Kuzungulira DNA ya DNA Kungathandize Kuthandiza Lymphoma
Kugwiritsa ntchito mankhwala osokoneza bongo ndi minofu yong'onoting'ono ya kafukufuku wa labotale-kawirikawiri kumafunika kuti matenda oyamba a lymphoma ayambe. Zomwe zimapangidwa kuchokera ku ziwalo zamakono zimathandiza akatswiri odziwa za matenda a khansa kuganizira za maselo a khansa, kapena mitundu yonse yosiyanasiyana ya maselo a khansa komanso mapuloteni.
Choncho, madokotala amathandiza kuti madokotala azidziŵa zofunika kwambiri kuti apeze chithandizo ndi mankhwala. Ngakhale kuti ndi ofunika kwambiri, biopsies sizowopsa ndi zoperewera.
Kuwonjezera pamenepo, anthu amene apezeka ndi ma lymphoma amafunikanso kuti matenda awo "ayambe" pazifukwa zosiyana: poyamba, kuti awone momwe zilili panthawi yomwe amatha; kenako, kuti awone kuti ikuchepa chifukwa cha mankhwala; ndi zina zotsatira, pakuwunika, kuonetsetsa kuti madokotala ali pamwamba pa zinthu ngati khansara ikhoza kubwerera pambuyo pa chithandizo choyamba. Apanso, kufunika kwa kujambula sikungatheke, koma kuganiza kumakhala ndi zovuta zake, monga kuwonetseredwa ndi mankhwala. Ndicho chifukwa chake mayeserowa amagwiritsidwa ntchito mobwerezabwereza kuti phindu likhale loposa kuopsa kwake.
Tsogolo: Kuthamangira Kuchokera ku Biopsies ndi Scans
Lero, njira ya golide yothetsera khansara monga momwe tafotokozera pamwambapa ndi kujambula. Mwachindunji, computed tomography ( CT ) ndi fluorodeoxyglucose (FDG) positron emission tomography (PET) akuyesa nthawi zambiri amagwiritsidwa ntchito poyesa ndi kudziwa momwe kansa ikuyankhira mankhwala.
Kawirikawiri njira ziwirizi zimagwirizanitsidwa, ndipo zimatchedwa PET / CT. Ngakhale kuti zojambulazo zapamwambazi ndizothandiza ndipo zasintha chithandizo cha odwala mu lymphoma, zimakhudzana ndi kutentha kwa dzuwa, ndalama, komanso nthawi zina, kusowa molondola.
Zonsezi zathandiza chidwi cha ochita kafukufuku kupeza njira zatsopano, zosavuta, zosawonongeka komanso zosavuta kuzikweza khansara ya munthu.
Cholinga chimodzi ndicho kupeza zizindikiro, monga machitidwe a jini, omwe angayesedwe kokha mwa kuyesedwa kwa magazi kuti asunge matenda pa khansara kotero kuti mwina simukuyenera kuyang'ana nthawi zonse panthawi yowunika.
Pamene maselo a khansa amafa, zina mwa DNA zawo zimatha m'magazi. DNA ya maselo a khansa yakufa akutchedwa kutulutsa DNA, kapena ctDNA. Asayansi apanga mayesero kuti adziwe kuti DNA ikuzungulira. Njira yotereyi nthawi zina imatchedwa "madzi osokoneza bongo," ndipo ofufuzira amasonyeza kuti phindu loyang'anira matenda, komanso kulongosola momwe munthu angayankhire kuchipatala msanga.
Kutulutsa Tumor DNA Study
Mu kafukufuku wofalitsidwa, openda ku National Cancer Institute anafufuza magazi kuchokera kwa 126 anthu omwe ali ndi DLBCL chifukwa cha kupezeka kwa DNA yotupa. Kuphwanya lalikulu-B-cell lymphoma, kapena DLBCL, ndi mtundu wochuluka wa lymphoma, khansa ya magazi imene imayamba m'ma maselo ena a chitetezo cha mthupi.
Ngakhale kuti ali ndi mawonekedwe ofanana ndi a microscope, magawo osiyanasiyana a DLBCL akhoza kukhala osiyana. Malingana ndi American Cancer Society, pafupifupi anthu atatu mwa anayi sadzakhala ndi zizindikiro za matenda pambuyo pa chithandizo choyamba, ndipo ambiri amachiritsidwa ndi mankhwala.
