Daya daga cikin ci gaba mai ban sha'awa a maganin cutar kanjamau ya fito ne daga fahimtar canjin halittar kwayar cutar kanjamau. Ganin cewa a baya mun karya ciwon huhu a cikin ƙwayoyi biyar, yanzu mun sani cewa babu kwayar cutar guda biyu. Idan akwai mutane 30 a cikin dakin da ke fama da ciwon huhu na huhu, za su sami nau'i daban-daban guda 30 daban daban.
Idan an samu kwanan nan kwanan nan da ciwon daji na huhu, musamman adenocarcinoma , likitanku na iya magana da kai game da gwajin kwayoyin (wanda ba a san shi ba kamar yadda kwayoyin halitta ko nazarin halittun halitta) na tumo. A yanzu an ba da shawarar cewa duk masu ciwon daji na ciwon huhu da tsofaffin ƙwayoyin cuta da ƙwayar cuta mai suna metastatic (irin marasa ciwon ƙwayar cutar ciwon huhu) sunyi gwaji don su bincika maye gurbin EGFR da ALK da ROS1 canje-canje.
Bugu da kari, marasa lafiya tare da wasu nau'in ƙwayar cutar ciwon huhu na kananan ƙananan (alal misali, carcinoma adenosquamous a cikin masu shan taba) ya kamata a yi la'akari da su don gwadawa.
Menene Jarabawa na Halitta?
Gwajin gwajin gwaji sun haɗa da gwaje-gwajen da mai ilimin likita ya yi a cikin layi ta yin amfani da samfurin ciwon daji. Wadannan gwaje-gwaje suna kallon ciwon daji daga matakin kwayoyin.
Jiki zai iya fitowa daga kwayar cutar ta jikinka ko kuma daga kayan da aka cire a lokacin aikin tiyata . Dalilin da baya shi ne cewa cututtuka na da maye gurbi da sauran canje-canje da "kullu" ko sarrafa ci gaban ciwon daji.
A sauƙaƙe, idan za'a iya gano wadannan maye gurbin, to ana iya amfani da jiyya wanda "manufa" wadannan maye gurbin, saboda haka dakatar da ci gaban ciwon daji. Wannan maye gurbi ne wanda zai haifar da cigaban ciwon daji a farkon wuri.
Kafin ka cigaba, yana taimakawa wajen magance wani abu da yake damuwa ga mutane da yawa.
Akwai nau'i biyu na asali na maye gurbi:
- Abubuwan da suka bambanta. Har ila yau ana kiransa maye gurbi, wannan yana nufin ka gaji kwayoyin tare da maye gurbin daga ɗaya ko fiye da iyaye. Misalai na yau da kullum na waɗannan maye gurbi sun hada da hawan jini da kuma maye gurbi wanda zai iya sa wani ya riga ya bunkasa ciwon nono, kamar BRCA1 da BRCA2 .
- Gyaran da aka samu. Irin irin maye gurbin da masana kimiyya ke bukata a halin yanzu ga mutanen dake fama da ciwon huhu na huhu shine ake kira maye gurbi, ko maye gurbi). Wadannan maye gurbi ba su kasance ba a lokacin haihuwar haihuwa (kuma ba su gudu cikin iyalai), amma ci gaba a cikin tsarin kwayoyin halitta su zama masu ciwo .
Menene Yanayin Mutum?
Halittar jinsin suna canje-canje ga wani nau'i na musamman a cikin chromosome. Dukkanin jinsin suna da jerin nau'o'in amino acid guda hudu (wanda ake kira asali) -adenine, tyrosine, cytosine, da guanine.
Lokacin da aka nuna jigon nama zuwa gubobi a cikin yanayi, ko lokacin da hatsari ya auku a cikin rarrabawar sel, maye gurbin, ko canji, zai iya faruwa. A wasu lokuta, yana iya nufin cewa an kafa wani tushe ga wani, kamar adenine maimakon guanine. A wasu lokuta, za a iya saka, za a iya share, za a share, ko kuma sake tsarawa a wasu hanyoyi.
