Yiziphi Izindlela Ezingavimbela Amanqamu Amanqunu NgamaLynch Syndrome
Yini ongayenza ukuze uvimbele umdlavuza ezithombeni zesifazane (kanomdlavuza wegazi) uma une-Lynch syndrome?
Ngenkathi ngeshwa asinayo izindlela zokuvimbela umdlavuza kubantu abane-Lynch Syndrome-noma ngaphandle kwe-Lynch syndrome ngaleyo ndaba-siyazi ezinye izinto ongase ukwazi ukuzenza ezinganciphisa ingozi yokuthuthukisa ukwelapha kwama-ovari noma isisu .
Siphinde sazi izindlela zokuhlola ama-khansa asebesifazane, futhi ngokwenza kanjalo, ithemba lokuthola la kansela emagcekeni okuqala angaphatha kakhulu.
Sibutsetelo
I-Lynch syndrome nayo yaziwa nangokuthi i- nonpolyposis i-colorectal syndrome ye-non-colyposis (i-HNPCC) engeyona ifa . Kuyisimo esizuzwe njengefa lapho okungavamile khona kwezakhi zofuzo kungadluliselwa ezizukulwaneni ngezizukulwane.
I-syndrome ihlobene nezinguquko kumagciwane amane: MLH1, MSH2, MSH6, ne-PMS2. Lezi zinguquko zakhi zofuzo zizuzwe njengefa elihle kakhulu, okusho ukuthi udinga nje ukuzuza ifa lesandulela ngculazi komunye wabazali bakho ukuze ubhekene nengozi ye-syndrome. I-Lynch syndrome inesibopho samaphesenti amabili kuya kwesikhombisa samakhansela e-colon, kanti isilinganiso esilinganiselwe sokuthuthukisa umdlavuza wamakoloni singama-45 kumuntu one-Lynch syndrome.
Izingozi Zomdlavuza
Ingozi yomdlavuza jikelele kubantu abane-Lynch syndrome zihlanganisa:
- Umdlavuza weColon - amaphesenti angu-80
- Umdlavuza wesisu - amaphesenti angu-11- 18
- Ubhubhane nomdlavuza we-bile wokuvuza - amaphesenti angu-2 kuya ku-7
- Umdlavuza wesibindi nesifo sezinso - amaphesenti angu-4.5 kuya ku-5
- Umdlavuza wezinambuzane - amaphesenti angu-1 kuya kwangu-4
- Umdlavuza wobunongo - amaphesenti angu-1 - 3
Ingozi yezinsikazi zegciwane lesigungu sesifazane ihlanganisa:
- Umdlavuza wesibeletho - amaphesenti angu-20 kuya kwangu-60 abesifazane
- Umdlavuza we-Ovarian - amaphesenti angu-9 kuya kwabangu-12 wabesifazane
Lesi simo sibeka abantu eminye imikhakha, njengengculaza yesifuba .
Ukunciphisa Ingozi Yomdlavuza
Uma ukhuluma ngokunciphisa ubungozi, kubalulekile ukuthi uqale wenze umehluko. Izivivinyo eziningi zokuhlola ozokuzwa ngazo zihlobo lokutholwa kokuqala. Lezi zivivinyo azivimbeli umdlavuza, noma zinciphise ingozi yokuthi uzoba nomdlavuza. Kunalokho, zandisa ithuba lokuthi umdlavuza uzotholakala uma uncane. Futhi eziningi ze-kansa zitholwa kakhulu, futhi mhlawumbe ziphilisa, uma zincane.
Ngokuphambene, kunezinto abantu abangayenza ukuze banciphise amathuba abo okuba nomdlavuza kuqala. Ukudla ukudla okunempilo nokuzivocavoca kungena kulesi sigaba. Ukuhlolwa komdlavuza weColon, noma kunjalo, kuyinto ehlukile phakathi kwezivivinyo zokuhlola umdlavuza. Ihlinzeka ithuba lokuthola umdlavuza ekuqaleni-ukutholakala kokuqala-kodwa kungase futhi kusize ekuvimbeleni, lapho kutholakala izicubu eziqanjiwe futhi zisuswe, ngaphambi kokuba zibe umdlavuza.