Komano khansa imabwerera kwa 40 peresenti ya anthu, komabe nthawi zambiri imakhala yosachiritsika, makamaka ikabwerera mofulumira ndipo / kapena pamene maselo a maselo a m'magazi ali pamwamba, malinga ndi National Cancer Institute.
Aliyense pa kafukufukuyu adalandira chithandizo cha DLBCL malingana ndi ndondomeko zitatu zosiyana siyana, ndi mankhwala monga etoposide, prednisone, vincristine, cyclophosphamide, ndi doxorubicin, yotchedwa EPOCH, kapena popanda rituximab, m'mayesero odwala pakati pa May 1993 ndi December 2013.
Kuyezetsa magazi kunkachitika musanayambe kupanga mankhwala a chemotherapy, kumapeto kwa chithandizo, komanso nthawi iliyonse yomwe ayesedwa.
Anthu adatsatiridwa kwa zaka zambiri pambuyo pochizidwa, ndipo ma scans a CT anachitidwa panthawi imodzimodzimodzi poyezetsa magazi. Anthu mu phunziroli adatsatiridwa kwa zaka zisanu ndi ziwiri (11) pambuyo pa chithandizo-ndiko kuti, nambala yapakati pa mndandanda unali zaka 11, koma anthu adatsatiridwa kwa nthawi yayitali komanso yayitali.
Kuyesera kwa Magazi Kuneneratu, Kubwereza
Mwa anthu 107 omwe anali ndi chikhululukiro chathunthu cha khansara, awo omwe anapeza ctDNA yowonongeka m'magazi a magazi anali oposa 200 nthawi zambiri kuti matenda awo apitirire kuposa awo omwe analibe CD.
Kuyezetsa magazi kunatha kufotokozera kuti ndi anthu ati omwe sangayankhe ngati mankhwalawa atangotenga kachilombo koyambitsa khansa.
Kuyezetsa magazi kunathandizanso kuti munthu adziwe kuti khansa yayamba kubwerera kwa miyezi 3.4 musanakhalepo umboni wina wa matenda, musanayambe kupezeka pogwiritsa ntchito CT.
Pakalipano, zochitika zamadzi zozungulira mu DLBCL ndi kufufuzira ndipo sizovomerezedwa ndi FDA kapena zotsatiridwa ndi malangizo a NCCN. Zomwe zimaperekedwa ndi mankhwala osokoneza bongo siziyenera kugwiritsidwa ntchito kutsogolera mankhwala mu DLBCL.
Malangizo Otsogolera
Pali mafunso ambiri osayankhidwa ndi zovuta zomwe zikukhudzana ndi kusunga ma kansalu pogwiritsa ntchito zizindikiro zamagazi m'mayesero a magazi, koma chidziwitso chimawonjezeka ndikukula.
Pankhani ya lymphoma, makamaka mitundu yonse ya mitundu yambiri yosabadwa ya Hodgkin lymphoma , kusiyana kwakukulu kwa malungowa kumapangitsa ntchito yovuta. Ngakhale pamene mukuganizira zolakwika zomwezo, monga DLBCL, n'zotheka kuti chizindikiro chimodzi sichitha kugwira bwino nthawi zonse.
Komabe, patapita nthawi, chiyembekezocho ndi chakuti zina mwa zofuna, singano, ndi zokopa zomwe zimadziwika bwino kwa odwala khansa za lero zingapewe ndi kusankhidwa ndi mayesero omwe amazindikira zizindikirozi ndi kuyeza miyeso yawo mu thupi.
> Zotsatira:
> American Cancer Society. B-cell lymphomas. Kufalitsa kwambiri B-cell lymphoma.
> Melani C, Roschewski M. Mapangidwe a maselo osayendetsa maselo a DNA m'thupi lomwe silili Hodgkin lymphoma. Oncology (Williston Park). 2016; 30 (8). pii: 218406.
> NIH. Kuzungulira DNA yamagazi m'magazi kunganeneratu kuti mitundu yambiri ya lymphoma imabwereranso.