Iqhaza Ekubikezelweni kweKhemotherapy Response and Prognosis
I-Ki-67 iyi-antigen yomdlavuza (amaprotheni) etholakala ekukhuleni, ehlukanisa amaseli kodwa engekho esigabeni sokuphumula sokukhula kwamaseli (lapho amangqamuzana engakhuli). Ukuthi i-Ki-67 itholakala ekuhlukaniseni amaseli kwenza kube umakaki omuhle wokwanda (njengoba amangqamuzana omdlavuza akhula ngokushesha futhi ahlukanise) ukulandela ukuqhubeka komdlavuza webele, nakuba indima yawo ekwenzeni lokho okwamanje ingavumelani.
Uma kuziwa ngomdlavuza webele, ukuhlolwa kwe-Ki-67 kungenziwa esikhwameni sesishukela somdlavuza webele ukuze kusize ukubikezela ukuhlukumeza komdlavuza. Isivivinyo, esenziwa futhi sichazwa udokotela obizwa ngokuthi i- pathologist , silinganisa izinga lokukhulumisana kwe-Ki-67 kumaseli omdlavuza ngokusebenzisa inqubo yokusika.
Ngesikhathi uhlolo lwe-Ki-67 lwama-marker proliferation luyaqhubeka luyalwe odokotela, asiqiniseki ngokuzuzwa kwayo jikelele, ikakhulukazi uma kuziwa ekwenzeni izinqumo mayelana nokwelapha.
Ukuqonda imiphumela yakho ye-Ki-67
Udokotela wakho angalawula ukuhlolwa kwe-Ki-67 njengendlela yokukala ukuthi masinyane amathunsela akho anomdlavuza amabele ahlukanisa kanjani futhi adala amangqamuzana amasha. Umphumela wokuhlola wamaphesenti angaphansi kwezingu-10 uthathwa njengephansi lapho umphumela wokuhlolwa wamaphesenti angu-20 noma ngaphezulu uthathwa njengephezulu. Iphakethe "eliphakeme" lisho ukuthi i-tumor yebele ingase ibe yingozi futhi isakaze ngokushesha.
Noma kunjalo, akubona bonke odokotela abahlola ukuhlolwa kwe-Ki-67, ngakho-ke ungesabi uma ungayiboni embikweni wakho wezinkinga.
Ngaphezu kwalokho, kubalulekile ukuqaphela ukuthi ezinye izivivinyo zenziwa ukuze ufinyelele isisu sakho sebele, futhi le miphumela, kanye ne-Ki-67 Labeling Index yakho (isikolo sokuhlola) ingathinta uhlelo lwakho lwezokwelapha. Ngamanye amazwi, udokotela wakho uvame ukucabangela imiphumela eminingi yokuhlolwa lapho ezama ukuqonda umdlavuza wakho ohlukile.
Isibonelo, esinye isilingo esetshenziselwa ukufinyelela ukukhula komdlavuza wakho webele isigaba se-S. Lokhu kuhlolwa kubikwe njengephesenti futhi kukutshela ukuthi amangaki amangqamuzana omdlavuza asetshenziselwa ukukopisha i-DNA yawo. Amaphesenti amakhulu kunamaphesenti ayishumi kubhekwa njengephezulu.
Imiphumela ye-Ki-67 kanye nokubikezela i-Chemotherapy Response
Ukubona amaphuzu wakho we-Ki-67 kukusiza wena nodokotela wakho ukuthi unqume ukuthi umdlavuza wakho uyaphila yini noma ukuthi uyaphila. Eqinisweni, ucwaningo luye lwathola ukuthi izicubu ezinamazinga aphezulu ama-Ki-67 anezifo ezimbi eziphathelene nezicubu ezinamazinga aphansi.
