Teko ea liphatsa tsa lefutso e bapala karolo efe kalafong ea mofets'e oa matsoele?

Litaba

• Ho etsa liteko tsa liphatsa tsa lefutso ke eng?
• Mefuta ea liteko tsa lefutso bakeng sa mofetše oa matsoele
• Liteko tsa liphatsa tsa lefutso tsa BRCA
• Liteko tsa liphatsa tsa lefutso tsa HER2
• Na ke hloka tlhahlobo ea liphatsa tsa lefutso haeba ke na le mofetše oa matsoele?
• Liteko tsee li etsoa joang?
• Na ke lokela ho bona moeletsi oa lefutso?
• Tsa Tsau-tsau

Kankere ea matsoele ea metastatic ke mofetše o hasaneng kantle ho sefuba sa hau ho litho tse ling tse kang matšoafo, boko kapa sebete. Ngaka ea hau e ka bua ka mofets'e e le sethaleng sa 4, kapa mofetše oa matsoele oa morao-rao.

Sehlopha sa hau sa tlhokomelo ea bophelo se tla etsa liteko tse 'maloa ho fumana mofetše oa hau oa matsoele, ho bona hore na o hasane hakae, le ho fumana kalafo e nepahetseng. Liteko tsa lefutso ke karolo e 'ngoe ea ts'ebetso ea tlhahlobo. Liteko tsena li ka tsebisa ngaka ea hau hore na mofetše oa hau o amana le phetoho ea lefutso le kalafo efe e ka sebetsang hantle.

Ha se motho e mong le e mong ea hlokang tlhahlobo ea lefutso. Ngaka ea hau le moeletsi oa liphatsa tsa lefutso ba tla khothaletsa liteko tsena ho latela lilemo tsa hau le likotsi.

Ho etsa liteko tsa liphatsa tsa lefutso ke eng?

Liphatsa tsa lefutso ke likarolo tsa DNA. Li phela kahara khubu ea sele ka 'ngoe' meleng oa hau. Liphatsa tsa lefutso li na le litaelo tsa ho etsa liprotheine tse laolang mesebetsi eohle ea 'mele oa hau.

Ho ba le liphetoho tse itseng tsa lefutso, tse bitsoang liphetoho, ho ka eketsa menyetla ea ho ba le mofetše oa matsoele. Ho etsa liteko tsa lefutso ho sheba liphetoho tsena liphatseng tsa lefutso. Liteko tsa Gene li boetse li sekaseka li-chromosome - likarolo tse kholo tsa DNA - ho batla liphetoho tse amanang le mofets'e oa matsoele.

Mefuta ea liteko tsa lefutso bakeng sa mofetše oa matsoele

Ngaka ea hau e ka laela liteko ho li batla BRCA1, BRCA2, le HER2 liphetoho liphatseng tsa lefutso. Liteko tse ling tsa liphatsa tsa lefutso lia fumaneha, empa ha li sebelisoe hangata.

Liteko tsa liphatsa tsa lefutso tsa BRCA

BRCA1 le BRCA2 liphatsa tsa lefutso li hlahisa mofuta oa protheine e tsejoang e le li-protein suppressor protein. Ha liphatsa tsa lefutso tsena li tloaelehile, li lokisa DNA e senyehileng le ho thusa ho thibela lisele tsa mofetše ho hola.

Liphetoho liphatseng tsa lefutso BRCA1 le BRCA2 liphatsa tsa lefutso li baka kholo ea lisele tse ngata le ho eketsa menyetla ea hau ea mofetše oa matsoele le oa mae a bomme.

Teko ea liphatsa tsa lefutso ea BRCA e ka thusa ngaka ea hau ho ithuta kotsi ea mofetše oa matsoele. Haeba u se u ntse u e-na le kankere ea matsoele, ho etsa liteko tsa phetoho ena ea lefutso ho ka thusa ngaka ea hau ho bolela esale pele hore na kalafo e itseng ea mofetše oa matsoele e tla u sebeletsa.

Liteko tsa liphatsa tsa lefutso tsa HER2

Likhoutu tsa human epidermal growth factor receptor 2 (HER2) bakeng sa tlhahiso ea protheine ea receptor HER2. Protheine ena e ka holim'a lisele tsa matsoele. Ha protheine ea HER2 e butsoe, e joetsa lisele tsa matsoele hore li hole li arohane.

Phetoho phetohong ea HER2 liphatsa tsa lefutso li beha li-receptor tse ngata haholo tsa HER2 liseleng tsa matsoele. Sena se etsa hore lisele tsa matsoele li hōle ka mokhoa o sa laoleheng ebe li theha lihlahala.

Kankere ea matsoele e hlahlobang HER2 e bitsoa kankere ea matsoele ea HER2. Li hola ka potlako mme li na le monyetla oa ho hasana ho feta kankere ea matsoele ea HER2.

Ngaka ea hau e tla sebelisa e 'ngoe ea liteko tsena tse peli ho lekola boemo ba hau ba HER2:

• Immunohistochemistry (IHC) e leka hore na o na le protheine e ngata ea HER2 liseleng tsa hau tsa mofetše. Teko ea IHC e fa mofets'e lintlha tsa 0 ho isa ho 3+ ho ipapisitse le hore na u na le HER2 e kae kankere ea hau. Lintlha tsa 0 ho isa ho 1+ ke HER2-negative. Lintlha tse 2+ ke moeli oa moeli. 'Me lintlha tsa 3+ li na le HER2-positive.

