mob qog nqaij hlav hauv plab

Kab mob qog nqaij hlav hauv plab (CRC, suav nrog mob qog noj ntshav thiab mob plab hnyuv) yog ib qho ntawm cov qog nqaij hlav qog nqaij hlav hauv plab.

Tuam Tshoj tus kab mob plab hnyuv tau dhau los ua "tus neeg tua neeg thawj lub tebchaws", kwv yees li 50% ntawm cov neeg mob qog noj ntshav plab tshwm sim hauv Suav teb, thiab 60% ntawm nruab nrab thiab lig.

Txawm hais tias qhov xwm txheej tshiab lossis kev tuag, tag nrho cov qog nqaij hlav hauv plab tau dhau los ntawm lub ntsws cancer. Mob qog nqaij hlav hauv plab yog qhov kho tau yooj yim tshaj plaws ntawm txhua yam qog noj ntshav los ntawm kev tshuaj ntsuam ntxov. Nws yog thawj lub hauv paus ntawm tib neeg kom kov yeej mob qog noj ntshav. Tsuas yog 5% ntawm Suav cov qog nqaij hlav hauv plab tau kuaj pom ntxov, thiab 60-70% ntawm cov neeg mob qog nqaij hlav hauv plab tau pom tias muaj cov qog ntshav qog lossis cov qog ntshav nyob deb. Tus nqi rov qab yog siab li 30%.

Nyiv thiab Kaus Lim Qab Teb kuj yog lub tebchaws uas muaj mob qog noj ntshav siab, tab sis lawv qhov kev kuaj mob ntxov yog 50-60%, thiab ntau dua 90% ntawm cov neeg mob tuaj yeem kho tau. Kev tshawb fawb hauv tsev thiab thoob ntiaj teb qhia tau hais tias kev kuaj mob qog noj ntshav hauv plab tuaj yeem txo qis qhov tshwm sim thiab kev tuag ntawm cov qog nqaij hlav hauv plab.

Nyob rau hauv xyoo tas los no, ntxiv rau cov teb chaws Europe, North America, Nyiv, Singapore, Kaus Lim Qab Teb, Taiwan, thiab Hong Kong, tau muaj tsoomfwv cov kev tshuaj ntsuam loj hauv tebchaws. Kev tshuaj xyuas ntxov rau kev kuaj mob qog noj ntshav hauv plab muaj lub sijhawm los kho kom zoo, nrog rau kev sib raug zoo tseem ceeb thiab kev ua lag luam.

Qhov tshwm sim ntawm mob qog nqaij hlav hauv plab yog ib txoj haujlwm ntev. Los ntawm polyps mus rau qhov txawv txav ntawm hyperplasia mus rau mob qog noj ntshav, feem ntau nws yuav siv sij hawm ntev, uas muab lub sijhawm rau kev kuaj mob qog noj ntshav. Kev tshuaj ntsuam xyuas ntxov thiab kev pab cuam kho mob tuaj yeem txo qhov mob qog noj ntshav los ntawm 60% thiab kev tuag ntawm 80%.

2, Qhov tseem ceeb ntawm calprotectin hauv kev kuaj mob plab hnyuv

Calprotectin yog calcium-zinc-binding protein muab los ntawm neutrophils thiab macrophages, nrog ib tug luj molecular ntawm 36,000, ib tug heterodimer tsim los ntawm cov non-covalent koom haum ntawm ob hnyav saw MRP14 thiab ib lub teeb saw MRP8, teej tug mus rau S100. Tsev neeg protein.

Los ntawm ntau cov ntaub ntawv tshawb fawb thiab kev soj ntsuam kuaj xyuas, calprotectin muaj qhov rhiab heev rau kev kuaj mob qog noj ntshav thiab tsis cuam tshuam los ntawm cov qog nqaij hlav, uas tuaj yeem pom thaum ntxov thiab asymptomatic. Nws tuaj yeem siv los ua tus cim rau kev kuaj mob qog noj ntshav hauv plab.

Qhov rhiab heev ntawm fecal calprotectin, fecal occult blood test thiab serum CEA rau mob qog noj ntshav yog 88.51%, 83.91% thiab 44.83%, feem. Qhov txiaj ntsig zoo ntawm fecal occult ntshav kuaj thiab ntshav ntshav CEA hauv cov neeg mob uas muaj theem D thiab theem A tau qis dua li cov neeg mob uas muaj theem C thiab D. Tsis muaj qhov sib txawv loj ntawm qhov zoo ntawm fecal calprotectin hauv cov neeg mob uas muaj theem sib txawv. Dukes.

