Ukujikeleza i-Cancer DNA Kungasiza Ukutholakala Kwama-Lymphoma
Ukwehla isisu-ukuthatha isampula yamathishu okusolisayo ekuhlaziyweni kwelabhutri-ngokuvamile kuvunyelwe ukwenza ukuhlolisiswa kokuqala kwe-lymphoma. Ulwazi olusuka kumathisiphilini e-biopsied luvumela abavukeli be- oncologists ukuba bacabangele izici zamangqamuzana zomdlavuza, noma zonke izinhlobo ezihlukahlukene zezinhlayiya zomzimba zama-cancer kanye namaprotheni, besebenzisa lelo lwazi ukuze ukwandise ukwelashwa.
Ngakho-ke ama-Biopsies anika odokotela ulwazi olubalulekile oludingekayo ekuxilongweni nasekwelapha. Naphezu kokubaluleka kwazo okungenakuphikwa, ama-biopsies awakho ngaphandle kwezingozi nokulinganiselwa.
Ngaphezu kwalokho, abantu abaye bathola ukuthi bane-lymphomas nabo badinga ukuba isifo sabo "sibe phezulu" ngamaphuzu ahlukene: okokuqala, ukubona ukuthi sisakazeke kanjani ngesikhathi sokumisa; kamuva, ukubona ukuthi sehla ekuphenduleni ukwelashwa; futhi ngemuva kwalokho, ngokuqapha, ukuqinisekisa ukuthi odokotela bakho bangaphezulu kwezinto uma umdlavuza uphinde ubuye ngemuva kokulashwa kokuqala. Futhi, ukubaluleka kwe-imaging akunakuphika, kepha ukucabanga kufaka isethi sayo sokushiyeka, njengokuchayeka emisebeni. Yingakho lezi zivivinyo zisetshenziselwa ngokuzenzekelayo ukuze inzuzo ibe ngaphezu kwezingozi zokuchayeka.
Ikusasa: Ukuxhuma Kwezingxenyana Nezingcingo
Namuhla, indlela ejwayelekile yegolide yokususa umdlavuza njengoba kuchaziwe ngenhla i-imaging. Ngokucacile, ukuskena kwe-tomography ( CT ) kanye ne-fluorodeoxyglucose (FDG) ye-positron emission tomography (PET) isetshenziselwa ukufakwa kwesiteji nokuthola impendulo yomdlavuza ekwelapheni.
Ngokuvamile amasu amabili ahlangene, futhi abizwa ngokuthi i-PET / CT. Nakuba lezi zivivinyo eziphambili ze-imaging ziyigugu futhi zithuthukise ukunakekelwa kwesineke ku-lymphoma, zihlotshaniswa nokuvezwa kwemisebe, izindleko, futhi kwezinye izimo, ukungabi ncamashi.
Zonke lezi zinto ziye zakhuthaza isithakazelo sabacwaningi ekutholeni izindlela ezintsha, eziqondile, ezingabizi futhi ezingenasisindo zokusungula umdlavuza womuntu.
Omunye umgomo ukuthola izimpawu ezithile, ezifana nokulandelwa kwegazi, okungalinganiswa ngokuhlolwa kwegazi ukuze ugcine amathebhu emdlalweni ukuze ngokwesibonelo ungase ungadingeki uhlolwe njalo ngesikhathi sokuqapha esikhathini esizayo.
Lapho amangqamuzana omdlavuza efa, ezinye ze-DNA yazo ziphela egazini. I-DNA emangqamuzaneni omdlavuza afile ibizwa ngokuthi ihamba nge-DNA, noma i-ctDNA. Ososayensi baye bahlakulela ukuhlolwa ukuze bathole le DNA ejikelezayo. Ngezinye izikhathi lolu hlobo lokufinyelela lubizwa ngokuthi "i-biopsy yamanzi," futhi abaphenyi bakhomba izinzuzo zokuqapha izifo, kanye nokubikezela impendulo yomuntu yokwelashwa kusenesikhathi.
Ukusakaza i-Tumor DNA Study
Esicwaningweni esishicilelwe, abaphenyi e-National Cancer Institute bahlaziya igazi kubantu abangu-126 abane-DLBCL ukuze kube khona ukujikeleza i-DNA ye-tumor. Ukusabalalisa i-large-B-cell lymphoma, noma i-DLBCL, uhlobo oluvame kakhulu lwe-lymphoma, umdlavuza wegazi oqala kwamaseli athile omzimba omzimba.
