Ka ma'i 'a'ai kala

ʻO ka maʻi ʻaʻai ʻokoʻa (CRC, me ka maʻi ʻaʻai rectal a me ka maʻi ʻaʻai ʻāʻī) kekahi o nā maʻi maʻi maʻamau o ka ʻōpū ʻōpū.

Ua lilo ka maʻi maʻi ʻōpū o Kina i ka "pepehi mua o ka lāhui", ma kahi o 50% o nā maʻi maʻi maʻi maʻi maʻi ma Kina, a me 60% o ka waena a me ka hope.

Ma waho o ka hihia hou a i ʻole ka make ʻana, ʻoi aku ka nui o nā maʻi maʻi ʻōpū ma mua o ka maʻi kanesa. ʻO ka maʻi maʻi ʻaʻai ka mea maʻalahi loa ka ho'ōla ʻana o nā maʻi maʻi āpau ma o ka nānā mua ʻana. ʻO ia ka pā kaua mua o ke kanaka e lanakila ai i ka maʻi kanesa. ʻO 5% wale nō o nā maʻi maʻi ʻaʻai kala ʻo Kina i ʻike mua ʻia, a ʻo 60-70% o nā mea maʻi me ka maʻi ʻaʻai kala i ʻike ʻia he lymph nodes a i ʻole metastases mamao. Ua like ka nui o ka hoʻihoʻi hou ʻana i 30%.

ʻO Iapana a me South Korea kekahi mau ʻāina me ke kiʻekiʻe o ka maʻi maʻi maʻi maʻi, akā ʻo kā lākou hōʻoia mua ʻana he 50-60%, a ʻoi aku ma mua o 90% o nā maʻi hiki ke ho'ōla. Hōʻike ka noiʻi kūloko a me ka honua e hiki ke hoʻemi i ka maʻi maʻi ʻaʻai colorectal a me ka make ʻana o ka maʻi kanesa colorectal.

I nā makahiki i hala iho nei, ma waho aʻe o ʻEulopa, ʻAmelika ʻĀkau, Iapana, Singapore, South Korea, Taiwan, a me Hong Kong, aia nā mākaʻikaʻi aupuni nui i alakaʻi ʻia e ke aupuni. ʻO ka hoʻomaʻamaʻa mua ʻana no ka hōʻoia ʻana o ka maʻi maʻi ʻōpū i loaʻa ka manawa e hoʻōla loa ʻia, me ka waiwai nui a me ka waiwai o ka mākeke.

ʻO ka loaʻa ʻana o ka maʻi maʻi colorectal he hana lōʻihi. Mai ka polyps a hiki i ka hyperplasia abnormal a hiki i ka maʻi maʻi, he manawa lōʻihi ia, kahi manawa no ka nānā ʻana i ka maʻi maʻi colorectal. Hiki ke hōʻemi i ka nui o ka maʻi kanesa e 60% a me ka nui o ka make ma 80%.

2, ʻO ke koʻikoʻi o ka calprotectin i ka nānā ʻana i ka hana o ka ʻōpū

ʻO Calprotectin he kinikini paʻa calcium-zinc-binding i loaʻa mai nā neutrophils a me 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, nona ka S100. ʻohana pūmua.

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

He 88.51%, 83.91% a me 44.83% ka sensitivity o ka fecal calprotectin, fecal occult blood test a me serum CEA no ka ma'i 'a'ai colorectal. ʻO ka helu maikaʻi o ka hoʻāʻo koko fecal occult a me ka CEA serum i nā maʻi me ka pae D a me ka pae A he haʻahaʻa haʻahaʻa ma mua o nā mea maʻi me ka pae C a me D. Dukes.

Ua hiki i ka 92.7% ka sensitivity o ka calprotectin fecal diagnostic i ka rectal cancer, a ua hiki i ka 98.6%. Fecal calprotectin no ka colorectal cancer, ≥10mm colorectal polyps total negative predictive value NPV i hiki i 97.2%.

A hiki i kēia manawa, ʻoi aku ma mua o 20 mau ʻāina e like me ʻAmelika Hui Pū ʻIa, Beretania, Kanada, Farani, Kelemānia, a me Switzerland ua hoʻohana i ka calprotectin ma ke ʻano he hōʻailona koʻikoʻi no ka nānā ʻana i ka maʻi ʻeha a me ka maʻi kanesa i nā heluna kiʻekiʻe o nā maʻi ʻōpū, a loiloi ʻia ka inflammatory. maʻi ʻōpū. Hoʻohana nui ʻia nā hōʻailona koʻikoʻi a hoʻōla i ka hana lapaʻau.

3, ʻO nā pono o ka calprotectin a me ke koko huna i hui pū ʻia ka ʻike ʻana i ka loiloi ʻana i ka maʻi maʻi ʻaʻai.

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: kau ʻia ka mea kani, a ua hoʻolako ʻia nā mea hana e like me nā koi.
3. ʻO ka naʻau kiʻekiʻe a me ka kikoʻī: ka helu ʻana o ka mumū, ke koko o ka ʻōpū
4. ʻO ka hoʻomaka ʻana o ka hoʻomaʻamaʻa ʻana: 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. Ka hoʻomau ʻana: ka nānā ʻana i ka hui makahiki

Nā hōʻailona maʻamau o ka maʻi maʻi colorectal:

ʻO ka ʻōpū o ka ʻōpū - calprotectin, Dukes pae ka pae A a me B nā maʻi me ka hoʻāʻo ʻana i ke koko occult a me ka serum CEA maikaʻi ʻoi loa ka haʻahaʻa ma mua o nā mea maʻi me ka C a me D pae, Dukes nā ʻanuʻu like ʻole o ka mea maʻi, ka helu maikaʻi o ka fecal calprotectin Nui nā ʻokoʻa.

ʻO ke koko o ka ʻōpū - ke koko huna, transferrin. ʻO ka hemorrhage gastrointestinal e pili ana i ke kahe o ke koko ma o ka ʻōpū ʻōpū no nā kumu like ʻole. ʻO nā kumu maʻamau e pili ana i ka mumū o ka digestive tract pono'ī, ka pōʻino mechanical, ka maʻi vascular, ka tumora, a me nā maʻi visceral i loko o ka ʻōpū ʻōpū. ʻO ka hoʻāʻo ʻana i ke koko he mea maʻamau a koʻikoʻi no ka ʻike ʻana i ke koko o ka ʻōpū.

4, Ke ala no ka ʻike ʻana i ka calprotectin fecal

Hiki ke hoʻohana wale ʻia kā mākou pahu hoʻāʻo calprotectin (colloidal gold method) i ka semi-quantitatively e ʻike i ka calprotectin i loko o nā laʻana kuʻekuʻe kanaka. Hiki ke hoʻohana pū me ka WIZ series of immunoassays.

Hiki i ka calprotectin assay kit (fluorescence immunochromatography) ke hoʻokō i ka ʻike quantitative, nā helu helu pololei, a me ka laulā laina ākea, i hiki ai ke hoʻokō i ka hopena o ka hoʻokaʻawale ʻana i nā maʻi ʻōpū.

Hoʻohana ʻia ka pahu hoʻāʻo koko occult (colloidal gold method) no ka ʻike qualitative o ka hemoglobin kanaka i loko o nā feces kanaka, kahi kūpono no ka ʻike ʻana i ke koko o ka ʻōpū.