Iimbalasane
Ukubeka iliso kwi-DNA ye-tumor ejikelezayo (ctDNA) kwiisampulu zegazi lezigulana kunokubonelela ngexabiso lokulindela umhlaza ophezulu. Ukulandelelanisa kunye nokubeka iliso kumanqanaba okujikeleza ithumba DNA ngokusebenzisa umhlaza uhambo lonyango lwezigulane lunokunceda oogqirha benze isigqibo malunga nobude kunye namandla okhetho lonyango.
Yintoni ejikeleza ithumba DNA (ctDNA)?
Ukujikeleza ithumba DNA (ctDNA) ngamaqhekeza amancinane DNA ukuba uphalazwe kwi umhlaza iiseli egazini. I-DNA ifumaneka kakhulu ngaphakathi kwinucleus yeeseli kodwa njengoko ithumba likhula, lisanda kwaye lithatyathelwa indawo ziiseli ezintsha, i-DNA ichithwa kwiiseli zethumba ukuya kwindawo engqongileyo. Ubungakanani be-ctDNA bunokwahluka phakathi kwezigulana ezinomhlaza kwaye kuya kuxhomekeka kuhlobo lwethumba, indawo ekuyo kunye nenqanaba lesi sifo.
Ngaba ukujikeleza kwesifo se-DNA (cTDNA) kuluncedo njani?
Ulwazi malunga nobungakanani kunye nokulandelelana kwe-ctDNA (ukujikeleza i-tumor DNA) kunokunceda ekuchongeni isifo somhlaza kunye nokuxela kwangaphambili, ukukhetha unyango olukhethiweyo kunye nokuqhubeka nokubeka iliso kwesi sifo kwimpembelelo yonyango kunye nokuphindaphinda.
Kwenziwa njani ukuvavanywa kwe-ctDNA kunye noVavanyo?
Uvavanyo lwe-ctDNA lunokwenziwa kwiisampulu zegazi kwaye ke uvavanyo lwe-DNA yesifo esijikelezayo lunokwenziwa amaxesha amaninzi ngexesha lesigulana somhlaza sesifo. Uvavanyo lwe-ctDNA egazini lunokwenziwa ngokusekwe kwiindlela ezahlukeneyo kubandakanya a ulwelo olumnyama kunye nendlela yokulandelelanisa okanye ubuchule obubizwa ngokuba yi-digital droplet polymerase chain reaction (ddPCR). Indlela yokulandelelanisa i-biopsy yolwelo inika ulwazi oluthe kratya malunga nokutshintsha kwe-genomic kwimfuza yomhlaza kuvavanywa, kuthatha ixesha elide ukubuyisa iziphumo kwaye kunokuba kubiza kakhulu, kungoko kungenzeki ukuba wenze rhoqo. Inkqubo ye-ddPCR ayiniki ubugqwetha bolwazi umntu anokulufumana ngendlela yokulandelelana kodwa unexesha elifutshane lokujika, elingabizi kakhulu kwaye elinokubuyiselwa, kungoko kunokwenziwa rhoqo kuhambo lwesigulana. Indlela ye-ddPCR inokunika ulwazi ngobungakanani be-ctDNA ekhoyo egazini kodwa ayizukukwazi ukunika iinkcukacha ezithile ngobume be-ctDNA ngaphandle kokuba isampulu ilandelwe.
Ukutya okuTyiwa emva kokuChongwa koMhlaza!
Akukho mhlaza mibini ifanayo. Yiya ngaphaya kwezikhokelo zesondlo esiqhelekileyo kuwo wonke umntu kwaye wenze izigqibo ezizezakho malunga nokutya kunye nezongezo ngokuzithemba.
Isifundo se-IDEA-i-ctDNA (ejikeleza ithumba le-DNA) kuvavanyo kwiCancer Cancer
Isigaba se-III se-IDEA-France samva nje (kuvavanyo lweXesha leHlabathi lwe-Adjuvant (IDEA)) kuvavanyo lweklinikhi kwizigulana ezinomdlavuza weSigaba III, kuvavanywa iimpembelelo zexesha elifutshane (iinyanga ezi-3) ngokuchaseneyo (neenyanga ezi-6) ubude be-oxaliplatin based chemotherapy adjuvant treatment kwi Ukuphila ngaphandle kwezifo. Kolu phando, abaphandi baphinde bahlalutya i-ctDNA yezigulana ngaphambi kokuqala ichemotherapy (UAndre T. okqhubekayo, J Clin. I-Oncol., 2018). Iinkcukacha kunye neziphumo zophando kunye nohlalutyo lwamanqanaba e-ctDNA ngokusinda kwesigulana zezi zilandelayo:
- Zizonke izigulana ezingama-805 zazineesampulu zegazi zazo ezihlalutyiweyo ze-ctDNA (ejikeleza ithumba DNA) ngaphambi kokuqala ichemotherapy. Kwezi zigulana ziyi-696 (86.5%) yayine-ctDNA engalunganga kwaye i-109 (13.5%) yezigulana yayine-ctDNA elungileyo.
