Ka maʻi ʻaʻai colorectal

ʻO ke kanesa Colorectal (CRC, me ke kanesa rectal a me ke kanesa colon) kekahi o nā puʻupuʻu malignant maʻamau o ka ʻōpū gastrointestinal.

Ua lilo ke kanesa ʻōpū o Kina i ka "pepehi kanaka mua o ka ʻāina", ma kahi o 50% o nā maʻi kanesa ʻōpū e loaʻa ana ma Kina, a ʻo 60% o ka waena a me ka hope.

Me ka nānā ʻole i ka hihia hou a i ʻole ka make ʻana, ua ʻoi aku ka nui o nā maʻi ʻaʻai gastrointestinal ma mua o ke kanesa māmā. ʻO ke kanesa ʻōpū ka mea maʻalahi loa e ho'ōla ʻia ma o nā kanesa āpau ma o ka nānā mua ʻana. ʻO ia ka pā kaua mua o kānaka e lanakila ai i ke kanesa. 5% wale nō o nā maʻi kanesa colorectal Kina i ʻike mua ʻia, a ua ʻike ʻia he 60-70% o nā maʻi me ke kanesa colorectal he mau lymph node a i ʻole nā ​​metastases mamao. Ua kiʻekiʻe ka helu hoʻi hou ʻana e like me 30%.

ʻO Iapana a me Kōlea Hema kekahi mau ʻāina me ka nui o ka maʻi ʻaʻai gastrointestinal, akā ʻo ko lākou helu ʻike mua ʻana he 50-60%, a ʻoi aku ma mua o 90% o nā maʻi hiki ke ho'ōla ʻia. Hōʻike nā noiʻi kūloko a me ka honua e hiki i nā hana nānā ʻana i ke kanesa colorectal ke hōʻemi i ka nui a me ka make ʻana o ke kanesa colorectal.

I nā makahiki i hala iho nei, ma waho aʻe o ʻEulopa, ʻAmelika ʻĀkau, Iapana, Singapore, Kōlea Hema, Taiwan, a me Hong Kong, ua hana ʻia nā hoʻokolohua aupuni nui. Loaʻa i ka hoʻokolohua mua no ka ʻike ʻana i ka maʻi ʻaʻai gastrointestinal ka manawa kūpono e ho'ōla loa ʻia, me ke koʻikoʻi nui o ka nohona a me ka waiwai mākeke.

He hana lōʻihi ka hanana ʻana o ke kanesa colorectal. Mai nā polyps a i ka hyperplasia maʻamau ʻole a hiki i ke kanesa, he manawa lōʻihi ia, kahi e hāʻawi ai i kahi manawa no ka nānā ʻana i ke kanesa colorectal. ʻO ka nānā mua a me ka mālama ʻana i ka hana hiki ke hōʻemi i ka nui o ke kanesa ma 60% a me ka helu make ma 80%.

2, Ke koʻikoʻi o ka calprotectin i ka hoʻokolokolo ʻana i ka hana o ka ʻōpū

ʻO Calprotectin kahi protein calcium-zinc-binding i loaʻa mai nā neutrophils a me nā macrophages, me ke kaumaha molekala o 36,000, he heterodimer i hoʻokumu ʻia e ka hui non-covalent o ʻelua kaulahao kaumaha MRP14 a me hoʻokahi kaulahao māmā MRP8, no S100. Protein ʻohana.

Ma o nā palapala noiʻi nui a me ka hōʻoia lapaʻau, loaʻa iā calprotectin ke kiʻekiʻe o ka ʻike no ka ʻike ʻana i ke kanesa colorectal a ʻaʻole i hoʻopilikia ʻia e ke kahua tumor, hiki ke loaʻa i ka wā mua a me ka wā asymptomatic. Hiki ke hoʻohana ʻia ma ke ʻano he māka no ka nānā ʻana i ke kanesa colorectal.

ʻO ka ʻike o ka fecal calprotectin, ka hoʻāʻo koko fecal occult a me ka serum CEA no ka maʻi ʻaʻai colorectal he 88.51%, 83.91% a me 44.83%, kēlā me kēia. ʻO ka helu maikaʻi o ka hoʻāʻo koko fecal occult a me ka serum CEA i nā maʻi me ke kahua D a me ke kahua A ua haʻahaʻa loa ia ma mua o nā maʻi me ke kahua C a me D. ʻAʻohe ʻokoʻa koʻikoʻi i ka helu maikaʻi o ka fecal calprotectin i nā maʻi me nā pae like ʻole o Dukes.

