Umdlavuza we-Colorectal

Umdlavuza we-Colorectal (CRC, okuhlanganisa umdlavuza we-rectal kanye nomdlavuza we-colon) ungenye yezimila ezivamile ezibulalayo zomgudu wokugaya ukudla.

Umdlavuza wesisu waseShayina usube “umbulali wokuqala kazwelonke”, cishe ama-50% eziguli ezinomdlavuza wesisu atholakala eShayina, kanti ama-60% atholakala maphakathi nasekupheleni.

Kungakhathaliseki ukuthi ikesi elisha noma ukufa kunjani, inani eliphelele lomdlavuza wesisu lidlule umdlavuza wamaphaphu. Umdlavuza wamathumbu ululama kalula kunayo yonke imidlavuza ngokuhlolwa kusenesikhathi. Uyisiphephelo sokuqala sabantu ukunqoba umdlavuza. Ama-5% kuphela omdlavuza we-colorectal waseShayina atholakale kusenesikhathi, kanti ama-60-70% eziguli ezinomdlavuza we-colorectal atholakale enama-lymph node noma ama-metastases akude. Izinga lokuphindeka laliphezulu ngama-30%.

IJapan neNingizimu Korea nazo zingamazwe anezinga eliphezulu lomdlavuza wesisu, kodwa izinga lokutholakala kwawo kusenesikhathi lingu-50-60%, kanti iziguli ezingaphezu kuka-90% zingelapheka. Ucwaningo lwasekhaya nolwamazwe ngamazwe lubonisa ukuthi izindlela zokuhlola umdlavuza we-colonectal zinganciphisa ukwanda kanye nokufa komdlavuza we-colonectal.

Eminyakeni yamuva nje, ngaphezu kweYurophu, eNyakatho Melika, eJapane, eSingapore, eNingizimu Korea, eTaiwan, naseHong Kong, kube nokuhlolwa okukhulu kukazwelonke okuholwa nguhulumeni. Ukuhlolwa kwangaphambi kwesikhathi kokuxilongwa komdlavuza wesisu kunethuba lokwelashwa ngokuphelele, ngokubaluleka okukhulu emphakathini kanye nenani lemakethe.

Ukwenzeka komdlavuza we-colorectal kuyinqubo ende kakhulu. Kusukela kuma-polyps kuya ku-hyperplasia engavamile kuya kumdlavuza, kuvame ukuthatha isikhathi eside, okunikeza isikhathi sokuhlolwa komdlavuza we-colorectal. Ukuhlolwa kokuqala okuphumelelayo kanye nokwelashwa kokungenelela kunganciphisa ukwanda komdlavuza ngo-60% kanye nezinga lokufa ngo-80%.

2, Ukubaluleka kwe-calprotectin ekuhlolweni kokusebenza kwamathumbu

I-Calprotectin iyiprotheni ebopha i-calcium-zinc etholakala kuma-neutrophils nama-macrophage, enesisindo sama-molecule esingu-36,000, i-heterodimer eyakhiwe yi-non-covalent association yamaketanga amabili asindayo i-MRP14 kanye neketanga elilodwa elilula i-MRP8, eliyi-S100. Iphrotheni yomndeni.

Ngokucwaninga okubanzi kanye nokuqinisekiswa kwemitholampilo, i-calprotectin inozwela oluphezulu lokuthola umdlavuza we-colonectal futhi ayithinteki esigabeni sesimila, esingatholakala ekuqaleni nangesikhathi sokungabi nazimpawu. Ingasetshenziswa njengophawu lokuhlolwa komdlavuza we-colonectal.

Ukuzwela kwe-calprotectin yendle, ukuhlolwa kwegazi elingabonakali lendle kanye ne-CEA ye-serum yomdlavuza we-colorectal kwakungu-88.51%, 83.91% kanye no-44.83%, ngokulandelana. Izinga elihle lokuhlolwa kwegazi elingabonakali lendle kanye ne-CEA ye-serum ezigulini ezinesigaba D kanye nesigaba A laliphansi kakhulu kuneleziguli ezinesigaba C no-D. Kwakungekho mehluko obalulekile esilinganisweni esihle se-calprotectin yendle ezigulini ezinezigaba ezahlukene ze-Dukes.