Qhov rhiab heev ntawm fecal calprotectin kuaj mob rau qhov mob qog noj ntshav mus txog 92.7%, thiab qhov kev kwv yees tsis zoo ntawm NPV mus txog 98.6%. Fecal calprotectin rau mob qog nqaij hlav hauv plab, ≥10mm colorectal polyps tag nrho cov nqi kwv yees tsis zoo NPV mus txog 97.2%.

Txog tam sim no, ntau tshaj 20 lub teb chaws xws li Tebchaws Meskas, Tebchaws Askiv, Canada, Fabkis, Lub Tebchaws Yelemees, thiab Switzerland tau siv calprotectin los ua ib qho tseem ceeb rau kev tshuaj xyuas cov kab mob plab hnyuv thiab mob qog noj ntshav hauv cov neeg muaj kev pheej hmoo siab ntawm cov kab mob hauv plab, thiab tshuaj xyuas kev mob plab. kab mob plab. Active thiab kho cov cim tseem ceeb yog siv dav hauv kev kho mob.

3, Qhov zoo ntawm calprotectin thiab occult ntshav ua ke tshawb pom kev soj ntsuam kev pheej hmoo mob qog noj ntshav

1. Yooj yim rau kev khiav lag luam: ib qho qauv, ntau yam kev xeem tau
2. Tsis ua rau kom qhov nyuaj ntawm kev ua haujlwm thiab tus nqi ntawm cov twj paj nruag: qhov ntsuas tau muab tso rau, thiab cov khoom siv tau nruab raws li qhov yuav tsum tau ua.
3. High rhiab heev thiab tshwj xeeb: inflammatory Performance index, gastrointestinal los ntshav
4. Kev tshuaj ntsuam thaum ntxov ua ntej: nce qhov tshwm sim ntawm kev tshuaj ntsuam rau adenocarcinoma thiab polyps
5. Tsawg tus nqi nrhiav pom, tuaj yeem siv los ua kua dej ntawm colonoscopy
6. Persistence: Kev tshuaj ntsuam xyuas txhua xyoo

Cov tsos mob ntawm tus mob qog nqaij hlav hauv plab:

Cov kab mob plab hnyuv - calprotectin, Dukes theem yog theem A thiab B cov neeg mob uas kuaj ntshav occult thiab ntshav CEA tus nqi zoo yog qis dua cov neeg mob C thiab D theem, Dukes theem sib txawv ntawm tus neeg mob, qhov zoo ntawm fecal calprotectin muaj qhov sib txawv tseem ceeb.

Mob plab los ntshav - occult ntshav, transferrin. Gastrointestinal hemorrhage yog hais txog kev poob ntshav los ntawm txoj hnyuv rau ntau yam laj thawj. Feem ntau ua rau muaj xws li o ntawm lub plab zom mov nws tus kheej, kev puas tsuaj, kab mob vascular, qog, thiab kab mob visceral hauv plab hnyuv. Kev kuaj ntshav occult yog ib txoj hauv kev niaj hnub thiab tseem ceeb ntawm kev kuaj mob plab hnyuv los ntshav.

4, Txoj kev kuaj xyuas fecal calprotectin

Peb cov khoom siv kuaj calprotectin (colloidal kub txoj kev) tuaj yeem siv ib leeg los kuaj pom calprotectin hauv tib neeg cov quav. Nws kuj tuaj yeem siv nrog WIZ series ntawm immunoassays.

Cov khoom siv calprotectin assay (fluorescence immunochromatography) tuaj yeem ua tiav qhov kev kuaj pom ntau, qhov tseeb ntawm tus lej, thiab cov kab ntau yam, txhawm rau ua tiav cov txiaj ntsig ntawm qhov txawv ntawm cov kab mob hauv plab.

Cov khoom siv kuaj ntshav occult (colloidal kub txoj kev) yog siv rau kev kuaj pom zoo ntawm tib neeg hemoglobin hauv tib neeg cov quav, uas tsim nyog rau kev kuaj mob plab hnyuv los ntshav.