He aha te mate pukupuku Stromal Gastrointestinal? Tohutohu, Take, me te Maimoatanga

Ko te mate pukupuku stromal gastrointestinal (GIST) tētahi momo mate pukupuku onge i te pūnaha kai, te nuinga i roto i te kopu, te whekau iti rānei. Ka tipu ēnei mate pukupuku mai i ngā pūtau motuhake e kiia nei ko ngā pūtau interstitial o Cajal, ā, koinei ngā pūtau e āwhina ana i te nekehanga o te kai i roto i tō pūnaha kai.

Ahakoa ka raru pea te kupu “mate pukupuku”, he mea nui kia mōhio kei te tupu haere ngā GIST maha, ā, ka taea te whakaora pai ina kitea wawe. Mā te mārama ki te mea kei te pā ki a koe, ka āwhina koe ki te whakarite me te whakapono ki tō rongoā.

He aha ngā tohu o ngā mate pukupuku stromal gastrointestinal?

Kaore te nuinga o te hunga e pangia ana e ngā GIST iti e kite i ētahi tohu i te tīmatanga, koia te take i kitea ai ēnei mate pukupuku i ngā whakamātautau hauora noa rānei, i ngā mahi rongoā mō ētahi atu āhuatanga rānei. Ina puta mai ngā tohu, ka tupu haere pea i te tipu o te mate pukupuku.

Ko ngā tohu tino noa ka kitea e koe ko te mamae kopu roa, te kore ranei e pai te ahua o te kopu, kāore hoki he take mārama. Ka rite pea tēnei mamae ki te mamae ngawari, ki te pehanga rānei i roto i tō rohe kopu.

Ko ēnei ngā tohu e kitea pinepine ana e te hunga e pangia ana e ngā GIST:

• Te mamae kopu, te korokoro rānei e haere ana, e haere mai ana
• Te ngākau tere ki te kai, ahakoa he iti te nui
• Te ruaki, te ruaki rānei, ina koa i muri i te kai
• Te toto i roto i tō tiēre, ka pouri, ka rite rānei ki te tar
• Te ruaki toto, te mea rānei e rite ana ki te oneone kōpi
• Te ngaro o te taumaha kāore i whakamaaramahia i roto i ngā wiki, ngā marama rānei
• Te ngenge, te ngoikore rānei kāore e pai ake me te okioki
• He pūnga ka taea te kite i roto i tō kopu

Ka kitea hoki e ētahi te hunga e pangia ana e ngā tohu onge ake, pēnei i te uaua ki te horomia mena kei te pūnaha kai o runga te mate pukupuku, te whakarereke rānei i ngā nekehanga o te whekau. Ko te mea nui kia mahara kei te maha ngā take o ēnei tohu, ā, ko te whai i a rātou kāore e tino tikanga kei te mate pukupuku koe.

He aha ngā momo mate pukupuku stromal gastrointestinal?

Ka whakarōpūhia ngā GIST i runga i te wāhi i tipu ai rātou i roto i tō pūnaha kai, me te āhua hoki o te mahi. Mā te mārama ki te momo, ka taea e tō rōpū hauora te hanga i te mahere maimoatanga tino pai mō tō āhuatanga motuhake.

Ko te wāhi tino noa mō ngā GIST ko tō kopu, kei reira te 60% o ēnei mate pukupuku e tipu ana. Ka tupu haere pea ngā GIST kopu, ā, ka pai ake pea te tirohanga i te hunga kei ētahi atu wāhi.

Ko ngā GIST whekau iti te 30% o ngā take, ā, ka kitea pea ina nui ake, nā te mea he nui ake te wāhi o tēnei wāhi o tō pūnaha kai mō ngā mate pukupuku ki te tipu i mua i te puta mai o ngā tohu.

Kaore i te noa, ka taea e ngā GIST te tipu i roto i tō whekau nui, tō tūtae rānei, tō whekau kai rānei. Ko ēnei wāhi te toenga o ngā take, ā, ka hiahia pea ia ki ngā huarahi maimoatanga rerekē.