Ua hōʻea ka ʻike o ka maʻi ʻaʻai fecal calprotectin i ka maʻi ʻaʻai rectal i 92.7%, a ua hōʻea ka waiwai wānana maikaʻi ʻole o NPV i 98.6%. ʻO ka calprotectin fecal no ka maʻi ʻaʻai colorectal, ≥10mm colorectal polyps huina waiwai wānana maikaʻi ʻole NPV i hōʻea i 97.2%.

A hiki i kēia manawa, ua hoʻohana ʻo ʻoi aku ma mua o 20 mau ʻāina e like me ʻAmelika Hui Pū ʻIa, Pelekane, Kanada, Palani, Kelemānia, a me Kuikilana i ka calprotectin ma ke ʻano he hōʻailona koʻikoʻi no ka nānā ʻana i nā maʻi ʻōpū mumū a me ke kanesa i nā heluna kanaka kiʻekiʻe o nā maʻi ʻōpū, a ua loiloi i nā maʻi ʻōpū mumū. Hoʻohana nui ʻia nā hōʻailona koʻikoʻi ikaika a ho'ōla i ka hana lapaʻau.

3, Nā pono o ka calprotectin a me ke koko huna i hui pū ʻia o ka loiloi pilikia o ka maʻi ʻōpū

1. Maʻalahi e hana: hoʻokahi laʻana, nā hopena hoʻāʻo he nui
2. ʻAʻole ia e hoʻonui i ka paʻakikī o ka hana a me ke kumukūʻai o ka mea kani: ua kau ʻia ka mea kani, a ua lako pono nā lako e like me nā koi.
3. ʻIke kiʻekiʻe a me ke kikoʻī: ka helu hoʻopili, ke kahe koko gastrointestinal
4. ʻO ka holomua o ke kahua nānā mua: hoʻonui i ka hiki ke nānā ʻia no ka adenocarcinoma a me nā polyps
5. ʻO ke kumukūʻai ʻike haʻahaʻa, hiki ke hoʻohana ʻia e like me ka hoʻokahe ʻana o ka colonoscopy
6. Hoʻomau: nānā ʻana i ka pūʻulu makahiki

Nā hōʻailona maʻamau o ka maʻi ʻaʻai colorectal:

ʻO ka mumū ʻōpū - calprotectin, ʻo ke kahua Dukes ke kahua A a me B me ka hoʻāʻo koko huna a me ka serum CEA maikaʻi ka haʻahaʻa loa ma mua o nā mea maʻi me ke kahua C a me D, nā pae like ʻole o ka mea maʻi Dukes, ʻo ka helu maikaʻi o ka fecal calprotectin he ʻokoʻa koʻikoʻi.

ʻO ke kahe koko ʻōpū - ke koko huna, transferrin. ʻO ke kahe koko ʻōpū e pili ana i ka nalowale o ke koko ma o ke ala gastrointestinal no nā kumu like ʻole. ʻO nā kumu maʻamau e komo pū ana me ka mumū o ke ala digestive ponoʻī, ka hōʻino mechanical, nā maʻi vascular, ka puʻupuʻu, a me nā maʻi visceral i loko o ke ala gastrointestinal. ʻO ka hoʻāʻo koko huna kahi hana maʻamau a he ala koʻikoʻi ia no ka ʻike ʻana i ke kahe koko ʻōpū.

4, Ke ʻano hana no ka ʻike ʻana i ka calprotectin fecal

Hiki ke hoʻohana wale ʻia kā mākou pahu hoʻāʻo calprotectin (ʻano gula colloidal) e ʻike semi-quantitatively i ka calprotectin i loko o nā hāpana ʻōpala kanaka. Hiki ke hoʻohana pū ʻia me ka moʻo WIZ o nā immunoassays.

Hiki i ka pahu hoʻāʻo calprotectin (fluorescence immunochromatography) ke hoʻokō i ka ʻike quantitative, nā waiwai helu pololei, a me ka laulā linear ākea, i mea e hoʻokō ai i ka hopena o ka hoʻokaʻawale ʻana i nā maʻi ʻōpū.

Hoʻohana ʻia ka pahu hoʻāʻo koko huna (ʻano gula colloidal) no ka ʻike qualitative o ka hemoglobin kanaka i loko o nā feces kanaka, kahi kūpono no ka ʻike ʻana i ke kahe koko gastrointestinal.