Izigulana ezinomhlaza wemiphunga, ngaba uvavanyo lwe-MRD luyimfuneko?

I-MRD (i-Minimal Residual Disease), okanye i-Minimal Residual Disease, inani elincinci leeseli zomhlaza (iiseli zomhlaza ezingaphenduliyo okanye ezichasene nonyango) ezihlala emzimbeni emva kokunyangwa komhlaza.
I-MRD ingasetyenziswa njenge-biomarker, enesiphumo esihle esithetha ukuba izilonda ezishiyekileyo zisenokubonwa emva konyango lomhlaza (iiseli zomhlaza zifunyenwe, kwaye iiseli zomhlaza eziseleyo zinokusebenza kwaye ziqale ukuphindaphindeka emva konyango lomhlaza, okukhokelela ekuphindeni kwesifo), ngelixa isiphumo esibi sithetha ukuba izilonda ezishiyekileyo azibonwa emva konyango lomhlaza (akukho ziseli zomhlaza zifunyenwe);
Kuyaziwa ukuba uvavanyo lwe-MRD ludlala indima ebalulekileyo ekuchongeni izigulana zomhlaza wemiphunga (NSCLC) ezikwinqanaba lakwangoko elisemngciphekweni omkhulu wokuphindaphinda kunye nokukhokela unyango lwe-adjuvant emva kotyando olukhulu.
Iimeko apho i-MRD inokusetyenziswa khona:

Kwinqanaba lokuqala lomhlaza wemiphunga

1. Emva kokutshatyalaliswa ngokukhawuleza kwezigulane zomhlaza wemiphunga yeseli engeyiyo encinci, i-MRD positivity ibonisa umngcipheko omkhulu wokuphindaphinda kwaye ifuna ulawulo olusondeleyo. Ukujongwa kwe-MRD kunconywa rhoqo kwiinyanga ezi-3-6;
2. Kucetyiswa ukuba kwenziwe ulingo lwezonyango lwe-perioperative yomhlaza wemiphunga weseli ongasebenziyo osekwe kwi-MRD, kwaye ubonelele ngeendlela zonyango ezichanekileyo kangangoko kunokwenzeka;
3. Ncoma ukuphonononga indima ye-MRD kuzo zombini iindidi zezigulane, i-driver gene positive kunye ne-driver gene negative, ngokwahlukileyo.

Kumhlaza wemiphunga weseli ongengomncinci omncinci

Uvavanyo lwe-1.MRD lunconywa kwizigulane ekuxoxweni okupheleleyo emva kwe-radical chemoradiotherapy kumhlaza wemiphunga we-cell non-small cell, onokunceda ukufumanisa i-prognosis kunye nokuqulunqa izicwangciso zonyango olongezelelweyo;
2. Uvavanyo lwezonyango lwe-MRD-based based consolidation therapy emva kwe-chemoradiotherapy iyacetyiswa ukuba ibonelele ngeendlela zonyango ezichanekileyo zonyango kangangoko kunokwenzeka.
Kumhlaza wemiphunga weseli ongekho mncinane
1. Kukho ukunqongophala kwezifundo ezifanelekileyo kwi-MRD kumhlaza wemiphunga yeseli engeyiyo encinci;
2. Kucetyiswa ukuba i-MRD ifunyanwe kwizigulane ekuxolweni ngokupheleleyo emva konyango lwe-systemic kumhlaza wemiphunga yeseli engeyiyo encinci, enokunceda ukugweba i-prognosis kunye nokwenza ezinye iindlela zonyango;
3. Kucetyiswa ukuba kwenziwe uphando malunga nezicwangciso zonyango ezisekelwe kwi-MRD kwizigulane ekuxoxweni okupheleleyo ukuze kwandiswe ixesha lokuxolelwa okupheleleyo kangangoko ukwenzela ukuba izigulane zikwazi ukwandisa izibonelelo zabo.

Kunokubonwa ukuba ngenxa yokunqongophala kwezifundo ezifanelekileyo malunga nokufunyanwa kwe-MRD kumhlaza wemiphunga weseli ongengomncinci omncinci, ukusetyenziswa kokufunyaniswa kwe-MRD kunyango lwezigulane ezinomhlaza wemiphunga we-cell ongewona omncinci akukhange kuboniswe ngokucacileyo.
Kwiminyaka yakutshanje, inkqubela phambili ekujoliswe kuyo kunye ne-immunotherapy iye yaguqula imbonakalo yonyango kwizigulana ezine-NSCLC ephucukileyo.
Ubungqina obuvelayo bubonisa ukuba ezinye izigulane zifezekisa ukuphila kwexesha elide kwaye zilindeleke ukuba zifezekise ukuxolelwa okupheleleyo ngokucinga. Ke ngoko, phantsi kwengqikelelo yokuba amanye amaqela ezigulane ezine-NSCLC ephucukileyo ziye zaqonda ngokuthe ngcembe injongo yokuphila ixesha elide, ukujongwa kwakhona kwesifo kuye kwaba ngumba omkhulu weklinikhi, kwaye nokuba uvavanyo lwe-MRD lunokudlala indima ebalulekileyo kuyo lufanele ukuphononongwa kwiimvavanyo ezingakumbi zeklinikhi.