Ka whakarōpūhia hoki e tō tākuta tō GIST i runga i tōna taumata tūponotanga, e whakawhirinaki ana ki ngā take pēnei i te rahi, te wāhi, me te tere o te wehewehenga o ngā pūtau. Ka āwhina tēnei whakarōpū ki te kī he aha te āhua o te mate pukupuku, ā, ka ārahi i ngā whakatau maimoatanga.

He aha ngā take o ngā mate pukupuku stromal gastrointestinal?

Ka tipu te nuinga o ngā GIST ina puta mai ngā huringa, ngā tauhohenga rānei i roto i ngā pūtau o tō pūnaha kai. Ko te huringa tino noa ko te pānga ki te pūtau KIT, e whakahaere ana i te tipu me te wehewehenga o ngā pūtau.

Ko te 85% o ngā GIST kei a rātou ngā tauhohenga i roto i te pūtau KIT, ko te 5-10% rānei kei a rātou ngā huringa i roto i te pūtau e hono ana, ko te PDGFRA. Ka puta ēnei huringa ira ki te tipu me te tupu o ngā pūtau, ka hanga ai i te mate pukupuku.

Ko te mea nui kia mōhio kei te tupu ngā huringa ira i roto i tō oranga, kāore i te whakawhiwhia mai i ō mātua. Kaore te nuinga o te hunga e pangia ana e ngā GIST e whai i te hītori whānau o te āhuatanga.

Heoi, he āhuatanga ira onge e taea te whakapiki ake i tō tūponotanga:

• Neurofibromatosis momo 1 (NF1), e pā ana ki te 1 i roto i ngā tāngata 3,000
• Carney-Stratakis syndrome, he āhuatanga ira tino onge
• Carney triad, tētahi atu syndrome tino onge e taea te whakauru i ngā GIST maha

Mena he hītori whānau o ngā GIST, o ngā āhuatanga ira e hono ana rānei, ka tūtohu pea tō tākuta i te tohutohu ira ki te āwhina i a koe ki te mārama ki ō tūponotanga me ō kōwhiringa mo te tirotiro.

Nōhea te haere ki te tākuta mō ngā mate pukupuku stromal gastrointestinal?

Me whakapiri atu koe ki tō kaiwhakarongo hauora mena ka kitea e koe ngā tohu kai roa kāore e pai ake i muri i te wiki, rua rānei o te tiaki whare. Ahakoa ko ēnei tohu te nuinga o ngā āhuatanga noa, he pai tonu te tirotiro.

Rapua te tiaki hauora wawe mena ka kitea e koe te toto i roto i tō tiēre, i tō ruaki rānei, ina koa ki te pouri, ki te pango rānei te toto. Ka taea tēnei te tohu i te toto i tētahi wāhi o tō pūnaha kai e hiahia ana ki te aromatawai wawe.

Ko ētahi atu tohu whakatūpato e hiahia ana ki te tiaki hauora tere ko te mamae kopu nui e puta mai ana, te ruaki roa e ārai ana i a koe ki te pupuri i te kai, i ngā wai rānei, te ngaro o te taumaha kāore i whakamaaramahia neke atu i te 10 pauna i roto i ngā marama torutoru.

Mena ka taea e koe te kite i te pūnga, te nui rānei i roto i tō kopu kāore i reira i mua, ka tika hoki tēnei ki te aromatawai hauora tere. Ahakoa ka puta mai he mea ngāwari, he mea nui kia tirohia e te kaimahi hauora.

He aha ngā take tūponotanga mō ngā mate pukupuku stromal gastrointestinal?

He maha ngā take e taea te whakapiki ake i ō tūponotanga ki te whanake i te GIST, ahakoa he mea nui kia mahara kei te tikanga o te whai i ngā take tūponotanga kaore koe e whanake i tēnei āhuatanga. Kaore te nuinga o te hunga e whai take tūponotanga e whanake i ngā GIST, engari ko ētahi atu kāore he take tūponotanga e mohiotia ana.