Ukuzwela kokuxilongwa kwe-fecal calprotectin kumdlavuza we-rectal kufinyelele ku-92.7%, kanti inani elibi lokubikezela le-NPV lifinyelele ku-98.6%. I-fecal calprotectin yomdlavuza we-colorectal, ≥10mm colorectal polyps inani eliphelele elibi lokubikezela i-NPV lifinyelele ku-97.2%.

Kuze kube manje, amazwe angaphezu kuka-20 afana ne-United States, iBrithani, iCanada, iFrance, iJalimane neSwitzerland asebenzise i-calprotectin njengesibonakaliso esibalulekile sokuhlola izifo zamathumbu ezivuvukalayo kanye nomdlavuza kubantu abasengozini enkulu yezifo zamathumbu, futhi ahlola izifo zamathumbu ezivuvukalayo. Izimpawu ezibalulekile ezisebenzayo nezokwelapha zisetshenziswa kabanzi emitholampilo.

3, Izinzuzo ze-calprotectin kanye negazi elingabonakali elihlangene lokuthola ukuhlolwa kwengozi yomdlavuza wamathumbu

1. Kulula ukuyisebenzisa: isampula eyodwa, imiphumela eminingi yokuhlolwa
2. Akukhulisi ubunzima bokusebenza kanye nezindleko zethuluzi: ithuluzi liyabekwa, futhi imishini ifakwe ngokwezidingo.
3. Ukuzwela okuphezulu kanye nokucaciswa: inkomba yokuvuvukala, ukopha kwamathumbu
4. Ukuhlolwa kusenesikhathi kusenesikhathi: kwandisa amathuba okuhlolwa kwe-adenocarcinoma kanye nama-polyps
5. Izindleko zokutholwa eziphansi, zingasetshenziswa njengokukhipha amanzi e-colonoscopy
6. Ukuphikelela: ukuhlolwa kweqembu lonyaka

Izimpawu ezijwayelekile zomdlavuza we-colorectal:

Ukuvuvukala kwamathumbu – i-calprotectin, isigaba se-Dukes yisigaba A ne-B iziguli ezine-occult blood test kanye ne-serum CEA positive rate iphansi kakhulu kuneziguli ezine-C ne-D stage, i-Dukes izigaba ezahlukene zesiguli, izinga elihle le-fecal calprotectin Umehluko omkhulu.

Ukopha kwamathumbu – igazi elingaqondakali, i-transferrin. Ukopha kwamathumbu kubhekisela ekulahlekelweni kwegazi ngendlela yokugaya ukudla ngezizathu ezahlukahlukene. Izimbangela ezivamile zifaka phakathi ukuvuvukala kwendlela yokugaya ukudla uqobo, umonakalo womshini, isifo semithambo yegazi, isimila, kanye nezifo zesisu endleleni yokugaya ukudla. Ukuhlolwa kwegazi elingaqondakali kuyindlela evamile nebalulekile yokuxilonga ukopha kwamathumbu.

4, Indlela yokuthola i-calprotectin yendle

Ikhithi yethu yokuhlola i-calprotectin (indlela ye-colloidal gold) ingasetshenziswa yodwa ukuthola i-calprotectin ngokwesilinganiso esincane kumasampula endle yabantu. Ingasetshenziswa futhi nochungechunge lwe-WIZ lwe-immunoassays.

Ikhithi yokuhlola i-calprotectin (i-fluorescence immunochromatography) ingafinyelela ekutholakaleni kwenani, amanani anembile ezinombolo, kanye nobubanzi obubanzi, ukuze kufezwe umphumela wokuhlukanisa izifo zamathumbu.

Ikhithi yokuhlola igazi elingabonakali (indlela yegolide ye-colloidal) isetshenziselwa ukuthola i-hemoglobin yomuntu endle yomuntu, efanelekela ukuxilongwa kokuphuma kwegazi esiswini.