Kenza yemudumbu

Kenza yemudumbu (CRC, kusanganisira kenza yemudumbu nekenza yemudumbu) ndeimwe yemabundu anowanzoitika mudumbu.

Gomarara remudumbu muChina rave "muurayi wekutanga munyika", vanhu vanosvika 50% vane gomarara remudumbu vanorwara muChina, uye 60% vepakati nepakati.

Pasinei nechirwere chitsva kana kufa kwevanhu, huwandu hwese hwekenza yemudumbu hwakapfuura kenza yemapapu. Kenza yemudumbu ndiyo inorapika zviri nyore kupfuura dzimwe kenza dzese kuburikidza nekuongororwa nekukurumidza. Ndiyo nzvimbo yekutanga yevanhu kukunda kenza. 5% chete yekenza yemudumbu yekuChina yakaonekwa nekukurumidza, uye 60-70% yevarwere vane kenza yemudumbu vakaonekwa vaine lymph nodes kana metastases dziri kure. Kudzoka kwechirwere kwacho kwakakwira kusvika 30%.

Japan neSouth Korea inyika dzine huwandu hwakawanda hwekenza yemudumbu, asi huwandu hwavo hwekuongororwa nekukurumidza huri pakati pe50-60%, uye vanopfuura 90% yevarwere vanogona kurapwa. Ongororo dzemuno nedzekunze dzinoratidza kuti nzira dzekuongorora kenza yemudumbu dzinogona kuderedza kuwanda kwekenza yemudumbu.

Mumakore achangopfuura, kuwedzera kuEurope, North America, Japan, Singapore, South Korea, Taiwan, neHong Kong, kwave nekuongororwa kukuru kwenyika kwakatungamirwa nehurumende. Kuongororwa kwekutanga kwegomarara remudumbu kune mukana wekuporeswa zvachose, zvine kukosha kukuru munharaunda uye kukosha kwemusika.

Kuonekwa kwegomarara remudumbu rinobuda ropa kunotora nguva yakareba. Kubva pamapolyps kusvika kuhyperplasia isina kujairika kusvika kugomarara, zvinowanzotora nguva yakareba, izvo zvinopa nguva yekuongorora gomarara remudumbu rinobuda ropa. Kuongorora nekupindira kwegomarara nekukurumidza kunogona kuderedza kuwanda kwegomarara ne60% uye huwandu hwerufu ne80%.

2, Kukosha kwe calprotectin mukuongorora mashandiro emudumbu

Calprotectin ipuroteni inosunga calcium-zinc inobva muma neutrophils nema macrophages, ine huremu hwemamorekuru hwe36,000, heterodimer inoumbwa nekubatana kwe non-covalent kwemaketani maviri anorema MRP14 uye ketani imwe chete yechiedza MRP8, iri yeS100. Mapuroteni emhuri.

Kuburikidza nemabhuku akawanda ekutsvagisa uye kuongororwa kwekiriniki, calprotectin ine mukana wekuona kenza yemudumbu uye haikanganisike nedanho rebundu, iro rinogona kuwanikwa pakutanga uye munguva isina zviratidzo. Inogona kushandiswa sechiratidzo chekuongororwa kenza yemudumbu.

Kunzwa kwefecal calprotectin, fecal occult blood test uye serum CEA yekenza yemudumbu kwaive 88.51%, 83.91% uye 44.83%, zvichiteerana. Mwero wakanaka wekuongororwa kwefecal occult blood test uye serum CEA muvarwere vane danho D nedanho A waive wakaderera zvakanyanya pane wevarwere vane danho C neD. Pakanga pasina musiyano wakakosha muhuwandu hwakanaka hwefecal calprotectin muvarwere vane matanho akasiyana eDukes.

Kunzwisiswa kwechirwere chekenza yemudumbu (fecal calprotectin) kunokonzerwa nekenza yemudumbu kwakasvika 92.7%, uye kukosha kweNPV kwakasvika 98.6%. Calprotectin yekenza yemudumbu, ≥10mm colorectal polyps total negative predictive value NPV yakasvika 97.2%.

Kusvika pari zvino, nyika dzinopfuura makumi maviri dzakadai seUnited States, Britain, Canada, France, Germany, neSwitzerland dzakashandisa calprotectin sechiratidzo chakakosha chekuongorora zvirwere zvemudumbu negomarara muvanhu vane njodzi huru yezvirwere zvemudumbu, uye dzakaongorora zvirwere zvemudumbu. Zviratidzo zvakakosha zvinoshanda uye zvinoporesa zvinoshandiswa zvakanyanya mukurapa.

3, Mabhenefiti e calprotectin neropa remashiripiti pamwe chete nekuongorora njodzi yekenza yemudumbu

1. Zviri nyore kushandisa: sampuro imwe chete, mhinduro dzakawanda dzebvunzo
2. Hazviwedzere kuoma kwekushanda uye mutengo wechishandiso: chishandiso chinoiswa, uye michina yacho inoshongedzerwa zvinoenderana nezvinodiwa.
3. Kunzwa kwakanyanya uye zvakananga: indekisi yekuzvimba, kubuda ropa mudumbu
4. Kufambira mberi kwedanho rekuongorora: kuwedzera mukana wekuongororwa kweadenocarcinoma uye polyps
5. Mutengo wakaderera wekuona, unogona kushandiswa senzira yekuburitsa colonoscopy
6. Kuramba uchienderera mberi: kuongorora kwepagore kweboka

Zviratidzo zvinowanzoonekwa zvegomarara remudumbu:

Kuzvimba kwemudumbu – calprotectin, Dukes danho ndiro danho A neB varwere vane occult blood test uye serum CEA positive rate yakaderera zvakanyanya pane varwere vane C neD danho, Dukes matanho akasiyana emurwere, positive rate yefecal calprotectin Misiyano mikuru.

Kubuda ropa mudumbu - ropa remashiripiti, transferrin. Kubuda ropa mudumbu zvinoreva kurasikirwa neropa kuburikidza nedumbu nekuda kwezvikonzero zvakasiyana-siyana. Zvikonzero zvinowanzo sanganisira kuzvimba kwedumbu pacharo, kukuvara kwemakemikari, chirwere chetsinga dzeropa, bundu, uye zvirwere zvemudumbu mudumbu. Kuongororwa kweropa remashiripiti inzira yakajairika uye inokosha yekuongorora kubuda ropa mudumbu.

4, Nzira yekuona tsvina ye calprotectin

Kiti yedu yekuyedza calprotectin (nzira yecolloidal gold) inogona kushandiswa yoga kuona calprotectin muzviyero zvetsvina yevanhu. Inogona zvakare kushandiswa neWIZ series of immunoassays.

Kiti yekuongorora calprotectin (fluorescence immunochromatography) inogona kuona huwandu hwemasero, nhamba dzakarurama, uye nzira dzakasiyana-siyana, kuitira kuti ikwanise kusiyanisa zvirwere zvemudumbu.

Kiti yekuyedza ropa remashiripiti (nzira yegoridhe recolloidal) inoshandiswa pakuona hemoglobin yemunhu mutsvina yemunhu, iyo yakakodzera kuongororwa kwekubuda ropa mudumbu.