Izindlela Zokuvimbela Umdlavuza jikelele
Kubalulekile ukuqaphela ukuthi abesifazane abane-Lynch syndrome, ngokungezelela kwezinye izinyathelo ezizoxoxwa ngazo, kufanele baphenye izivivinyo zokuhlolwa komdlavuza abesifazane abangenayo i-Lynch syndrome. Eqinisweni, lokhu kubaluleke kakhulu ukukhumbula, njengoba kubalulekile ukunakekela izindaba zezempilo ezingenzeka uma ungenayo i-Lynch syndrome.
Isibonelo, abesifazane abanomdlavuza wesifuba ngezinye izikhathi bagxila kakhulu ekuvimbeleni umdlavuza webele. Abakhohlwa ukulandela ukuhlolwa kokuvimbela umdlavuza wekoloni njengoba kubonakala "kungabalulekile."
Ukukhumbula lokhu kubalulekile ukuthi abesifazane abane-Lynch syndrome baxoxe nodokotela wabo mayelana nokukhathazeka kwezokwelapha okungahambisani ne-Lynch syndrome. Isibonelo, kusadingeka ukukhuluma ngokuvimbela isifo senhliziyo nakuba le syndrome engabangeli ingozi yesifo senhliziyo, ngoba wonke umuntu usesengozini.
Izinyathelo Zokuvimbela Ezingeziwe Kwabesifazane abane-Lynch Syndrome
Ukuze ubone ukuthi yiziphi izinyathelo ezingase zithathwe ukunciphisa amathuba okuthinteka ngengozi yokwanda kofuzo lwe-Lynch syndrome, abacwaningi baye babheka izinzuzo zokuhlola eziningana zokuhlola.
Ukunciphisa Ingozi ye-Ovarian ne-Uterine Cancer
Kunezinketho eziningi ezahlukene zokunciphisa ubungozi bokufa ngenxa yomdlavuza we-ovari noma umbelevuza wabesifazane abane-Lynch syndrome.
Ocwaningweni luka-2006 olwanyatheliswa eNew England Journal of Medicine , abacwaningi baphetha ngokuthi i-prophylactic hysterectomy nge-salpingo-oophorectomy yamazwe angama-200 iyindlela ephumelelayo yokuvimbela i-endometrial (uterine) nomdlavuza we-ovarian kwabesifazane abane-Lynch syndrome. Ucwaningo lwango-2011 olugxile ekuhlaziyweni kwezindleko zezindlela ezahlukene ezitholakala, ukuhlinzekwa kokunciphisa ingozi kube yindlela ebiza kakhulu kakhulu.
Njengokuba ummeli wakho ubaluleke kakhulu ekutholeni ukwelashwa okungcono kunokwenzeka, kungaba usizo ukwazi ukuthi ezinye zalezi zincomo zivelaphi. Khona-ke, futhi ngemva kokuqhathanisa ukukhetha okuhlukile nezifiso zakho siqu, ungenza isinqumo esilungele wena ngokwakho.
Abacwaningi baye babheka izindlela ezehlukene zokunciphisa ingozi yokufa kulawa kansela. Ezinye izinto eziye zahlolwa zifaka:
- Ukuhlolwa kwezinyanga zonyaka
- Ukuhlolwa kwonyaka usebenzisa i-biopsy ye-endometrili , i-ultrasonography ye-transvaginal, ne- serum CA 125
- Ukususwa kokuhlinzwa kwesibeletho, ama-ovari, nama-tublopian tubes eneminyaka engu-30 (noma okungenani ngaphambi kweminyaka engu-35)
Abacwaningi banqume ukuthi inketho engavamile kakhulu (ukuhlinzwa) yabangela ingozi yomdlavuza ophansi kunazo zonke kanye nokukhethwa okungenani okungavamile (ukuhlolwa kwonyaka) kwaholela engozini enkulu yomdlavuza. Lokhu kwaba yiqiniso kokubili umdlavuza we-ovarian kanye ne-uterine. Kodwa, ukusinda jikelele akuzange kushintshe okuningi. Ngokwesilinganiso, abesifazane ababenezibeletho zabo, ama-ovari, nama-tublopian tubes abasuswe eminyakeni engama-30 bahlala iminyaka emithathu kunamathuba okuba ababenokuhlolwa kwezigameko zonyaka.