Ko te tau te take tūponotanga tino nui, ko ngā GIST te nuinga i roto i te hunga neke atu i te 50. Ko te tau toharite i te whakatau ko te 60, ahakoa ka puta pea ēnei mate pukupuku i roto i ngā tāngata taitamariki, i ngā tamariki rānei.

Ko ēnei ngā take matua e taea te whakapiki ake i tō tūponotanga:

• Ko te neke atu i te 50 tau te pakeke, me te tūponotanga e haere tonu ana me te pakeke
• Te whai i te neurofibromatosis momo 1 (NF1), he āhuatanga ira
• Te hītori whānau o te GIST, o ngā syndromes ira e hono ana rānei
• Te whakamahinga o te radiation ki te kopu i mua, ahakoa he onge tēnei

Kāore i rite ki ētahi atu mate pukupuku, ko ngā take oranga pēnei i te kai, te wāhine, te inu waipiro rānei kāore e kitea he pānga nui ki te tūponotanga GIST. Ko te tikanga kāore he huringa oranga motuhake e taea te ārai i ēnei mate pukupuku ki te whanake.

He aha ngā raruraru pea o ngā mate pukupuku stromal gastrointestinal?

Ahakoa he maha ngā GIST e whakaorahia ana, ka taea e ētahi te raruraru mena ka nui, ka horapa rānei ki ētahi atu wāhi o tō tinana. Mā te mārama ki ēnei wāhi pea, ka taea e koe te mohio ki ngā tohu wawe, ka mahi tahi rānei me tō rōpū hauora ki te whakaoti i a rātou.

Ko te toto tetahi o ngā raruraru tino noa, ina koa ki ngā mate pukupuku nui. Ka puta mai tēnei ina pakaru te mate pukupuku i ngā oko toto i roto i tō pūnaha kai, ā, ka rereke te toto mai i te ngāwari, te roa rānei ki te tere, te nui rānei.

Ka taea hoki e ngā mate pukupuku nui te aukati i tō pūnaha kai, ka uaua ai te nekehanga o te kai. Ka arahi pea tēnei ki te ruaki roa, te ruaki rānei, te kōpū rānei kāore e whakautu ki ngā maimoatanga noa.

Ko ētahi atu raruraru pea ko:

• Te pakaru o te mate pukupuku, e taea te puta mai i te mamae kopu nui me te toto o roto
• Te whākotinga o te pakitara whekau, te hanga i te rua e tuku ana i ngā mea kai ki te rere
• Te horapa (horapa) ki ētahi atu whekau, te ate te nuinga
• Te anemia mai i te ngaro toto roa, te puta mai i te ngenge me te ngoikore
• Te aukati whekau e hiahia ana ki te rongoā hauora tere

Ko te rongo pai, me ngā maimoatanga hou, ka taea te ārai i te nuinga o ēnei raruraru, te whakahaere pai rānei ina kitea wawe. Ko te whai i te whai wāhi tonu ki tō rōpū hauora he mea nui ki te tirotiro i ngā huringa.

Me pēhea te whakatau i te mate pukupuku stromal gastrointestinal?

Ko te whakatau i te GIST te nuinga o ngā mahi maha, te tīmatanga me tō tākuta e kōrero ana mō ō tohu me tō hītori hauora. Ka hiahia rātou ki te mārama ki te wā i tīmata ai ō tohu, te āhua o te huringa i te wā, me te mea he aha te mea e pai ake ai, te kino rānei.

Ka mahi tō tākuta i te tirotiro tinana, te arotahi motuhake ki tō kopu ki te tirotiro i ngā pūnga, te ngawari, te pupuhi rānei. Ka whakarongo pea rātou ki ō oro whekau, ka tirotiro hoki i ngā tohu o te anemia.

Ko te mahi e whai ake nei ko te nuinga o ngā whakamātautau whakaahua ki te tiki i te tirohanga taipitopito o tō pūnaha kai. Ko te CT scan o tō kopu me tō upoko te whakamātautau tuatahi e whakaritea ana, nā te mea ka taea te whakaatu i te rahi, te wāhi, me ngā āhuatanga o ngā mate pukupuku.