Ngenye inothi elihle, ucwaningo luye lwathola ukuthi izicubu ezinezinga eliphezulu ze-Ki-67 zingaphendula ngokukhethekile ekhemotherapy. Njengoba i-chemotherapy iklanyelwe ukuhlasela wonke amangqamuzana akhula ngokushesha (kufaka phakathi "amangqamuzana avamile" afana nezinwele zezinwele), izicubu ezinonya kakhulu (zahlukanisa ngokushesha) zingaphendula ikakhulukazi kulezi zinhlawulo. Lokhu, empeleni, kungani ezinye izifo zomdlavuza (ezinjenge-lemonemic acute lymphocytic) eziye zafa ngokushesha, manje ziyakwazi ukwelashwa nge-chemotherapy. Lokho kusho ukuthi ukusebenzisa i-Ki-67 njengesimemezelo sokubikezela kwempendulo yamakhemikhali okwamanje kunengxabano.
Ngesikhathi samanje, mhlawumbe ukusetshenziswa okuvame kakhulu kwalolu vavanyo ukubikezela impendulo ku-neoadjuvant chemotherapy kubantu abanomdlavuza webele wesifuba.
I-neoadjuvant chemotherapy i-chemotherapy enikeziwe ngaphambi kokuhlinzwa ukuze ihlehlise isisu kanye / noma amantombazane omzimba ukuze kwenziwe ukuhlinzwa. Umdlavuza webele wesifuba usanda kubhekisela kumdlavuza wesifuba osakazekele odongeni lwesifuba, isikhumba sesifuba, noma eziningi zamantombazane (ikakhulukazi isigaba 3A noma isisu se-3B).
Ekugcineni, uma izinga lakho le-Ki-67 libuyele phezulu, ungase uzizwe ucindezeleke kakhulu. Futhi, umphumela wokuhlola we-Ki-67 ungumunye owodwa we-puzzle, ngakho zama ukungafundi okuningi kuwo. Esikhundleni salokho, khuluma nodokotela wakho mayelana nendlela ongcono ngayo ukuhumusha imiphumela yakho yokuhlola ngayinye, nokuthi kungenzeka (noma cha) ingathinta uhlelo lwakho lwezokwelapha.
Izwi elivela
Imfundo mayelana nomdlavuza webele ingaba namandla futhi ikusize uthole ukulawula okunye emuva kwesimo sakho esibucayi. Nakuba ube ngummeli wakho siqu ukunakekelwa komdlavuza wakho kuhle, qiniseka ukuthi uzondla futhi uthole ukwesekwa ngokomzwelo, njengoba uhamba ngalezi zihloko eziyinkimbinkimbi, izinqumo, kanye nokwelapha.
Okokugcina, ngenkathi ufunda kuyindlela enhle kakhulu yokuthola ulwazi ngomdlavuza wesifuba, cabangela ukujoyina iqembu lokusekela umdlavuza webele emphakathini wakho, noma umphakathi wesifo somdlavuza webele . Ngokuvamile, la maqembu yizindlela ezengeziwe zokuhlala phezu kocwaningo lwamuva ngomdlavuza. Kungaduduza futhi "ukukhuluma" nabanye abaye babhekana nokungaqiniseki nokuphikisana okuzungeze ukuhlolwa okuphakeme kwe-Ki-67.
> Imithombo
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> Koz, Z., noD.Dabbs. Ukuhlolwa kwe-Biomarker kanye nokuhlolwa kweMolokhi yokuHlonyelwa kweCanscer Breast. I-Histopathology . 2016. 68 (1): 70-85.
> Luporsi, E., Andre, F., Spyratos, F. et al. I-Ki-67: izinga lobufakazi kanye nokucabangela kokwenza umsebenzi walo ekulawulweni kwemitholampilo yomdlavuza webele: ukuhlaziywa nokuhlaziywa okubucayi. Ucwaningo lwe-Cancer Research and Treatment . 2012. 132 (3): 895-915.
> Perez-Lopez, M., Garcia-Gomez, J., Alves, M. et al. I-Ki-67 iyi-marker prognostic yama-tumor receptor positive. I-Oncology yemitholampilo nokuhumusha. 2016. 18 (10): 996-1002.
> Yagi, T., Inoue, N, Yanai, A. et al. Ukubaluleka kokubikezelwa kwamazinga okuveza amaGeminin ku-Ki67-High Subset ye-Estrogen Receptor-Positive and HER2-Negative Cancer Cancer. Umdlavuza webele . 2016. 23 (2): 224-30.