Kwinkqubela phambili enkulu ekuhlolweni komhlaza, uphononongo olutsha luphuhlise uvavanyo lwegazi olulula lokubona ii-cancer ezisibhozo ezahlukeneyo kumanqanaba abo okuqala, ezintlanu zazo ezingenayo inkqubo yokuhlola ukubhaqwa kwangoko.
Cancer isengomnye woonobangela abaphambili bokusweleka kwihlabathi jikelele. Kuqikelelwa ukuba inani labantu ababulawa ngumhlaza kwihlabathi liza kunyuka ukusuka kwi-8 yezigidi ukuya kwi-13 yezigidi ngo-2030. Ukuxilongwa kwangoko komhlaza ngundoqo ekunciphiseni ukusweleka okunxulumene nomhlaza kuba kwangethuba isifo sifunyaniswa, amathuba onyango oluyimpumelelo aye aphezulu. Ukuxilongwa komhlaza womhlaza yinkqubo ende kwaye inzima. Xa umntu eneempawu ezibonisa umhlaza, ugqirha ujonga imbali yakhe yobuqu kunye neyonyango aze enze uviwo lomzimba. Emva kolu vavanyo lokuqala, iimvavanyo ezininzi ziyacetyiswa ngokubanzi. Okokuqala, iimvavanyo zaselabhoratri ze igazi, umchamo, ulwelo lomzimba njl njl ezinokunceda kodwa ngokuqhelekileyo zingawufumani umhlaza xa usenziwa ngokuzimeleyo. Ugqirha uya kucebisa inkqubo yokucinga yonyango enye okanye ngaphezulu eyenza imifanekiso yeendawo ngaphakathi emzimbeni ezinceda ugqirha ukuba abone ukuba ithumba likhona - i-ultrasound okanye i-CT scan ukuqala.
Ukongeza, kwiimeko ezininzi oogqirha kuya kufuneka benze i-biopsy ukuze kufunyaniswe umhlaza - i-biopsy yinkqubo apho ugqirha esusa isampulu yethishu emzimbeni ukuze ihlolwe elabhoratri ukubona ukuba ngumhlaza na. Esi sixhobo sinokususwa emzimbeni kusetyenziswa inaliti okanye inkqubo yotyando encinci okanye nge-endoscopy. I-Biopsy yinkqubo yokuxilonga entsonkothileyo nentsonkothileyo, eyenziwa ngokubanzi emva kokuba isigulana siqale ukubonisa ubuncinane uphawu olunye olucacileyo oluthi ke lunyanzelise ukuba atyelele ugqirha. Uninzi lwabantu abadala bomhlaza lukhula ngokucothayo, ngamanye amaxesha luthatha iminyaka engama-20 ukuya kuma-30 ukuqhubela phambili kumhlaza ogcwele ngokupheleleyo. Ngexesha befunyaniswa ukuba le mihlaza idla ngokunwenwa oko kwenza ukuba kube nzima kakhulu ukunyanga. Kuba uninzi lomhlaza sele kusemva kwexesha xa uphawu lokuqala luvela, oku kuyinkxalabo enkulu kwikamva loxilongo lomhlaza kuba kwangethuba ulwazi luyafumaneka kunokwenzeka ukuba unyango lomhlaza lunokuphumelela. Ngelishwa, uninzi lwe-cancer alubanjwa kude kube ngamanqanaba okugqibela kwaye oku kubalelwa kukungabikho kwezixhobo zokuxilonga ezikhawulezayo nezisebenzayo.
Ingaba lusebenza njani olu vavanyo lutsha, lomhlaza wokuhlola igazi?
Kuphononongo lwakutsha nje olupapashwe kwi inzululwazi, abaphandi baye baphuhlisa uvavanyo olutsha lwegazi, olunokubonelela ngobuchule obulula kodwa obusebenzayo bokuxilonga uninzi lwee-cancer.1. Uvavanyo olubizwa ngokuba yi-'CancerSEEK' yinoveli, indlela engangeneleliyo yokubona ngaxeshanye iintlobo zomhlaza ezisibhozo kwisampulu yegazi enye. Olu phononongo luqhutywe liqela leYunivesithi yaseJohns Hopkins School of Medicine, e-USA, lubonise ukuchaneka okuphezulu kunye novakalelo lokubhaqwa komhlaza phakathi kwabantu abangaphezu kwe-1000 abanomhlaza kwaye kuphawulwa njengendlela ekhawulezayo nelula yokubona umhlaza kumanqanaba awo okuqala. kwaye ikwalathe indawo yayo.
