Mob qog nqaij hlav ntawm txoj hnyuv

Mob qog noj ntshav hauv txoj hnyuv loj (CRC, suav nrog mob qog noj ntshav hauv qhov quav thiab mob qog noj ntshav hauv txoj hnyuv loj) yog ib qho ntawm cov qog nqaij hlav phem uas feem ntau pom ntawm txoj hnyuv plab thiab txoj hnyuv.

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

Txawm hais tias muaj tus mob tshiab lossis tuag li cas los xij, tag nrho cov mob qog noj ntshav hauv plab hnyuv tau ntau dua li mob qog noj ntshav ntsws. Mob qog noj ntshav hauv plab hnyuv yog qhov yooj yim kho tshaj plaws ntawm txhua yam mob qog noj ntshav los ntawm kev kuaj mob thaum ntxov. Nws yog thawj lub hauv paus ntawm tib neeg kom kov yeej mob qog noj ntshav. Tsuas yog 5% ntawm cov mob qog noj ntshav hauv Suav teb tau kuaj pom thaum ntxov, thiab 60-70% ntawm cov neeg mob uas muaj mob qog noj ntshav hauv plab hnyuv tau pom tias muaj cov qog ntshav lossis cov qog metastases deb. Tus nqi rov tshwm sim yog siab txog 30%.

Nyiv Pooj thiab Kaus Lim Qab Teb kuj yog cov teb chaws uas muaj mob qog noj ntshav hauv plab hnyuv ntau, tab sis lawv qhov kev kuaj mob thaum 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 tias cov kev ntsuas tshuaj ntsuam mob qog noj ntshav hauv plab hnyuv tuaj yeem txo qhov tshwm sim thiab kev tuag ntawm mob qog noj ntshav hauv plab hnyuv.

Nyob rau xyoo tas los no, ntxiv rau Tebchaws Europe, North America, Nyiv Pooj, Singapore, Kaus Lim Qab Teb, Taiwan, thiab Hong Kong, muaj tsoomfwv tau ua kev kuaj mob loj hauv tebchaws. Kev kuaj mob thaum ntxov kom paub tias muaj mob qog noj ntshav hauv plab hnyuv muaj lub sijhawm kho tau tag nrho, nrog rau qhov tseem ceeb hauv zej zog thiab tus nqi lag luam.

Kev tshwm sim ntawm mob qog noj ntshav hauv plab hnyuv yog ib qho txheej txheem ntev heev. Txij li cov polyps mus rau qhov hyperplasia txawv txav mus rau mob qog noj ntshav, feem ntau nws siv sijhawm ntev, uas muab sijhawm rau kev kuaj mob qog noj ntshav hauv plab hnyuv. Kev kuaj mob thaum ntxov thiab kev kho mob zoo tuaj yeem txo qhov tshwm sim ntawm mob qog noj ntshav los ntawm 60% thiab tus nqi tuag los ntawm 80%.

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

Calprotectin yog cov protein uas khi calcium-zinc los ntawm neutrophils thiab macrophages, nrog rau qhov hnyav molecular ntawm 36,000, ib qho heterodimer tsim los ntawm kev sib koom ua ke tsis-covalent ntawm ob txoj saw hlau hnyav MRP14 thiab ib txoj saw hlau sib dua MRP8, uas yog S100. Tsev neeg protein.

Los ntawm kev tshawb fawb ntau yam thiab kev txheeb xyuas hauv kev kho mob, calprotectin muaj kev nkag siab zoo rau kev kuaj mob qog noj ntshav hauv plab hnyuv thiab tsis cuam tshuam los ntawm theem qog noj ntshav, uas tuaj yeem pom thaum ntxov thiab tsis muaj tsos mob. Siv tau ua lub cim rau kev kuaj mob qog noj ntshav hauv plab hnyuv.