Muhimmancin Gene Mutations
Me yasa masu ilimin likita masu sha'awar samun maye gurbi a cikin ƙwayar cuta?
Na farko, ya kamata muyi magana game da nau'i biyu na maye gurbin da aka samu a cikin ciwon huhu na huhu:
- Hanyoyin maye gurbin . Wadannan maye gurbin, ta hanyoyi daban-daban, "kullun" ci gaban kwayar cutar. A cikin ciwon huhu a cikin huhu, yawan adadin direbobi ya canza. A cikin nazarin daya, an gano kimanin direbobi 11 da suka samu ciwon daji.
- Fassara fasinjoji. Kamar yadda wani ya iya zama fasinja a cikin mota, waɗannan kwayoyin ba sa fitar da ciwon daji, amma suna da mahimmanci don tafiya. Bugu da ƙari, ba mu san yadda yawancin fasinjojin fasinjoji suka kasance a cikin ƙwayar cuta ba (kuma lambar ta bambanta daga ciwon tumo da ciwon sukari), amma wasu ciwace-ciwacen na iya samun fiye da 1,000 daga cikin wadannan maye gurbin. Sakamakon gyaran motar ba kawai ya fara ci gaban ciwon daji ba, amma aiki don kula da ci gaban ciwon daji.
Harkokin Kasuwanci na Musamman
Akwai wasu maye gurbin da masana kimiyya suke nazarin da suke kallon ciwon huhu. Ya zuwa yanzu, an gano alamar motar direbobi a kimanin kashi 60 na adinocarcinomas na huhu kuma yana iya yiwuwa wannan lambar zai karu a lokaci.
Masu bincike na yanzu suna samun masu maye gurbi a cikin ciwon sikila na kwayar cutar. Gaba ɗaya, waɗannan maye gurɓata suna da alaƙa guda ɗaya kuma suna da wuya a gani a cikin wannan ƙwayar. Karancin direbobi na yau da kullum a cikin ciwon huhu na huhu ya hada da:
- EGFR maye gurbin
- Karshen KRAS
- EML4-ALK sake shiryawa
- ROS1 canje-canje
- MET amplifications
- Hanyoyin maye gurbin HER2
- RET canje-canje
- BURF maye gurbin
Jiyya na musamman
Yin amfani da "maganin kwaskwarima," magunguna da ke cike da magungunan kwayoyin halitta a cikin ƙwayar cuta, an riga an yi amfani da maganin likita ko kuma magani na musamman. Abin da ake nufi shi ne, maimakon magungunan ƙwayar cutar shan magani wanda ke haifar da mummunan kwayoyin halitta, maganin da aka yi niyya ya kai hari kan wani mummunar haɓaka da ke tattare da kwayoyin cutar kanjamau.
Bugu da ƙari, maganin jiyya yana da rassa masu tasiri fiye da chemotherapy. Har zuwa yau, hanyoyin da aka tsara da aka ba da izini ga mutanen dake fama da ciwon huhu a cikin mahaifa sun hada da:
- Tarceva (erlotinib) ga mutanen da tumutsu suna da maye gurbin EGFR (Lura: akwai nau'ikan maye gurbin EGFR kuma ba dukkanin su ba daidai ba ne ga wannan.)
- Xalkori (crizotinib) ga mutanen dake da ƙwayar cuta na ALK4-EML (Lura: FDA ta amince da wannan a 2011 kuma an ba shi matsayi na gaba ga ROS1 na sake gina cutar kanjamau a 2015.)
An riga an yarda da wasu magunguna kuma ana nazarin su a gwaje-gwaje na asibiti, ciki har da hanyoyin da aka tsara don wadanda tumatinsu ke da alaƙa ga Tarceva ko Xalkori.
