Umhlaza weColoral

Umhlaza we-Colorectal (CRC, kuquka umhlaza we-rectal kunye nomhlaza we-colon) yenye yeethumba ezinobungozi eziqhelekileyo kwindlela yokugaya ukutya.

Umhlaza wesisu eTshayina ube “ngumbulali wokuqala wesizwe”, malunga nama-50% ezigulana zomhlaza wesisu zivela eTshayina, kwaye ama-60% aphakathi nasekupheleni.

Nokuba yeyiphi imeko entsha okanye ukufa, inani lilonke lomhlaza wesisu lidlule umhlaza wemiphunga. Umhlaza wamathumbu ngowona unyangeka lula kuzo zonke iintlobo zomhlaza ngokuhlolwa kwangethuba. Liliqonga lokuqala labantu ukoyisa umhlaza. Yi-5% kuphela yomhlaza we-colorectal waseTshayina oye wafunyaniswa kwangethuba, kwaye i-60-70% yezigulana ezinomhlaza we-colorectal zifunyenwe zine-lymph nodes okanye i-metastases ezikude. Izinga lokuphinda libuye laliphezulu ukuya kwi-30%.

IJapan kunye neSouth Korea nazo zingamazwe anezinga eliphezulu lomhlaza wesisu, kodwa izinga lokufunyaniswa kwawo kwangoko liyi-50-60%, kwaye ngaphezulu kwe-90% yezigulana zinokunyangwa. Uphando lwasekhaya nolwamanye amazwe lubonisa ukuba amanyathelo okuhlola umhlaza wesisu anokunciphisa ukwanda nokufa komhlaza wesisu.

Kwiminyaka yakutshanje, ukongeza eYurophu, eMntla Melika, eJapan, eSingapore, eMzantsi Korea, eTaiwan, naseHong Kong, kuye kwakho uhlolo olukhulu lwesizwe olukhokelwa ngurhulumente. Uhlolo lwakwangoko lokufumanisa umhlaza wesisu lunethuba lokunyangwa ngokupheleleyo, ngokubaluleka okukhulu kwezentlalo kunye nexabiso lemarike.

Ukwenzeka komhlaza we-colorectal yinkqubo ende kakhulu. Ukusuka kwi-polyps ukuya kwi-hyperplasia engaqhelekanga ukuya kumhlaza, kudla ngokuthatha ixesha elide, nto leyo enika ixesha lokuhlolwa komhlaza we-colorectal. Ukuhlolwa kwangethuba kunye nonyango olusebenzayo kunokunciphisa ukwanda komhlaza ngama-60% kunye nezinga lokufa ngama-80%.

2, Ukubaluleka kwe-calprotectin kuvavanyo lomsebenzi wamathumbu

I-Calprotectin yiproteni ebopha i-calcium-zinc ephuma kwi-neutrophils kunye ne-macrophages, enobunzima be-molecular obuyi-36,000, i-heterodimer eyenziwe yi-non-covalent association ye-heavy chain MRP14 ezimbini kunye ne-light chain MRP8 enye, eyi-S100. Iproteni yosapho.

Ngophando olubanzi kunye nokuqinisekiswa kweklinikhi, i-calprotectin inobuthathaka obuphezulu bokubona umhlaza we-colorectal kwaye ayichaphazeleki kwinqanaba le-tumor, elinokufumaneka ekuqaleni nangexesha lokungabikho kweempawu. Ingasetyenziswa njengophawu lokuhlola umhlaza we-colorectal.

Uvakalelo lwe-fecal calprotectin, uvavanyo lwegazi olufihlakeleyo kunye ne-serum CEA yomhlaza we-colorectal yayiyi-88.51%, 83.91% kunye ne-44.83%, ngokulandelelana. Izinga elihle lovavanyo lwegazi olucocekileyo kunye ne-serum CEA kwizigulane ezinesigaba D kunye nesigaba A laliphantsi kakhulu kunelo kwizigulane ezinesigaba C kunye no-D. Akukho mahluko ubalulekileyo kwizinga elihle le-fecal calprotectin kwizigulane ezinezigaba ezahlukeneyo zeDukes.

