Ithumba isiphawuli CA 19-9. Uhlalutyo CA 19-9: nanjengokwesimo kwaye xa wavusa

Ithumba isiphawuli CA 19-9 yi ezinto glycoprotein eliphezulu ubunzima. Kokuba lukhutshwe leseli epithelium kwinkqubo yokwetyisa. Njengoko uhlalutyo immunohemilyuminestsentny indlela uphando esetyenzisiweyo. CA 19-9 lu dityanisiwe ezimbi ngumhlaza.

ulwazi jikelele

Ukuba bafunde izinto eziphilayo njengoko kusetyenziswa igazi lwemithambo. CA 19-9 - esebenzayo ithumba isiphawuli. inkcazelo yayo esetyenziswa uxilongo, ukubeka esweni kunye ukubhaqwa kwezinto Ukudlulela esiswini, injeke, isibindi, namathumbu (colon kunye isikali). CA amanqanaba 19-9 anda phantse kuzo zonke izigulane nangezilonda emathunjini, ingakumbi zepancreas. Ukuvelisa iiseli e nangezilonda, glycoprotein lingena singene kwegazi. Ukuqwalasela nokuphonononga umxholo, iingcali kufuneka ithuba ukulandela ikhondo sifo. Uhlalutyo CA19-9, izinga apho umntu esempilweni hayi ngaphezulu kwe 10 U / ml alisetyenziswa uxilongo zaseprayimari.

Yintoni umhlaza pancreatic? isishwankathelo

Esi sifo oncological ukuza kuthi ga iqukiwe kuluhlu ezimbi kakhulu yingozi. Malunga ne-90% yezigulane kufa kwisithuba kunyaka wokuqala sifo. Ngelo xesha loxilongo ngo-80% yezigulane bafumana metastases ekude okanye lommandla. Iingcali bathi oku kakhulu efihliweyo phezu ngezifo. Le isifo bezenze iinkqubo ezingapheliyo ukudumba kwindawo flow amalungu hepatopancreatoduodenal (cholelithiasis, cholecystitis, pancreatitis ezinganyangekiyo). Malunga nalo kufuneka ngokukhawuleza kangangoko ukwenza isifo umahluko, ngaphandle phambi yobubi. Oku, kuya khetha isicwangciso isebenzayo kwezonyango kwezi ezingapheliyo.

Isilwa CA 19-9. yoxinaniso

Xa umhlaza nepancreas kukho izinga eliphezulu glycoprotein. Uhlalutyo CA19-9, leyo iqulathe ulawulo ngasentla, ifuna ekufumanekeni carcinoma, ukuphonononga kungenzeka resection. Xa iqela ngaphezulu kwe 1000 U / ml neoplasm kuthathwa operable% 5 kuphela kwizigulane. Ukuba umxholo ungaphantsi amanani abonisa, nethumba ngokuqhelekileyo asuswe. Noko ke, emva kokuba ungenelelo ngesithuba seenyanga omnye abasixhenxe, kukho ingozi ukuphinda. Ithumba isiphawuli CA 19-9 yeyesibini ukubaluleka emva BCEA isiphawuli lokufumana yobubi esiswini. Ukongeza, uphononongo ngakumbi ubunzima eliphezulu ezinto glycoprotein eyabelwe Alpha-fetoprotein kwi uxilongo kunye nokujonga unyango umhlaza wesibindi, iphecana biliary kunye isinye.

nokwanda

imigangatho ephakamileyo le glycoprotein inokubonakalisa phezu imvelaphi ezimbi ezahlukeneyo ukudumba kwaye nabungozi esibindini kunye nenkqubo yokucola (ukuya kuma-500, kodwa ngokwesiqhelo kwi 100 U / ml), kunye abanesigulo esinganyangekiyo. Kwimeko yokuqala, ukufumaneka yaligqiba-12% yezigulane. Inqanaba eliphezulu kule - ngaphezulu akukho kwe 45 U / ml. Glycoprotein kwazona kwi enyongweni. Kulo mba, nayiphi cholestasis kufuneka sikhatshwe kukunyuka umxholo wayo. Kwiimeko ezinjalo ke kuyimfuneko ukuba ukuqhuba uphando ngaxeshanye GGT (gamma-glutamattransferazy) kunye phosphatase obrak. ingqondo Ukwanda nayo kwenziwa imvelaphi yezinye yamathumba localizing (e umhlaza colorectal, umhlaza ovarian), isifo sesibindi (kwesibindi, ihepatitis).

Ukungabikho okanye yancitshiswa

Iingcali ziye zaphawula ukuba xiyimiso eqhelekileyo akukhethi ubukho somhlaza kwi pancreas. Kulo mzekelo, oko kwafunyaniswa ukuba izifo kwakudala xa inqanaba lokuba kuziwe, asikabi ixesha ukuvuka. Kwesifundo izigulane zifumana unyango, wehlisa umxholo glycoprotein sinokubonisa ukusebenza kongenelelo zonyango.