Uphononongo lweCancerSEEK luqukunjelwe kubantu abayi-1,005 abafunyaniswa beneendlela ezingezizo ze-metastatic zomhlaza omnye kwezisibhozo (ibele, imiphunga, i-colorectal, i-ovarian, isibindi, isisu, i-pancreatic, kunye nenqanaba lommizo I ukuya ku-III), ezintlanu zazo iimvavanyo zovavanyo lwesiqhelo kubantu abasemngciphekweni ophakathi (oomhlaza yi-ovarian, isibindi, isisu, ipancreatic kunye nommizo). Olu vavanyo lwegazi lusebenza ngendlela elula kakhulu. Xa amathumba omhlaza enza ngaphakathi emzimbeni emva kokuqala kwesi sifo, ezi seli zethumba zikhupha amaqhekeza amancinci aguqulweyo. DNA kunye neeproteni ezingaqhelekanga ezijikeleza egazini kwaye zinokusebenza njengeempawu ezikhethekileyo zomhlaza. Ezi zixa zemizuzu ye-DNA eguqulweyo kunye neeprotheni ezingaqhelekanga zijikeleza kwi igazi kudala ngaphambi kokuba kubangele naziphi na iimpawu kwaye zodwa kakhulu xa kuthelekiswa DNA kunye neeprotheni ezifumaneka kwiiseli eziqhelekileyo. Uvavanyo lwegazi lusebenza ngokuchonga iimpawu zokuguqula imizila yemfuza eli-16 kunye neeproteni zomhlaza eziqhelekileyo ezisibhozo (ezifakwe kuluhlu olufutshane emva kokuphonononga amakhulu aliqela emfuza kunye neempawu zeprotheyini ezingama-40) ezinxulumene neendidi ezisibhozo ezahlukeneyo zomhlaza ezibonisa ubukho bomhlaza. Iphaneli encinci kodwa eyomeleleyo yotshintsho inokubhaqa ubuncinci utshintsho olunye kwimihlaza eyahlukeneyo. Oku kuchongwa kweziphawuli zomhlaza yindlela eyodwa yokuhlela kuba idibanisa ukuba nokwenzeka kokujonga iinguqu ezahlukeneyo zeDNA kunye namanqanaba eeproteni ezininzi ukuze kuthathwe isigqibo sokuxilongwa kokugqibela.Le ndlela isekelwe kwingqiqo efanayo yokusebenzisa indibaniselwano yamachiza ukunyanga umhlaza.Kubalulekile ukuqaphela ukuba olu vavanyo lwemolekyuli lujolise ekuhloleni umhlaza kwaye lwahluke kakhulu kwezinye iimvavanyo zemolekyuli ezihlalutya amanani amakhulu emfuza eqhuba umhlaza ukuchonga iithagethi ezinokuthi zisetyenziswe ukuphuhlisa unyango.