• Fluorescence in situ hybridization (FISH) e batla likopi tse ling tsa HER2 liphatsa tsa lefutso. Liphetho li tlalehiloe hape e le HER2-positive kapa HER2-negative.

Na ke hloka tlhahlobo ea liphatsa tsa lefutso haeba ke na le mofetše oa matsoele?

Haeba u fumanoe u na le mofetše oa matsoele, ho ka ba molemo ho tseba hore na phetoho e futsitsoeng e bakile mofetše oa hau. Ho etsa liteko tsa lefutso ho ka u thusa ho tataisa kalafo ea hau. Lithethefatsi tse ling tsa mofets'e li sebetsa feela kapa li sebetsa haholo ho mofets'e oa matsoele ka liphatsa tse itseng tsa lefutso.

Mohlala, PARP inhibitor lithethefatsi olaparib (Lynparza) le talazoparib (Talzenna) ke tumello ea FDA feela ea ho alafa mofetše oa matsoele o bakoang ke BRCA phetoho ea lefutso. Batho ba nang le liphetoho tsena ba ka arabela betere ho chemotherapy drug carboplatin ho feta docetaxel.

Boemo ba hau ba liphatsa tsa lefutso bo ka thusa ho tseba hore na u buuoa ka mofuta ofe le hore na u tšoaneleha ho kenella litekong tse ling tsa bongaka. E ka thusa bana ba hau kapa beng ka uena ba haufi hore ba tsebe hore na ba ka ba kotsing e kholo ea mofetše oa matsoele mme ba hloka ho hlahlojoa ho eketsehileng.

Tataiso e tsoang ho National Comprehensive Cancer Network e khothaletsa tlhahlobo ea liphatsa tsa lefutso bakeng sa batho ba nang le mofetše oa matsoele ba:

• ba fumanoe ba le lilemo li 50 kapa pele
• na le kankere ea matsoele e nang le makhetlo a mararo e sa tsejoeng a le lilemo li 60 kapa pele
• na le mong ka uena ea haufi le letsoele, mae a bomme, tšoelesa ea senya, kapa mofetše oa pancreatic
• ba le mofets'e matsoeleng ka bobeli
• ke ba leloko la Bajuda ba Europe Bochabela (Ashkenazi)

Leha ho le joalo, tataiso ea 2019 e tsoang ho American Society of Breast Surgeons e khothaletsa hore batho bohle ba fumanoeng ba na le mofetše oa matsoele ba fuoe liteko tsa lefutso. Bua le ngaka ea hau ka hore na u lokela ho etsa tlhahlobo.

Liteko tsee li etsoa joang?

Bakeng sa BRCA liteko tsa liphatsa tsa lefutso, ngaka kapa mooki oa hau o tla nka sampole ea mali a hau kapa swab ea mathe ka har'a lerama la hao. Sampole ea mali kapa ea mathe e ea labong, moo litsebi li e hlahlobang bakeng sa BRCA liphetoho liphatseng tsa lefutso.

Ngaka ea hau ea sebetsa HER2 liteko tsa liphatsa tsa lefutso liseleng tsa matsoele li tlosoa nakong ea biopsy. Ho na le mekhoa e meraro ea ho etsa biopsy:

• Phofo e ntle ea nalane e tlosa lisele le mokelikeli ka nale e tšesaane haholo.
• Core nale biopsy e tlosa sampole e nyane ea lisele tsa matsoele ka nale e kholo, e sekoti.
• Biopsy ea ho etsa opereishene e etsa karolo e nyane ka har'a sefuba nakong ea ts'ebetso ea ho buoa mme e tlosa sengoathoana sa lisele.

Uena le ngaka ea hau le tla fumana kopi ea liphetho, tse tlang ka sebopeho sa tlaleho ea bolwetse.Tlaleho ena e kenyelletsa tlhaiso-leseling ka mofuta, boholo, sebopeho, le chebahalo ea lisele tsa hau tsa mofetše, le hore na li ka hola kapele hakae. Liphetho li ka thusa ho tataisa kalafo ea hau.

Na ke lokela ho bona moeletsi oa lefutso?

Moeletsi oa liphatsa tsa lefutso ke setsebi litlhahlobong tsa lefutso. Li ka u thusa ho etsa qeto ea hore na u hloka liteko tsa lefutso le melemo le likotsi tsa tlhahlobo.

Hang ha liphetho tsa hau tsa liteko li se li le teng, moeletsi oa liphatsa tsa lefutso a ka u thusa ho utloisisa hore na li bolelang, le mehato eo u lokelang ho e nka kamora moo. Ba ka thusa hape ho tsebisa beng ka uena ba haufi ka likotsi tsa mofetše.

Tsa Tsau-tsau

Haeba u fumanoe u e-na le mofetše oa matsoele, bua le ngaka ea hau ka liteko tsa liphatsa tsa lefutso. Ho ka thusa ho bua le moeletsi oa liphatsa tsa lefutso ho utloisisa hore na liteko tsa hau li bolelang.

Liphetho tsa liteko tsa hau tsa lefutso li ka thusa ngaka ea hau ho u fumanela kalafo e nepahetseng. Liphetho tsa hau li ka tsebisa le litho tse ling tsa lelapa la hau ka kotsi ea tsona le tlhoko ea tlhahlobo ea kankere ea matsoele e eketsehileng.