Ko ētahi atu whakamātautau ka tūtohu pea tō tākuta ko:

• Te whakamātautau MRI mō ngā whakaahua taipitopito ake, ina koa o ngā kiko ngawari
• Te endoscopy o runga ki te tiro tika i ngā mate pukupuku i roto i te kopu, i te whekau iti o runga rānei
• Te colonoscopy mena kei te whekau nui, te tūtae rānei te mate pukupuku
• Te whakamātautau PET ki te tirotiro mena kua horapa te mate pukupuku ki ētahi atu wāhi
• Ngā whakamātautau toto ki te tirotiro i te anemia me ngā tohu hauora whānui

Mena ka whakaatu te whakaahua i te GIST, ka tūtohu pea tō tākuta i te biopsy ki te whakau i te whakatau. Ka whakauruhia tēnei ki te tango i te tauira iti o te kiko mō te tirotiro i raro i te microscope, te nuinga o te aronga ki te whakaahua CT, ki te ultrasound rānei.

Ka taea e ngā whakamātautau motuhake i runga i te tauira biopsy te tautuhi i ngā tauhohenga ira motuhake i roto i tō mate pukupuku, e āwhina ana ki te whakatau i te huarahi maimoatanga pai mō tō take motuhake.

He aha te maimoatanga mō ngā mate pukupuku stromal gastrointestinal?

Kua pai ake te maimoatanga mō ngā GIST i ngā tekau tau rua kua pahure, te hoatu i ngā hua pai ki te maha o te iwi. Ka whakawhirinaki tō mahere maimoatanga ki ngā take pēnei i te rahi o te mate pukupuku, te wāhi, te hanganga ira, me te mea kua horapa rānei.

Ko te pokanga te maimoatanga matua mō ngā GIST e taea te tango katoa. Ko te whāinga ko te tango i te mate pukupuku katoa me te iti o te kiko hauora kia kore ai he pūtau mate pukupuku e toe.

Mō ngā mate pukupuku nui, ngā wāhi uaua rānei, ka tūtohu pea tō tākuta i te rongoā whāinga i mua i te pokanga ki te whakaiti i te mate pukupuku, ki te ngāwari ake te tango haumaru. Ka taea e tēnei huarahi te āwhina i te tiaki i te nuinga o tō pūnaha kai noa.

Ko ēnei ngā kōwhiringa maimoatanga matua:

• Te tango pokanga (resection) o te mate pukupuku me ngā kiko e karapoti ana
• Te rongoā whāinga me ngā rongoā pēnei i te imatinib (Gleevec)
• Sunitinib (Sutent) mō ngā mate pukupuku kāore e whakautu ki te imatinib
• Regorafenib (Stivarga) mō ngā take whanake
• Ngā rongoā whāinga hou pēnei i te ripretinib mō ngā mate pukupuku ātete

Ka mahi ngā rongoā rongoā whāinga mā te aukati i ngā pūtau ira koretake e puta ai te tipu o ngā pūtau GIST. Ka tangohia ēnei rongoā hei pire, ā, ka tino whai hua ki te whakahaere i te tipu o te mate pukupuku.

Ka tirotirohia e tō oncologist tō whakautu ki te maimoatanga me ngā scans me ngā whakamātautau toto, te whakarereke i tō mahere maimoatanga kia rite ai ki te hiahia kia whiwhi koe i ngā hua pai rawa atu.

Me pēhea te whakahaere i ngā tohu i te kāinga i te wā o te maimoatanga?

Ko te whakahaere i ō tohu me ō pānga i te kāinga he wāhanga nui o tō tiaki whānui. Mā te mahi tata atu ki tō rōpū hauora, ka āwhina koe ki te whakawhanake i ngā rautaki e pai ana mō tō āhuatanga motuhake.

Mena kei te pangia koe e te ruaki mai i te maimoatanga, ko te kai i ngā kai iti ake, i ngā kai maha ake i te rā ka taea te āwhina. Kōwhiria ngā kai ngawari, ngāwari ki te kai pēnei i ngā keke, te toa, te raihi rānei ina kore e pai tō puku.

