma.
Ukuguquguquka kwezinto eziphilayo ezakhiweni ezilawula ama-protein, ama-Fas amaprotheni, ahilelekile enkambweni yemvelo ye-cell self-destruction ebizwa ngokuthi i-apoptosis, ingabangela amangqamuzana e-melanoma ukuba aphumelele ekulawuleni.
Izinqubo zamangqamuzana eziholela ekuthuthukiseni kokuqala kanye ne-metastasis ye-melanoma engeyona inhlobo yinkimbinkimbi kakhulu futhi iqala ukuphenywa. Ngempela, izinkulungwane zocwaningo zocwaningo mayelana ne-melanoma genetic ziye zanyatheliswa eminyakeni eyishumi nje edlule. Lezi zintuthuko zizoholela ekuqalisweni kwezivivinyo ezinembile kakhulu zokuxilongwa nokuchazwa kwe-melanoma, kanye nezinhloso zokwelashwa eziphumelelayo zalesi sifo esibulalayo.
Imithombo:
"I-Genetics yeMelanoma." ASCO. 26 Febhuwari 2009.
I-Hocker TL, Singh MK, Tsao H. "Izakhi zofuzo ze-Melanoma nezindlela zokwelapha ekhulwini lama-21: ukuhamba ukusuka ebhentshini kuya embhede." J Invest Dermatol 2008 128 (11): 2575-95. 26 Febhuwari 2009.
I-Lin J, i-Hocker TL, u-Singh M, i-Tsao H. "I-Genetics of Melanoma Preredposition." Br J Dermatol 2008 159 (2): 286-9. 26 Febhuwari 2009.
"I-melanoma ejwayelekile." I-Melanoma Map Mapulamende Project. 27 Febhuwari 2009.
Firoz EF, Warycha M, Zakrzewski J, et al. Umhlangano we-MDM2 SNP309, ubudala bokuqala, nobulili ku-melanoma enqanyuliwe. I-Clin Cancer Res . 2009 Apr 1; 15 (7): 2573-80.
Shekar SN, Duffy DL, Youl P, et al. Isifundo Esisuselwa Ezintweni Zama-Twins ase-Australia nge-Melanoma Iphakamisa Umthelela Wezakhi Zofuzo Eziswini. J Invest Dermatol . 9 Apreli 2009.