Iziguli ezinomdlavuza wamaphaphu, ingabe ukuhlolwa kwe-MRD kuyadingeka?

I-MRD (I-Minimal Residual Disease), noma I-Minimal Residual Disease, inombolo encane yamangqamuzana omdlavuza (amangqamuzana omdlavuza angaphenduli noma amelana nokwelashwa) ahlala emzimbeni ngemva kokwelashwa komdlavuza.
I-MRD ingasetshenziswa njenge-biomarker, ngomphumela omuhle okusho ukuthi izilonda ezisele zingase zibonakale ngemva kokwelashwa komdlavuza (amangqamuzana omdlavuza atholakala, futhi amangqamuzana omdlavuza asele angasebenza futhi aqale ukuphindaphindeka ngemva kokwelashwa komdlavuza, okuholela ekuphindeni komdlavuza. isifo), kuyilapho umphumela omubi usho ukuthi izilonda ezisele azitholakali ngemva kokwelashwa komdlavuza (awekho amangqamuzana omdlavuza atholakele);
Kwaziwa kahle ukuthi ukuhlolwa kwe-MRD kudlala indima ebalulekile ekuhlonzeni iziguli ezinomdlavuza wamaphaphu ongewona omncane (i-NSCLC) ezisengcupheni enkulu yokuphinda ziphinde futhi ziqondise ukwelashwa kwe-adjuvant ngemva kokuhlinzwa okukhulu.
Izimo lapho i-MRD ingasetshenziswa khona:

Ngomdlavuza wamaphaphu ongasebenza esigabeni sokuqala

1. Ngemva kokuhlinzwa kabusha okukhulu kweziguli ezinomdlavuza wamaphaphu wengqamuzana ongewona omncane wesigaba sokuqala, ukuba ne-MRD positivity kuphakamisa ingozi enkulu yokuphinda futhi kudinga ukuphathwa kokulandelela okuseduze. Ukuqapha kwe-MRD kunconywa njalo ezinyangeni ezingu-3-6;
2. Kunconywa ukwenza izivivinyo zomtholampilo ze-perioperative zomdlavuza wamaphaphu wengqamuzana ongewona omncane osebenzisekayo ngokusekelwe ku-MRD, futhi unikeze izinketho zokwelapha ezinembayo ze-perioperative ngangokunokwenzeka;
3. Ncoma ukuhlola indima ye-MRD kuzo zombili izinhlobo zeziguli, isakhi sofuzo somshayeli kanye ne-negative yomshayeli, ngokuhlukana.

Ngomdlavuza wamaphaphu ongewona omncane othuthuke endaweni

Ukuhlolwa kwe-1.MRD kunconywa ezigulini ezixole ngokuphelele ngemva kwe-radical chemoradiotherapy yomdlavuza wamaphaphu wamangqamuzana ongewona omncane othuthuke kakhulu endaweni, ongasiza ekunqumeni ukubikezela kanye nokwenza amanye amasu okwelapha;
2. Izivivinyo zemitholampilo zokwelashwa kokuhlanganisa okusekelwe ku-MRD ngemva kwe-chemoradiotherapy ziyanconywa ukuthi zinikeze izinketho ezinembile zokwelapha zokuhlanganisa ngangokunokwenzeka.
Ngomdlavuza wamaphaphu ongewona omncane wamaseli
1. Kukhona ukushoda kwezifundo ezifanele nge-MRD kumdlavuza wamaphaphu ongewona omncane wamangqamuzana;
2. Kutuswa ukuthi i-MRD itholwe ezigulini esezikhululeke ngokuphelele ngemva kokwelashwa okuhleliwe komdlavuza wamaphaphu wamangqamuzana ongewona omncane, ongasiza ekwahluleleni ukubikezela kanye nokwenza amanye amasu okwelapha;
3. Kunconywa ukwenza ucwaningo ngamasu okwelapha asekelwe ku-MRD ezigulini ezixolelwe ngokuphelele ukuze kunwetshwe isikhathi sokuxolelwa okuphelele ngangokunokwenzeka ukuze iziguli zikwazi ukwandisa izinzuzo zazo.

Kungabonakala ukuthi ngenxa yokushoda kwezifundo ezifanele mayelana nokutholwa kwe-MRD kumdlavuza wamaphaphu ongewona omncane omncane, ukusetshenziswa kokutholwa kwe-MRD ekwelapheni iziguli ezinomdlavuza wamaphaphu ongewona omncane osezingeni eliphezulu akuzange kuboniswe ngokucacile.
Eminyakeni yamuva nje, inqubekelaphambili ekuhlosweni kwayo kanye ne-immunotherapy iguqule umbono wokwelashwa kweziguli ezine-NSCLC ethuthukisiwe.
Ubufakazi obusafufusa bubonisa ukuthi ezinye iziguli zithola ukuphila isikhathi eside futhi kulindeleke ukuba zithole ukukhululwa okuphelele ngokuthwebula izithombe. Ngakho-ke, ngaphansi kwesisekelo sokuthi amanye amaqembu eziguli ezine-NSCLC ethuthukisiwe ziye zaqaphela kancane kancane umgomo wokuphila isikhathi eside, ukuqapha ukuphindaphinda kwezifo kuye kwaba yinkinga enkulu yomtholampilo, nokuthi ukuhlolwa kwe-MRD nakho kungadlala indima ebalulekile kuyo kufanele kuhlolwe. kwezinye izivivinyo zomtholampilo.