Ko te ngenge he mea noa i te wā o te maimoatanga, na whakarongo ki tō tinana, okioki hoki ina hiahia koe. Ka taea e ngā mahi ngawari pēnei i ngā hikoi poto te whakapiki ake i ō taumata kaha ina pai koe ki te mahi.

Ko ēnei ētahi rautaki mahi e kitea ana e te maha o te iwi he whai hua:

• Pupuri i te puka tohu ki te aroturuki i ngā tauira me ngā whakaohooho
• Noho makuku mā te inu i ngā wai iti i te rā katoa
• Kai i ngā kai ngawari, ngā kai whai hua mena he uaua ki te horomia
• Whakamahia he papa whakamahana mō te kore e pai te kopu (tirohia tō tākuta i mua)
• Whakamahia ngā tikanga whakamahinga pēnei i te manawa hohonu, te whakaaroaro rānei
• Whakauru ki te rōpū tautoko mō te hunga e pangia ana e ngā GIST

Whakapiri tonu ki tō rōpū hauora mena ka kino ake ō tohu, mena ka puta mai ngā tohu hou e awangawanga ana pēnei i te kirika, te mamae nui, te ruaki roa rānei. Ka taea e rātou te whakarereke i tō maimoatanga, te whakarato rānei i te tautoko atu e hiahiatia ana.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō ō hui rongoā ka taea te āwhina i a koe ki te whakamahi pai i tō wā me tō rōpū hauora, kia whakarite hoki ka whiwhi koe i ngā mōhiohio katoa e hiahia ana koe. Tīmata mā te tuhi i ō pūrongo i mua i tō haerenga kia kaua e wareware i tetahi mea nui.

Kawe mai i te rārangi katoa o ngā rongoā katoa e tangohia ana e koe, tae atu ki ngā rongoā rongoā, ngā rongoā kore-whakahau, ngā huaora, me ngā tāpiri. Whakauruhia ngā horopeta me te maha o te tango i ia mea.

Pupuri i te puka tohu mo te wiki kotahi i mua i tō hui, te tuhi i te wā e puta mai ai ngā tohu, te aha e whakaohooho ana i a rātou, me te aha e āwhina ana ki te whakaora i a rātou. Ka taea e ēnei mōhiohio te whakarato i ngā tohu nui mō tō tākuta.

Whakaarohia te kawe mai i te mema whānau whakawhirinaki, i te hoa rānei ki tō hui, ina koa mō ngā haerenga nui ka kōrerohia ai e koe ngā kōwhiringa maimoatanga. Ka taea e rātou te āwhina i a koe ki te mahara ki ngā mōhiohio, ki te whakarato hoki i te tautoko hinengaro.

Whakamahia ēnei mea mō tō haerenga:

• Rārangi o ngā tohu o nāianei me te wā i tīmata ai
• Rārangi rongoā me ngā tāpiri katoa
• Kāri inihua me te whakaatu
• Ngā hua whakamātautau o mua, ngā rēkōta hauora rānei
• Rārangi tuhituhi o ngā pūrongo mō tō tākuta
• Mōhiohio whakapā mō ētahi atu tākuta e uru ana ki tō tiaki

Kaua e whakaroa ki te tono ki tō tākuta ki te whakamaarama i tetahi mea kāore koe e mārama. He mea nui kia pai koe ki tō mahere maimoatanga, kia mōhio hoki ki te mea e tatari ana koe ki te haere tonu.

He aha te mea nui mō ngā mate pukupuku stromal gastrointestinal?

Ko te mea nui rawa atu ki te mārama mō ngā GIST ko te tino whakaora, ina koa ina kitea wawe. Ahakoa ka raru pea te whiwhi i te whakatau mate pukupuku, ko ngā ahuatanga o te rongoā whāinga kua whakarereke i te tirohanga mō te hunga e pangia ana e ēnei mate pukupuku.