Ngokuqondile, umdlavuza we-ovarie wenziwa ngamaphesenti ayisishiyagalolunye wabesifazane abahlolwayo ngonyaka, amaphesenti amane ayebhekene nokuhlolwa kwonyaka, futhi angaphansi kuka-1/10 wephesenti labesifazane abahlinzwa. Umdlavuza wesibeletho uvele ngamaphesenti angu-49 abesifazane ababhekana nezivivinyo zonyaka, amaphesenti angu-18 abahlolwayo ngonyaka, futhi abangaphansi kwamaphesenti angu-1/10 abesifazane abahlinzwa. Yize kubonakala sengathi i-counterintuitive, namanje kungenzeka ukuthi abesifazane bathole umdlavuza we-ovari noma umbelevuza lapho lezo zitho zisusiwe. Isibonelo i-peritoneal carcinoma.
Abesifazane ababenemibuzo yonyaka baphila cishe abangaba ngu-77, labo ababebe nokuhlolwa kwonyaka bahlala cishe abangaba ngu-79, futhi labo abahlinzwa bahlala cishe abangaba ngu-80.
Ukunciphisa Ingozi Yamanye Amakhansela
Kunezinkinga eziningi zokuhlola abantu abane-Lynch syndrome ekutholeni ngokushesha kwamanye amagciwane. Isibonelo, amakolonoscopies waminyaka yonke noma ama-biyearly anconywa kusukela ekuqaleni kweminyaka engu-20 kuya ku-25 noma eminyakeni emihlanu engaphansi kwesilinganiso lapho isihlobo sathuthukisa khona lesi sifo. Khuluma nodokotela wakho mayelana nalezi zivivinyo zokuhlola ukuthola ukuthi yini efanele kuwe.
Imithombo:
I-American Society of Clinical Oncology. I-Cancer.Net Lynch Syndrome. 12/2004. http://www.cancer.net/cancer-types/lynch-syndrome
Bonis, P., Ahnen, D., noL. Axell. I-Lynch syndrome (umdlavuza we-nonpolyposis oyinzalo): Ukuhlolwa nokuphathwa. UpToDate . Kubuyekezwe 05/12/16.
Chen, L., Yang, K., Little, S., Cheung, M., no-A. Caughey. I-Gynecologic Cancer Prevention ku-Lynch Syndrome / Hereditary Nonpolyposis Imindeni Yomdlavuza We-Colorectal. I-Obstetrics ne-Gynecology . 2007. 110 (1): 18-25.
Schmeier, K., Lynch, J., Chen, L. et al. Ukwelapha Kwe-Prophylactic Yokunciphisa Ingozi Ye-Cancer E-Gynecologic ku-Lynch Syndrome. I-New England Journal of Medicine . 2006. 354 (3): 261-9.
Vasen, H., Ignacio, B., Aktan-Collan, K. et al. Iziqondiso ezibuyekeziwe zokuphathwa kwemitholampilo ye-Lynch syndrome (HNPCC): izincomo zeqembu labachwepheshe baseYurophu. Gut . 2013. 62 (6): 812-23.
Yang, K., Caughey, A., Little, S., Cheung, M., noL. Chen. Ukuhlaziywa Kwezindleko Zokuhlinzwa Kwe-Prophylactic Ukubhekana Nokuqapha KwamaGynecologic Kwabesifazane abavela eHereditary Non-Polyposis Colorectal Cancer (HNPCC) Imindeni. I-Cancer Ejwayelekile . 2011. 10 (3): 535-43.