Qhov kev nkag siab ntawm fecal calprotectin, fecal occult blood test thiab serum CEA rau mob qog noj ntshav colorectal yog 88.51%, 83.91% thiab 44.83%, raws li. Tus nqi zoo ntawm fecal occult blood test thiab serum CEA hauv cov neeg mob uas muaj theem D thiab theem A qis dua li cov neeg mob uas muaj theem C thiab D. Tsis muaj qhov sib txawv tseem ceeb hauv tus nqi zoo ntawm fecal calprotectin hauv cov neeg mob uas muaj ntau theem ntawm Dukes.

Qhov kev nkag siab ntawm fecal calprotectin kuaj mob rau mob qog noj ntshav hauv qhov quav tau txog 92.7%, thiab qhov tsis zoo kwv yees tus nqi ntawm NPV tau txog 98.6%. Fecal calprotectin rau mob qog noj ntshav hauv plab hnyuv, ≥10mm colorectal polyps tag nrho qhov tsis zoo kwv yees tus nqi NPV tau txog 97.2%.

Txog rau tam sim no, ntau tshaj 20 lub tebchaws xws li Tebchaws Meskas, Tebchaws Askiv, Canada, Fabkis, Lub Tebchaws Yelemees, thiab Switzerland tau siv calprotectin ua ib qho cim qhia tseem ceeb rau kev tshuaj xyuas kab mob plab hnyuv thiab mob qog noj ntshav hauv cov pej xeem muaj kev pheej hmoo siab ntawm cov kab mob plab hnyuv, thiab soj ntsuam kab mob plab hnyuv. Cov cim tseem ceeb thiab kho tau siv dav hauv kev kho mob.

3, Cov txiaj ntsig ntawm calprotectin thiab occult ntshav ua ke nrhiav tau qhov kev ntsuam xyuas kev pheej hmoo mob qog noj ntshav hauv plab hnyuv

1. Yooj yim rau kev khiav lag luam: ib qho qauv, ntau qhov tshwm sim ntawm kev xeem
2. Tsis ua rau qhov nyuaj ntawm kev ua haujlwm thiab tus nqi ntawm lub cuab yeej nce ntxiv: lub cuab yeej raug tso rau, thiab cov khoom siv tau nruab raws li qhov yuav tsum tau ua.
3. Kev rhiab heev thiab qhov tshwj xeeb: qhov ntsuas kev o, kev los ntshav hauv plab hnyuv
4. Kev tshuaj ntsuam xyuas thaum ntxov ua ntej: ua kom muaj feem ntau ntawm kev tshuaj ntsuam xyuas rau adenocarcinoma thiab polyps
5. Tus nqi kuaj pom qis, siv tau ua cov kua dej ntawm kev kuaj mob plab hnyuv
6. Kev ruaj khov: kev tshuaj xyuas txhua xyoo

Cov tsos mob ib txwm muaj ntawm mob qog nqaij hlav plab hnyuv:

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

Kev Los Ntshav Hauv Plab - cov ntshav uas tsis pom, transferrin. Kev Los Ntshav Hauv Plab yog hais txog kev poob ntshav los ntawm txoj hnyuv plab rau ntau yam laj thawj. Cov laj thawj feem ntau suav nrog kev o ntawm txoj hnyuv plab, kev puas tsuaj ntawm lub cev, kab mob ntawm cov hlab ntsha, qog, thiab cov kab mob hauv plab hnyuv. Kev kuaj ntshav uas tsis pom yog ib txoj kev kuaj mob niaj hnub thiab tseem ceeb rau kev kuaj mob los ntshav hauv plab.

4, Txoj kev los nrhiav cov quav calprotectin

Peb cov khoom siv kuaj calprotectin (txheej txheem kub colloidal) siv tau ib leeg xwb los ntes tau calprotectin hauv cov quav tib neeg. Nws kuj tseem siv tau nrog WIZ series ntawm immunoassays.

Cov khoom siv calprotectin assay (fluorescence immunochromatography) tuaj yeem ua tiav kev kuaj pom ntau yam, cov nqi lej raug, thiab ntau yam kab dav, yog li ua tiav cov txiaj ntsig ntawm kev sib txawv ntawm cov kab mob plab hnyuv.

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