Umdlavuza we-colorectal

Umdlavuza we-Colorectal (CRC, okuhlanganisa nomdlavuza we-rectal kanye nomdlavuza wekoloni) ungenye yezimila eziyingozi ezivamile zepheshana lesisu.

Umdlavuza wesisu waseShayina usuphenduke "umbulali wokuqala kazwelonke", cishe u-50% weziguli ezinomdlavuza wesisu zenzeka eShayina, kanti u-60% waba phakathi nendawo nasekupheleni.

Kungakhathalekile ukuthi kuyini okusha noma ukufa, ingqikithi yenani lomdlavuza wamathumbu weqe umdlavuza wamaphaphu. Umdlavuza wamathumbu yiwo owelapheka kalula kunayo yonke imidlavuza ngokuhlolelwa kusenesikhathi. Yinqaba yokuqala yabantu ukunqoba umdlavuza. Ama-5% kuphela omdlavuza we-colorectal waseShayina atholakale kusenesikhathi, futhi u-60-70% weziguli ezinomdlavuza we-colorectal kwatholakala ukuthi zinama-lymph nodes noma ama-metastases akude. Izinga lokuphinda likhuphuke lafika ku-30%.

I-Japan ne-South Korea nazo zingamazwe anezibalo eziphezulu zomdlavuza wesisu, kodwa izinga lawo lokusheshe litholakale lingama-50-60%, futhi ngaphezu kuka-90% weziguli zingelapheka. Ucwaningo lwasekhaya nolwamazwe ngamazwe lubonisa ukuthi izinyathelo zokuhlola umdlavuza we-colorectal zinganciphisa izehlakalo nokufa komdlavuza we-colorectal.

Eminyakeni yamuva nje, ngaphezu kweYurophu, iNyakatho Melika, iJapane, iSingapore, iNingizimu Korea, iTaiwan, neHong Kong, kuye kwaba nokuhlolwa okukhulu kwezwe okuholwa uhulumeni. Ukuhlolwa kusenesikhathi ukuze kuhlonzwe umdlavuza wamathumbu kunethuba lokwelashwa ngokuphelele, ngokubaluleka okukhulu kwezenhlalo kanye nenani lemakethe.

Ukuvela komdlavuza we-colorectal kuyinqubo ende. Kusukela kuma-polyps kuya ku-hyperplasia engavamile kuya kumdlavuza, ngokuvamile kuthatha isikhathi eside, okunikeza isikhathi sokuhlolwa komdlavuza wekoloni. Ukuhlolwa kusenesikhathi kanye nokwelashwa kokungenelela kunganciphisa izehlakalo zomdlavuza ngama-60% kanye nezinga lokufa ngama-80%.

2, Ukubaluleka kwe-calprotectin ekuhlolweni kokusebenza kwamathumbu

I-Calprotectin iyiprotheni ebopha i-calcium-zinc etholakala ku-neutrophils nama-macrophages, enesisindo samangqamuzana angu-36,000, i-heterodimer eyakhiwe yinhlangano engeyona i-covalent ye-MRP14 enezintambo ezimbili kanye neketango elilodwa lokukhanya i-MRP8, eliyingxenye ye-S100. Amaprotheni omndeni.

Ngezincwadi zocwaningo ezibanzi nokuqinisekiswa komtholampilo, i-calprotectin inokuzwela okuphezulu ekutholeni umdlavuza we-colorectal futhi ayithinteki ngesiteji sesimila, esingatholakala ekuqaleni kwesikhathi kanye ne-asymptomatic. Ingasetshenziswa njengomaka wokuhlolwa komdlavuza we-colorectal.

Ukuzwela kwe-fecal calprotectin, ukuhlolwa kwegazi le-fecal occult kanye ne-serum CEA yomdlavuza we-colorectal bekungama-88.51%, 83.91% kanye nama-44.83%, ngokulandelana. Izinga elihle lokuhlolwa kwegazi le-fecal occult kanye ne-serum CEA ezigulini ezinesiteji D kanye nesiteji A laliphansi kakhulu kunalelo ezigulini ezinesigaba C no-D. Kwakungekho mehluko obalulekile esilinganisweni esihle se-fecal calprotectin ezigulini ezinezigaba ezahlukene Dukes.