Ka haere tonu te maha o te hunga e pangia ana e ngā GIST ki te ora i ngā oranga katoa, ngā mahi kaha me te maimoatanga tika me te tirotiro. Ko te matua ko te mahi tata atu ki tō rōpū hauora, te noho mārama ki tō āhuatanga, te kore hoki e whakaroa ki te rapu awhina ina he awangawanga.

Kia mahara he motuhake te āhuatanga o ia tangata, ā, ko tō tākuta te puna mōhiohio pai mō tō take motuhake. Noho whakauru ki tō tiaki, ui pūrongo, kaua hoki e wehi ki te rapu i tētahi atu whakaaro mena ka whai hua.

Me ngā kōwhiringa maimoatanga o nāianei me te rangahau haere tonu ki ngā rongoā hou, he take pono mō te tumanako me te koa ki te whakahaere i ngā GIST pai.

Ngā pūrongo e ui pinepinetia ana mō ngā mate pukupuku stromal gastrointestinal

Q1: He ira ngā mate pukupuku stromal gastrointestinal?

Ko te nuinga o ngā GIST ka puta noa, kāore hoki i te whakawhiwhia mai i ō mātua. Ko te 5% anake o ngā take e hono ana ki ngā syndromes ira i whakawhiwhia mai pēnei i te neurofibromatosis momo 1. Mena he hītori whānau o ngā GIST, o ngā āhuatanga ira e hono ana rānei, ka taea e te tohutohu ira te awhina i te aromatawai i tō tūponotanga whaiaro, te kōrero hoki i ngā kōwhiringa tirotiro.

Q2: Ka taea te ārai i ngā mate pukupuku stromal gastrointestinal?

Aroha mai, kāore he huarahi e mohiotia ana ki te ārai i ngā GIST, nā te mea ko te nuinga o te puta mai i ngā huringa ira noa e puta ana i tō oranga. Kāore i rite ki ētahi atu mate pukupuku, ko ngā take oranga pēnei i te kai, te whakakori tinana, te karo rānei i te tapeka kāore e kitea he pānga ki te tūponotanga GIST. Ko te huarahi pai ko te noho mōhio ki ngā tohu, te rapu hoki i te tiaki hauora tere mena ka puta mai ngā tohu e awangawanga ana.

Q3: E hā roa te ora o te iwi me ngā mate pukupuku stromal gastrointestinal?

Kua pai ake te tirohanga mō te hunga e pangia ana e ngā GIST me ngā maimoatanga hou. Ka taea te whakaora i te maha o te hunga e whai mate pukupuku iti, rohe rānei me te pokanga. Ahakoa mō ngā take whanake, ka taea e ngā rongoā rongoā whāinga te whakahaere i te mate mō ngā tau maha. Ka whakawhirinaki tō whakatau motuhake ki ngā take pēnei i te rahi o te mate pukupuku, te wāhi, te hanganga ira, me te āhua o te whakautu ki te maimoatanga.

Q4: Me hiahia tonu ngā mate pukupuku stromal gastrointestinal ki te pokanga?

Kāore ngā GIST katoa e hiahia ana ki te pokanga wawe. Ka taea te tirotiro i ngā mate pukupuku iti rawa (i raro i te 2 cm) kāore e puta mai ngā tohu me ngā scans noa. Ko ētahi mate pukupuku nui ake ka maimoatia tuatahi me te rongoā whāinga ki te whakaiti i a rātou i mua i te pokanga. Ka tūtohu tō tākuta i te huarahi pai i runga i ngā āhuatanga o tō mate pukupuku me tō hauora whānui.

Q5: He aha taku e tatari ana i te wā o te ora mai i te pokanga GIST?

Ka rerekē te wā ora i runga i te rahi me te wāhi o tō mate pukupuku me te momo pokanga i mahia. Ko te nuinga o te hunga e noho ana i te whare hauora mō te 3-7 rā i muri i te pokanga. Ka hoki haere koe ki ngā mahi noa i roto i ngā wiki 4-6, me te ora katoa e toru ki te toru marama. Ka whakarato tō rōpū pokanga i ngā aratohu motuhake mō te kai, te mahi, me te tiaki o te whara i te wā o tō wā ora.