Naphezu kokubonakala okufanayo ngaphansi kwe-microscope, ama-subsets ahlukile e-DLBCL angahle aguquke ngokuhlukile. Ngokusho kwe-American Cancer Society, jikelele, cishe abantu abathathu kwabangu-4 ngeke babe nezibonakaliso zesifo ngemva kokwelapha kokuqala, futhi abaningi baphulukiswa ngemithi yokwelapha.
Umdlavuza uphindela ngamaphesenti angaba ngu-40, kodwa-ke, ngakho-ke ngokuvamile awukwazi ukuphulukiswa, ikakhulukazi uma ubuya ekuqaleni futhi / noma uma amazinga wegciwane lesisindo egazini lawo ephakeme, ngokusho kweNational Cancer Institute.
Wonke umuntu ocwaningweni lwamanje uthola ukwelashwa kwe-DLBCL ngokwezinhlelo ezintathu ezihlukene, ngezidakamizwa ezifana ne-etoposide, prednisone, i-vincristine, i-cyclophosphamide, ne-doxorubicin, eyaziwa njenge-EPOCH, noma ngaphandle kwe-rituximab, ekuvivinyweni kwemitholampilo phakathi kuka-Meyi 1993 noDisemba 2013.
Ukuhlolwa kwegazi kwenziwa ngaphambi komjikelezo ngamunye we-chemotherapy, ekupheleni kokwelashwa, futhi njalo lapho kuhlolwa khona isiteji.
Abantu balandelwa iminyaka eminingi emva kokwelapha, kanti ukuhlolwa kwe-CT kwenziwa ngesikhathi esifanayo nokuhlolwa kwegazi. Abantu kulolu cwaningo balandelwe iminyaka engu-11 emva kokwelapha-okungukuthi, inombolo ephakathi kochungechunge yayineminyaka engu-11, kepha abantu balandelwa kokubili isikhathi esifushane nesikhathi eside.
Ukuqhutshwa kweGciwane Lokubikezelwa Okubikezelwe, Ukuphindaphindiwe
Kulabo bantu abangu-107 ababenokukhululwa okuphelele komdlavuza, labo abahlakulele i-ctDNA ebonakalayo emasampula egazi babenamathuba angaphezu kuka-200 amathuba okuba nesifo sabo siqhubekele kunabanye abangenayo i-cNA DNA.
Ukuhlolwa kwegazi kwakwazi ukubikezela ukuthi yiziphi abantu abangazange baphendule ekwelashweni njengoba nje umjikelezo wesibili wokulashwa komdlavuza.
Ukuhlolwa kwegazi kwabuye kwanika ukutholakala komdlavuza okuphindaphindiwe ezinyangeni ezingu-3.4 ngaphambi kokuba kube khona ubufakazi obuphikisayo bokugula, ngaphambi kokutholakala nge-CT scan.
Njengamanje, i-biopsies yamanzi e-DLBCL iyaphenywa futhi ayivunyelwe i-FDA noma iphakanyiswa imihlahlandlela ye-NCCN. Ulwazi oluhlinzekwa yi-biopsy lomswakama akufanele lusetshenziselwe ukuqondisa ukwelashwa ku-DLBCL.
Imiyalo Yesikhathi Esizayo
Kukhona imibuzo eminingi engaphenduliwe nezinselelo ezihilelekile ekugcineni amathebhu kuma-khansa esebenzisa izimpawu zamangqamuzana ezivela ekuhlolweni kwegazi, kodwa isisekelo solwazi siqhubeka sikhula futhi sithuthuka njalo.
Endabeni ye-lymphoma, futhi ngokuyinhloko zonke izinhlobo ezahlukene ze- non-Hodgkin lymphoma , ukuhlukahluka kwalezi zihlukumeza kwenza umsebenzi onzima. Ngisho nalapho ucabangela ukulimala okufanayo, okufana ne-DLBCL, kungenzeka ukuthi uphawu olulodwa lungase lungasebenzi kuzo zonke izimo.
Nokho, ekugcineni, ithemba lokuthi ezinye izimbangela, izinaliti, nezikrini ezijwayele iziguli zomdlavuza zanamuhla zingase zigwenywe futhi zithathelwe indawo yizivivinyo ezibona lezi zimaki bese zikala amazinga azo emzimbeni.
> Imithombo:
> I-American Cancer Society. B-cell lymphomas. Ukusakaza i-B-cell lymphoma enkulu.
> Melani C, Roschewski M. Ukuqapha kwamakhemikhali e-cell-free free circulation of DNA in-non-Hodgkin lymphoma. I-Oncology (i-Williston Park). 2016; 30 (8). i-pii: 218406.
> NIH. Ukujikeleza i-DNA ye-tumor egazini kungabikezela ukuphindaphinda uhlobo oluvame kakhulu lwe-lymphoma.