Uvakalelo lokuxilongwa kwe-calprotectin yendle kumhlaza we-rectal lufikelele kwi-92.7%, kwaye ixabiso elibi lokuqikelela le-NPV lifikelele kwi-98.6%. I-calprotectin ye-fecal yomhlaza we-colorectal, ≥10mm colorectal polyps ixabiso elipheleleyo elibi lokuqikelela i-NPV lifikelele kwi-97.2%.

Ukuza kuthi ga ngoku, amazwe angaphezu kwama-20 afana ne-United States, iBritane, iKhanada, iFransi, iJamani, neSwitzerland asebenzise i-calprotectin njengophawu olubalulekileyo lokuhlola isifo samathumbu esidumbileyo kunye nomhlaza kubantu abasengozini enkulu yezifo zamathumbu, kwaye avavanya isifo samathumbu esidumbileyo. Iimpawu ezibalulekileyo ezisebenzayo neziphilisayo zisetyenziswa kakhulu kwimisebenzi yezonyango.

3, Iingenelo ze-calprotectin kunye negazi elingaqhelekanga ukufumanisa umngcipheko womhlaza wamathumbu

1. Kulula ukuyisebenzisa: isampulu enye, iziphumo zovavanyo ezininzi
2. Ayinyusi ubunzima bokusebenza kunye neendleko zesixhobo: isixhobo sibekiwe, kwaye izixhobo zixhotyiswe ngokweemfuno.
3. Uvakalelo oluphezulu kunye nokucaciswa: isalathisi sokudumba, ukopha kwamathumbu
4. Ukuhlolwa kwangethuba kwinqanaba lokuhlolwa: kwandisa amathuba okuhlolwa kwe-adenocarcinoma kunye nee-polyps
5. Ixabiso eliphantsi lokufumanisa, lingasetyenziswa njengokukhupha amanzi kwi-colonoscopy
6. Ukuqina: uhlolo lwebhetshi yonyaka

Iimpawu eziqhelekileyo zomhlaza we-colorectal:

Ukudumba kwamathumbu – i-calprotectin, inqanaba le-Dukes linqanaba A kunye ne-B izigulane ezine-occult blood test kunye ne-serum CEA positive rate iphantsi kakhulu kunezigulane ezine-C kunye ne-D stage, i-Dukes izigaba ezahlukeneyo zesigulane, izinga elihle le-fecal calprotectin Umahluko omkhulu.

Ukopha kwamathumbu – igazi elingaqhelekanga, i-transferrin. Ukopha kwamathumbu kubhekisa ekulahlekelweni kwegazi ngendlela yesisu ngezizathu ezahlukeneyo. Izizathu eziqhelekileyo ziquka ukudumba kwendlela yokugaya ukutya ngokwayo, umonakalo woomatshini, isifo semithambo yegazi, ithumba, kunye nezifo zesisu kwindlela yesisu. Uvavanyo lwegazi elingaqhelekanga yindlela eqhelekileyo nebalulekileyo yokufumanisa ukopha kwamathumbu.

4, Indlela yokufumanisa i-calprotectin yendle

Ikhithi yethu yovavanyo lwe-calprotectin (indlela ye-colloidal gold) ingasetyenziswa yodwa ukubona i-calprotectin ngokwemilinganiselo engaphantsi kwiisampuli zendle yomntu. Ingasetyenziswa nothotho lwe-WIZ lwe-immunoassays.

Ikhithi yovavanyo lwe-calprotectin (i-fluorescence immunochromatography) inokufikelela ekufumaneni ubungakanani, amaxabiso achanekileyo eenombolo, kunye noluhlu olubanzi lomgca, ukuze kufezekiswe isiphumo sokwahlula izifo zamathumbu.

Isixhobo sovavanyo lwegazi olungaqhelekanga (indlela yegolide ye-colloidal) sisetyenziselwa ukufumanisa i-hemoglobin yomntu kwindle yomntu, efanelekileyo ekuxilongweni kokopha kwamathumbu.