- Abo banezicubu ezintle ze-ctDNA kwafunyaniswa ukuba banezilonda ezihambe phambili ngokungafaniyo.
- Isifo seminyaka emi-2 izinga lokuphila simahla kwizigulana ezithembekileyo ze-ctDNA yayiyi-64% ngelixa kwizigulana ezingalunganga ze-ctDNA yayiyi-82%.
- Umkhwa wokusinda kwesifo esincitshisiweyo wajongwa kwizigulana ezine-ctDNA ezazikumngcipheko omkhulu okanye kwinqanaba elisezantsi le-III colon. umhlaza, njengoko kuqinisekiswa luhlalutyo lwe-multivariate.
- Ukuqukunjelwa kwabaphandi besifundo se-IDEA ngokusetyenziswa kwe-oxaliplatin njenge-adjuvant yeenyanga ezi-3 okanye iinyanga ezi-6 yayikukuba iinyanga ezi-6 zivelise iziphumo ezingcono kunonyango lweenyanga ezi-3, kokubini kwizigulana ezineesampulu ezingalunganga ze-ctDNA okanye iisampulu ezilungileyo ze-ctDNA. Nangona kunjalo, umahluko wokusinda kweminyaka emi-3 phakathi kwenyanga ye-6 vs i-3 inyanga ye-oxaliplatin unyango lwe-adjuvant yayiyi-3.6% kuphela kwinyanga yesi-6 iminyaka emi-3 yokusinda kwesifo ngaphandle kwama-75.7% kunye ne-3 yenyanga engama-72.1%.
Isiphelo esivela kwiSifundo
Idatha kuhlalutyo lwe-ctDNA evela kwikholoni yophononongo ye-IDEA umhlaza izigulana, kunye nokulungelelaniswa nokusinda kwezifo, zanikezelwa kwi-ESMO Congress ngoSeptemba, 2019 (Taieb J et al, Abstract LBA30_PR, ESMO Congress, 2019). Le datha ayibonisi ukuba uvavanyo lwe-ctDNA kunye ne-ddPCR lunokuba luphawu oluzimeleyo lwe-prognostic ye-cancer ephezulu. Ulandelelwano kunye nokubekwa esweni kwe-ctDNA (i-Circular Tumor DNA) inokudityaniswa kwindlela yokusebenza yonyango lwesigulana somhlaza kwaye inokunceda oogqirha bathathe isigqibo malunga nobude kunye namandla onyango lwe-adjuvant oluya kulufuna isigulane, ngokusekelwe kumanqanaba e-ctDNA phambi kokuqala unyango.
Kukuphi ukutya okutyayo kwaye okuncedisayo kukuthatha sisigqibo osithathayo. Isigqibo sakho kufuneka sibandakanye ukuthathelwa ingqalelo kotshintsho lomhlaza kuhlobo lomhlaza, unyango oluqhubekayo kunye nezongezelelo, nakuphi na ukwaliwa, ulwazi ngobomi bakho, ubunzima, ukuphakama kunye nemikhwa.
Isicwangciso sesondlo somhlaza esivela kwi-addon asisekelwanga kukhangelo lwe-Intanethi. Isebenza ngokuzenzekelayo ukwenza izigqibo zakho kusekwe kwisayensi yemolekyuli ephunyezwe ngoososayensi kunye neenjineli zesoftware. Nokuba ukhathalele na ukuqonda iindlela ezisisiseko seemolekyuli okanye hayi - zokucwangciswa kwesondlo somhlaza ukuqonda kuyafuneka.
Qalisa NGOKU ngokucwangciswa kwesondlo ngokuphendula imibuzo ngegama lomhlaza, uguquko kwimfuza, unyango oluqhubekayo kunye nezincedisi, nakuphi na ukwaliwa, imikhwa, indlela yokuphila, iqela lobudala kunye nesini.
ISondlo esiSiqu soMhlaza!
Umhlaza uyatshintsha ngokuhamba kwexesha. Yenza ngokwezifiso kwaye uguqule isondlo sakho ngokusekwe kwisalathiso somhlaza, unyango, indlela yokuphila, ukhetho lokutya, i-allergies kunye nezinye izinto.
Izigulana ezinomhlaza zihlala zisebenza ngeendlela ezahlukeneyo iziphumo ebezingalindelekanga ezichaphazela umgangatho wobomi babo kwaye bajonge ezinye iindlela zonyango lomhlaza isondlo esifanelekileyo kunye nezongezelelo ezisekwe kuqwalaselo lwenzululwazi (ukunqanda ukuqikelela kunye nokukhetha okungahleliwe) lolona nyango lwendalo olungcono lomhlaza kunye nokunxulumene nonyango imiphumela.