Resistance zuwa jiyya
Matsalar ƙalubalen da ake amfani dashi a yau ana amfani dasu shine kusan dukkanin mutane ba zai yiwu ba don magance jiyya da muke da su. Akwai abubuwa da yawa da wannan ke faruwa yana da wuya a sami wata mafita. Bincike yana gudana a gwajin gwaji - kimantawa da amfani da maye gurbin wani magani na biyu don ƙaddamar da maye gurbin da kwayoyi da suke amfani da manufa daban-daban ko kayan aiki don kaiwa ga magungunan ciwon daji.
Gwaji
Ana gwada gwaji ga maye gurbin mutun da gyaggyarawa akan samfurori samfurori da aka samo daga wasu kwayoyin halitta ko kwayoyin halittu. Amma a watan Yuni 2016, duk da haka, gwaji na biopsy na yanzu yana samuwa a matsayin hanya don gwadawa ga maye gurbin EGFR a wasu mutane. Tun da za a iya yin gwaje-gwaje tare da zane mai sauƙi, wannan shine matukar farin ciki wajen kula da ciwon huhu na huhu.
Kalma Daga
Kwarewar fahimtar kwayar cutar kwayar cutar tumatir ita ce ɓangaren bincike mai ban sha'awa, kuma akwai yiwuwar sababbin jiyya ga wasu maye gurbin nan da nan.
Misalin yadda hanzarin wannan hanzarin maganin yana ci gaba shine gyaran gyare-gyare na ALK4-EML. An gano wannan "maye gurbin" jinsin halitta (a zahiri haɓaka) a kwanan nan a 2007. Ta hanyar hanyar da sauri, an yarda da Xalkori (crizotinib) magani a shekara ta 2011 don amfani da ita ta FDA ga wadanda marasa lafiya suke da wannan farfadowa. Akwai gwaje-gwaje na asibiti a halin yanzu suna ci gaba da kimanta amfani da kwayoyi na biyu zuwa ga waɗanda suka yi tsayayya ga Xalkori.
Idan an gano ku tare da ciwon huhu na ƙananan kwayoyin halitta, musamman adenocarcinoma ko ciwon huhu na mahaifa, magana da likitanku game da gwajin kwayoyin. Ko da yake an gwada gwajin yanzu ga kowa da kowa da ciwon ciwon huhu na kananan marasa lafiya, wani binciken da aka yi a kwanan nan ya nuna cewa kashi 60 cikin 100 na masu ilimin halitta ne kawai ke aiki a gwaji.
Kuna iya so ku yi magana da likitanku game da gwaji na gwaji wanda zai iya zama wani zaɓi a gare ku. Kwanan nan, ciwon daji na kwakwalwa na likitancin kwakwalwa wanda ya dace da goyon baya da wasu kungiyoyi masu fama da cutar kanjamau suka samu. Tare da wannan sabis na kyauta, mai kula da mai kula da ƙwararrun likita zai taimake ka ka gano duk gwaji na gwaji wanda zai iya zama wani zaɓi a gare ka.
> Sources:
> Hensing, T., Chawla, A., Batra, R., da R. Salgia. Yin magani na musamman don ciwon daji na huhu: hanyoyin ƙwayoyin kwayoyin, hanyoyin magance cutar, da kuma fasalin kwayoyin halitta. Ci gaba a Medicine Experimental da Biology . 2014. 799: 85-117.
> Kim, H., Mitsudomi, T., Soo, R., da B. Cho. Tsara ta mutum a kan sararin sama don ƙwayar ƙwayar kwayar halitta ta ƙwayar cuta. Lung Cancer . 2013. 80 (3): 249-55.
> Li, T., Kung, H., Mack, P. da D. Gandara. Labarin Genotyping da kuma kwayoyin cutar ciwon huhu na kananan kwayoyin halitta: abubuwan da ke faruwa a halin yanzu da kuma na gaba. Journal of Clinical Oncology . 2013. 31 (8): 1039-49.
> Villaruz, L., Burns, T., Ramfidis, V., da kuma Mr. Socinski. Gyara farfadowa a cikin ciwon daji marasa ciwon ƙwayar cutar kwayar cutar. Seminars a cikin na numfashi da m Care Medicine . 2013. 34 (6): 822-36.