Yiyiphi kufune uphando

Uvavanyo ithumba isiphawuli CA 19-9 iyafuneka ukuze esweni ukusebenza zokungenelela zonyango umhlaza pancreatic, kwakunye efumanise ukuphinda kusekwangoko isifo. Uphononongo ivumela unesifo mahluko of yobubi kunye nezinye izifo (umz, pancreatitis). Isalathisi CA 19-9 ibonisa ukwanda yenkqubo onobungozi, ubukho somhlaza imvelaphi metastases zikude sifo.

Kwezinye iimeko, izifundo eyabelwe

Uvavanyo ithumba isiphawuli CA 19-9 nekucetyiswa ukuba ukutyhileka iimpawu zomhlaza zepancreas: isicaphucaphu, iintlungu esiswini, nenyongo, ukwehla kobunzima bomzimba. Ngamaxesha athile wabelwa ukuba izigulane isifundo xi ekuqaleni eziphezulu glycoprotein nokufumana unyango. Uhlalutyo Kucetyiswa ukuba umhlaza kurhanelwa esinyini inyongo okanye iphecana biliary, isibindi, isisu okanye colon. Ngoko Uphando alawulwa ngokudityaniswa kunye nezinye iimvavanyo.

yombhalo

Ixabiso reference uluhlu ekufuneka ibe kwinqanaba iantigens - 0-35 U / ml. Njengoko sele kukhankanyiwe ngentla apha, le ndzo eliphezulu glycoprotein ibonisa ubukho yobubi kwi pancreas. Ukuba uphakamile lo umxholo, esi sifo kwinqanaba eliphezulu kakhulu. amanqanaba egqithisileyo abonisa ithumba Ukudlulela.

inkcazelo ebalulekileyo

isiqulatho Test ingqalelo glycoprotein kubaluleke ngokukodwa ekufumanekeni kuwenza somdlavuza zepancreas ekuqaleni. Malunga ne-7-10% abantu abanayo isakhi buqonda ezinto glycoprotein eliphezulu ubunzima. Ngokunjalo, emzimbeni kukho izakhono ngezemvelo nokulungelelanisa le iantigens CA 19-9. Ngoko ke, nkqu lokufunyaniswa kwinqanaba yobubi of glycoprotein akukho kubonakele ku serum.

Ukuze ufumane inkcazelo engakumbi,

Ngaphambi kokuba unikele ngegazi, iingcali bacebisa ndingatshayi kangangesiqingatha seyure. Ixabiso lokubhaqa ukunyuka test, lo gama isifundo kwi BCEA. Ukongeza nokucwangcisa uxilongo echanekileyo kwaye unyango olufanelekileyo kuyimfuneko ukuqeshwa iimvavanyo ekucetyiswa ukuba CA 72-4, yibilirubin iyonke, CA 242. izifundo zeLebhu amisele ziingcali ezifana hepatologist, internist, ugqirha okanye somdlavuza.

isiphelo

Iingcali uqaphele ukuba umhlaza namhlanje injeke Ziyanda kwizigulane emva kweminyaka engama-30. Lo ngezifo ngomnye kancinane esifunyenweyo kakuhle iSADC kunyango. Kulo mba, iimvavanyo ezininzi vakalelo ziyafuneka ukuchonga kuye. Ngelishwa, ukufunda iantigens xiyimiso ayikwazi ingasetyenziswa moshilongo lokuqala Inqanaba isifo. Kunjalo, olu vavanyo i-ethe kakhulu kwaye ulwazi malunga nokuvavanya ukusebenza konyango, ozibonayo izigaba zokuqala Ukudlulela lomhlaza. Alithandabuzeki elokuba, oyingcali uphando usebenzisa iziphumo ngeenkqubo ezahlukeneyo zokuxilonga. Ukongeza elebhu, isigulana onyulwe kunye nophando zomculo. Eyona lula kwezi ngoku US. Xa eqhuba umsebenzi wakhe, uyakwazi ukubona ubungakanani ithumba evela ngokweesentimitha ezimbini. Ukucacisa ubukhulu, indawo, kunye nokwanda yobubi amisele a CT scan. Esebenzisa le ndlela, oko zafunyanwa yobukhulu ithumba iisentimitha ezintathu. Kufuneka ke ukuba ukuziphatha i-CT elidityaniswe ukuvelisa yedosi ethile ye-X-reyi. Ngoko ke, lo sifundo akuzange kwenziwe njalo okanye prophylaxis. uxinezeleko kangako emzimbeni yomguli inikeza MRI. Kodwa olu hlobo lophando singàphunyezwa ukuba abantu babe naziphi implants yesinyithi. Zonke ezi manyathelo diagnostic, kunye iimvavanyo zegazi zinokuxela uyifundisa zophuhliso umhlaza okanye Ukudlulela kwi pancreas.