Ukuzwela kokuxilongwa kwe-fecal calprotectin kumdlavuza we-rectal kwafinyelela ku-92.7%, futhi inani lokubikezela elibi le-NPV lafinyelela ku-98.6%. I-calprotectin ye-fecal yomdlavuza we-colorectal, ≥10mm colorectal polyps inani elibikezelayo elingalungile le-NPV lifinyelele ku-97.2%.

Kuze kube manje, amazwe angaphezu kwama-20 anjenge-United States, iBrithani, iCanada, iFrance, iJalimane neSwitzerland asebenzise i-calprotectin njengenkomba ebalulekile yokuhlola isifo samathumbu esivuvukalayo kanye nomdlavuza ezindaweni ezisengozini enkulu yezifo zamathumbu, futhi kwahlolwa ukuvuvukala. isifo samathumbu. Izimpawu ezibalulekile ezisebenzayo neziphilisayo zisetshenziswa kabanzi emisebenzini yomtholampilo.

3, Izinzuzo ze-calprotectin kanye negazi lemimoya elihlangene lokutholwa kokuhlolwa kwengozi yomdlavuza wamathumbu

1. Kulula ukusebenza: isampula eyodwa, imiphumela yokuhlolwa eminingi
2. Ayikhulisi ubunzima bokusebenza kanye nezindleko zensimbi: ithuluzi libekwe, futhi okokusebenza kufakwe ngokuvumelana nezidingo.
3. Ukuzwela okuphezulu nokucacile: inkomba yokuvuvukala, ukuphuma kwegazi emathunjini
4. Isigaba sokuhlolwa kusenesikhathi: khulisa amathuba okuhlolwa kwe-adenocarcinoma nama-polyps
5. Izindleko zokutholwa eziphansi, zingasetshenziswa njenge-drainage ye-colonoscopy
6. Ukuphikelela: ukuhlolwa kwenqwaba yonyaka

Izimpawu ezijwayelekile zomdlavuza we-colorectal:

Ukuvuvukala kwamathumbu - i-calprotectin, isiteji se-Dukes yisiteji A no-B iziguli ezinokuhlolwa kwegazi okungaqondakali kanye ne-serum CEA izinga elihle liphansi kakhulu kuneziguli ezinesiteji se-C no-D, i-Dukes izigaba ezahlukene zesiguli, izinga elihle le-fecal calprotectin Umehluko omkhulu.

Ukopha emathunjini - igazi lemimoya, i-transferrin. I-gastrointestinal hemorrhage ibhekisela ekulahlekeni kwegazi ngokusebenzisa i-gastrointestinal tract ngenxa yezizathu ezihlukahlukene. Izimbangela ezivamile zihlanganisa ukuvuvukala komgudu wokugaya ukudla ngokwawo, ukulimala kwemishini, isifo se-vascular, isimila, kanye nezifo ze-visceral emgudwini wamathumbu. Ukuhlolwa kwegazi okunemimoya kuyindlela evamile futhi ebalulekile yokuhlonza ukopha kwamathumbu.

4, Indlela yokuthola i-fecal calprotectin

Ikhithi yethu yokuhlola i-calprotectin (indlela yegolide ye-colloidal) ingasetshenziswa yodwa ukuze kutholwe i-calprotectin kancane kumasampula endle yomuntu. Ingasetshenziswa futhi nochungechunge lwe-WIZ lwama-immunoassays.

Ikhithi ye-calprotectin assay (i-fluorescence immunochromatography) ingafinyelela ukutholwa kobuningi, amanani ezinombolo anembile, nobubanzi bomugqa obanzi, ukuze kuzuzwe umphumela wokuhlukanisa izifo zamathumbu.

Ikhithi yokuhlola igazi elisebenzelana nemimoya (indlela yegolide ye-colloidal) isetshenziselwa ukutholwa kwekhwalithi ye-hemoglobin yomuntu endle yomuntu, elungele ukuxilonga ukopha emathunjini.