Ukubakho kovavanyo kuba nefuthe kwizigulane
Uvavanyo luvelise isiphumo esipheleleyo esingaphezulu kweepesenti ze-99 kwaye yakwazi ukuchonga ipesenti ze-70 zee-cancer ezinobuzwe obupheleleyo ukusuka kwi-33 ephantsi (umhlaza wesifuba) ukuya kwi-98 yepesenti (ye-ovarian cancer). Uvakalelo lwemihlaza emihlanu ekungekho luvavanyo lufumanekayo (i-pancreas, i-ovary, isibindi, isisu kunye ne-esophageal) ukusuka kuma-69 ukuya kuma-98 ekhulwini. Okubangel 'umdla kukuba, uvavanyo lukwazile ukukhomba indawo yamathumba kwiipesenti ezingama-83 zabaguli. Ezi ziphumo zibizwa ngokuba 'zikhuthaza' kakhulu kwaye zikhomba kumathuba okuba neCancerSEEK njengovavanyo lwesiqhelo lokuvavanyelwa umhlaza kuba inamandla okuphucula iziphumo. Uvavanyo lulonke lwaluphezulu kwaye oku kubaluleke kakhulu ekuthinteleni ukuxilongwa ngokugqithisileyo kunye novavanyo olungeyomfuneko lokulandelela kunye neenkqubo zokuqinisekisa ubukho bomhlaza. Oku kukodwa kwaphunyezwa ikakhulu ngokugcina iphaneli yokuguqula inguqu encinci. Uvavanyo lwenziwa kubathathi-nxaxheba abasempilweni abangama-812 kwaye basixhenxe kuphela abaphawulwe ukuba banayo yiCancerSEEK, kwaye ezi zigulana zinokuba ziziphumo ezingeyonyani okanye zinokuba nomhlaza wenqanaba lokuqala kungekho zimpawu.
Ukuthelekisa iCancerSEEK nezinye iimvavanyo zokubona kwangethuba
Isampulu yegazi isetyenziselwe ukufumanisa umhlaza, kwinto ebizwa ngokuba 'yi-liquid biopsies' (xa kuthelekiswa ne-biopsy eqhelekileyo apho isampulu yesampula ikhutshwa emzimbeni kwaye ichaphazeleke ngakumbi). Ezi nkqubo zivavanya ngokubanzi inani elikhulu lemfuza kwiinzame zokuchonga iithagethi zonyango kumachiza. Xa kuthelekiswa, iCancerSEEK ilandela indlela eyahluke ngokupheleleyo yokujolisa ekufunyanisweni kwangoko komhlaza ngokujonga iinguqulelo zemfuza nje ezili-16 ezinxulumene nomhlaza kunye namanqanaba eeprotheyini ezisibhozo njengeempawu zomhlaza. Iziphumo ezivela kwezi zimbini zeeparamitha zinokudibaniswa ne-algorithm "yokukora" uvavanyo lwegazi ngalunye olunokuqinisekisa ngakumbi ukuchaneka nokuthembeka kweziphumo. Ngelishwa, uvavanyo olusekwe egazini “lwe-biopsy yolwelo” lusanda kuphawulwa njengempikiswano ekufumaneni ngokuchanekileyo utshintsho lomhlaza ngokusilela kwabo ekuboniseni indawo yethumba. Ziyabiza kwaye ukukwazi kwabo ukuba zizixhobo zesiqhelo zokuxilonga kunye nonyango olukhokelayo kwizigulane ezinomhlaza akucaci. Kuphononongo lwangoku, kwi-63% yezigulane, iCancerSEEK ichaze amalungu enika ulwazi malunga nendlela yokuchonga indawo yethumba kunye nezigulane ezingama-83% olu vavanyo lwalatha iindawo ezimbini ezizimeleyo.
Iimvavanyo ezininzi ezisebenzayo zokubona umhlaza kwangethuba zikhona kwezinye iindidi zomhlaza, umzekelo i-mammography yomhlaza wamabele kunye ne-pap smears yomlomo wesibeleko yomhlaza womlomo wesibeleko. Olona vavanyo lusetyenziswa ngokubanzi lusekwe kwigazi lolomhlaza wedlala lobudoda ojonga nje iprotein biomarker enye, i-prostate specific antigen (PSA). Nangona olu vavanyo sele lukhona ngaphezulu kwamashumi amathathu eminyaka, alukaphawulwa njengoluluncedo kwaye luyimfuneko. Ezinye iimvavanyo zovavanyo eziqinisekisiweyo ezikhokelela kuxilongo lwangaphambili, olufana novavanyo lwekolonoscopy yomhlaza wamathumbu, zinemingcipheko ehambelanayo kunye nescreen kuphela somhlaza omnye ngexesha. Kwakhona, olunye uvavanyo olusekwe egazini lokuxilongwa komhlaza njenge-GRIL2 enenkxaso eyomeleleyo kulingo lweklinikhi, iimvavanyo ze-tumor DNA kuphela, hayi iproteni eyongezelelweyo ye-biomarkers apho iCancerSEEK ibandakanya ngoku. Kufuneka kucace kwixa elizayo ukuba yeyiphi kwezi teknoloji zimbini enezinto ezibaluleke kakhulu okt ukukwazi ukubona iindidi ezahlukeneyo zomhlaza kunye nokuphepha izinto ezingezizo. Kwakhona, uninzi lovavanyo lweentlobo ezithile zomhlaza lucetyiswa kuphela kubantu abanokuba okanye ekulindeleke ukuba babe semngciphekweni ngenxa yembali yosapho lwabo lomhlaza okanye ubudala nje. Ke, iCancerSEEK inokuba yinto eqhelekileyo nakwizigulana ezisempilweni ezingenazimpawu.
