Iziguli ezinomdlavuza wamaphaphu, ingabe ukuhlolwa kwe-MRD kuyadingeka?

I-MRD (Isifo Esincane Esisele), noma Isifo Esincane Esisele, inani elincane lamaseli omdlavuza (amaseli omdlavuza angaphenduli noma amelana nokwelashwa) ahlala emzimbeni ngemva kokwelashwa komdlavuza.
I-MRD ingasetshenziswa njenge-biomarker, ngomphumela omuhle okusho ukuthi izilonda ezisele zisengatholakala ngemva kokwelashwa komdlavuza (kutholakala amangqamuzana omdlavuza, futhi amangqamuzana omdlavuza asele angasebenza futhi aqale ukwanda ngemva kokwelashwa komdlavuza, okuholela ekuphindeni kwesifo), kanti umphumela omubi usho ukuthi izilonda ezisele azitholakali ngemva kokwelashwa komdlavuza (awekho amangqamuzana omdlavuza atholakalayo);
Kuyaziwa kahle ukuthi ukuhlolwa kwe-MRD kudlala indima ebalulekile ekutholeni iziguli zomdlavuza wamaphaphu ongewona amaseli amancane (i-NSCLC) ezisesigabeni sokuqala ezisengozini enkulu yokuphinda zivele kanye nasekuqondiseni ukwelashwa okusizayo ngemva kokuhlinzwa okukhulu.
Izimo lapho i-MRD ingasetshenziswa khona:

Komdlavuza wamaphaphu ohlinzwa esigabeni sokuqala

1. Ngemva kokususwa okukhulu kweziguli ezinomdlavuza wamaphaphu ezingewona amangqamuzana amancane esigabeni sokuqala, ukuba ne-MRD positive kuphakamisa ingozi enkulu yokuphinda kuvele futhi kudinga ukuphathwa okuseduze. Ukuqashwa kwe-MRD kunconywa njalo ezinyangeni ezi-3-6;
2. Kunconywa ukwenza izivivinyo zemitholampilo zangaphambi kokuhlinzwa zomdlavuza wamaphaphu ongewona owamangqamuzana amancane ohlinzwa ngokusekelwe ku-MRD, futhi unikeze izinketho zokwelapha ngokunemba kwangaphambi kokuhlinzwa ngangokunokwenzeka;
3. Ncoma ukuhlola indima ye-MRD kuzo zombili izinhlobo zeziguli, i-driver gene positive kanye ne-driver gene negative, ngokwehlukana.

Komdlavuza wamaphaphu ongeyona iseli elincane othuthuke endaweni

1. Ukuhlolwa kwe-MRD kunconywa ezigulini esezikhululekile ngokuphelele ngemuva kokwelashwa ngamakhemikhali anomsakazo omkhulu womdlavuza wamaphaphu ongeyona iseli elincane othuthukisiwe endaweni, okungasiza ekunqumeni isibikezelo futhi kwakhiwe amanye amasu okwelapha;
2. Kunconywa izivivinyo zemitholampilo zokwelapha ngokuhlanganiswa okusekelwe ku-MRD ngemva kokwelashwa ngemisebe ye-chemotherapy ukuze kuhlinzekwe izinketho zokwelapha ngokuhlanganiswa okunembile ngangokunokwenzeka.
Ngomdlavuza wamaphaphu ongeyona iseli elincane othuthukile
1. Kukhona ukuntuleka kwezifundo ezifanele nge-MRD kumdlavuza wamaphaphu ongeyona iseli elincane othuthukile;
2. Kunconywa ukuthi i-MRD itholakale ezigulini esezikhululekile ngokuphelele ngemva kokwelashwa okuhlelekile komdlavuza wamaphaphu ongeyona iseli elincane, okungasiza ekuhluleleni isibikezelo futhi kwakhiwe amanye amasu okwelapha;
3. Kunconywa ukuthi kwenziwe ucwaningo ngamasu okwelapha asekelwe ku-MRD ezigulini ezikhululekile ngokuphelele ukuze kwandiswe isikhathi sokukhululeka okuphelele ngangokunokwenzeka ukuze iziguli zikwazi ukwandisa izinzuzo zazo.

Kungabonakala ukuthi ngenxa yokuntuleka kwezifundo ezifanele mayelana nokutholwa kwe-MRD kumdlavuza wamaphaphu ongewona amangqamuzana amancane othuthukile, ukusetshenziswa kokutholwa kwe-MRD ekwelapheni iziguli ezinomdlavuza wamaphaphu ongewona amangqamuzana amancane othuthukile akukakhonjiswanga ngokucacile.
Eminyakeni yamuva nje, intuthuko kwezokwelapha okuqondiwe kanye ne-immunotherapy ishintshe umbono wokwelashwa kweziguli ezine-NSCLC ethuthukile.
Ubufakazi obuvelayo busikisela ukuthi ezinye iziguli zifinyelela ukusinda isikhathi eside futhi kulindeleke ukuthi zifinyelele ukuphulukiswa okuphelele ngokuthwebula izithombe. Ngakho-ke, ngaphansi kwesisekelo sokuthi amanye amaqembu eziguli ezine-NSCLC ethuthukile afinyelele kancane kancane umgomo wokusinda isikhathi eside, ukuqapha ukuphindaphinda kwesifo sekuyinkinga enkulu yezokwelapha, nokuthi ukuhlolwa kwe-MRD kungadlala indima ebalulekile yini kukho kufanele kuhlolwe ezivivinyweni ezengeziwe zezokwelapha.