Future
Ayinakuphikiswa into yokuba ukuxilongwa kwangoko kubaluleke kakhulu ukunqanda impembelelo enobungozi yonyango oluninzi kunye nokufa komhlaza. Ngaphandle kweenzuzo ezenziweyo kunyango lomhlaza, ukhathalelo oluphambili lomhlaza lusenomthwalo omninzi ngokwasemzimbeni, ngokwengqondo nangokwezemali. Umhlaza obekwe kwindawo yawo kwiithishu zemvelaphi yawo kwaye ungasasazeki ngaphaya unokunyangwa ngotyando lodwa, ngaloo ndlela usindisa isigulana kwiziphumo ebezingalindelekanga zechemotherapy kunye nonyango lweradiotherapy.
I-CancerSEEK inokuthi kwixesha elizayo ibonelele ngesicwangciso esilula, esingahlaseli kunye nesikhawulezayo sokuxilonga umhlaza kumanqanaba ayo okuqala. Ababhali babonisa ukuba baye bamkela indlela yokwenene ngexesha lolu phononongo kwaye bayaqonda ukuba akukho vavanyo olunye luya kukwazi ukubona zonke ii-cancer. Nangona uvavanyo lwangoku aluwuthathi wonke umhlaza, luchonga ngempumelelo uninzi lwee-cancer ezinokuthi zingabonakali. Iindleko ezicetywayo zeCancerSEEK zimalunga ne-USD 500 kwaye oku kunoqoqosho ngakumbi ukuba uninzi lwezikrini ezikhoyo ngoku zeentlobo zomhlaza omnye. Eyona njongo iphambili iya kuba kukwenza olu vavanyo ludityaniswe kuxilongo lwesiqhelo (lothintelo okanye ngenye indlela) kukhathalelo lwempilo olusisiseko ngokwalo, into efana nokuba masithi ukukhangela i-cholesterol. Nangona kunjalo, kungathatha iminyaka ukuba olu vavanyo lufumaneke ekliniki.
Kuyimfuneko ukubonisa ukuba olu vavanyo lunokusebenza njani ekusindiseni ubomi kwixa elizayo kwaye amalingo amakhulu ngoku ayaqhubeka e-USA apho iziphumo ziya kufumaneka kwiminyaka emithathu ukuya kwemihlanu ezayo. Iingcali ze-oncologists kwihlabathi jikelele zilinde ulingo olukhulu oluqhubekayo ukuba lugqitywe. Alithandabuzeki elokuba olu vavanyo lukhethekileyo luvule indlela yokutshintsha ugxininiso kuphando lomhlaza ukusuka kumhlaza osemva kwexesha ukuya kwisifo sakwangoko esiya kubaluleka ekunciphiseni ukufa komhlaza kwixesha elide.
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{Unokufunda iphepha lokuqala lophando ngokunqakraza ikhonkco le-DOI elinikwe ngezantsi kuluhlu lwemithombo ecatshulweyo (s)}
Umthombo (s)
1. UCohen et al. 2018. Ukufumanisa kunye nokufumaneka kwendawo yomhlaza owenziwe ngotyando kunye novavanyo lwegazi oluninzi. inzululwazi. https://doi.org/10.1126/science.aar3247
2. UAravanis et al. 2017. Isizukulwana esilandelayo sokulandelelana kwe-Curculating Tumor DNA yokuFumana iCancer kwangethuba. Iseli. 168(4). https://doi.org/10.1016/j.cell.2017.01.030
