Created at:1/16/2025
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Ko te mate Lynch he āhuatanga ira tuku iho e whakapiki nui ana i tō tūponotanga ki te whanake i ētahi mate pukupuku, inā te mate pukupuku o te kōroke me te mate pukupuku o te kopu. E mohiotia ana hoki ko te mate pukupuku colorectal tuku iho kahore he polyp (HNPCC), ā, e pā ana ki te 1 o te 300 o te tangata puta noa te ao. Ahakoa pea ka rangona tēnei he nui rawa, ko te mārama ki te mate Lynch ka whakamana i a koe ki te tango i ngā mahi whakapau kaha mō te kimi wawe me te aukati.
Ko te mate Lynch he mate ira tuku iho e puta mai ana i ngā rerekētanga i roto i ngā ira motuhake e awhina ana i te whakatikatika i te kino o te DNA i roto i ō pūtau. Ki te kore ēnei ira e mahi tika ana, ka taea te kohikohi i te DNA kī, ā, ka ārahi ki te whanaketanga o te mate pukupuku. Whakaarohia ēnei ira hei pūnaha whakahaere kounga o tō tinana mō te pupuri i ngā pūtau hauora.
Ka tukuna tenei āhuatanga i roto i ngā whānau i te mea e kiia ana e ngā tākua he tauira rangatira autosomal. Ko te tikanga, ki te whai tētahi o ō mātua i te mate Lynch, he 50% te tūponotanga o te whiwhi i te mate. E pā ana te āhuatanga ki ngā tāne me ngā wāhine, ahakoa ka rerekē pea ngā tūponotanga o te mate pukupuku i waenga i ngā ira tangata.
Ko te mea tino nui kia mārama ko te whai i te mate Lynch kāhore e whakamana ka whanake koe i te mate pukupuku. Ko te tikanga noa iho he teitei ake tō tūponotanga i te toharite, ā, mā te tirotiro tika me te tiaki, ka taea te aukati i te maha o ngā mate pukupuku, kāore rānei ka mau wawe rawa atu i te wā e tino taea ai te whakaora.
Kāhore te mate Lynch ake e puta mai ai ngā tōmhanga. Engari, ka kite pea koe i ngā tōmhanga ki te whanake rānei ngā mate pukupuku. Ko te wāhanga uaua ko ngā mate pukupuku i ngā wā tīmata kāhore i te maha o ngā tōmhanga e kitea ana, koia te take i tino nui ai te tirotiro mo te hunga e whai ana i tēnei āhuatanga.
Ki te whanake te mate pukupuku colorectal, ka kite pea koe i ngā huringa i ō tikanga whekau e mau tonu ana mo te neke atu i ngā rā torutoru. Ka rongo pea ēnei huringa he awangawanga, engari kia mahara ko te maha o ngā huringa whekau he take kahore he mate pukupuku.
Ko ētahi o ngā tohu whānui hei titiro atu ko:
Mō ngā wāhine e pangia ana e te mate Lynch, ko ngā tohu o te mate pukupuku endometrial pea ko te toto e puta ana i te tara, ina koa i muri i te whakamutunga o te whakaotinga, te mamae o te upoko, te tukunga rānei e kore e pūmau. Me aro atu ki ēnei tohu, ahakoa ka taea hoki e rātou te tohu i te maha o ngā āhuatanga kaore i te tino kino.
Ko ētahi atu mate pukupuku e hono ana ki te mate Lynch ka taea te whakaoho i ngā tohu e rite ana ki tō rātou wāhi, pēnei i te mamae o te puku mō te mate pukupuku o te puku, i ngā huringa mimi rānei mō ngā mate pukupuku o te mimi. Ko te mea nui ko te mōhio ki ngā huringa e mau tonu ana i roto i tō tinana me te kōrero ki tō kaiwhakarato hauora.
Ko te mate Lynch te take i ngā rerekētanga i whakawhiwhia mai i roto i ngā ira e kawea ana te mahi whakatikatika o te koretake o te DNA. Ko ēnei ira te tikanga he rite ki ngā kaiāwhina, e hopu ana, e whakatika ana i ngā hapa e puta ana ina hanga e ō pūtau ngā kape o tō rātou DNA. Ki te kore ēnei ira e mahi tika, ka kohikohi ngā hapa ka āhei te arahi ki te mate pukupuku.
Ko te āhuatanga e puta mai ana i ngā rerekētanga i roto i tetahi o ngā ira maha, ko te nuinga rawa ko te MLH1, MSH2, MSH6, me te PMS2. Kei ia o ēnei ira he mahi nui ki te pupuri i te tika o tō rauemi ira. Kaore i te tino noa, ka taea hoki e te tango i roto i te ira EPCAM te whakaoho i te mate Lynch.
Ka riro i a koe te mate Lynch i tētahi o ō mātua, ā, ka whai i te tauira whakawhiwhi mana. Ko te tikanga, kotahi noa te kape o te ira rerekē e hiahiatia ana kia pangia koe e te āhuatanga. Ki te pangia koe e te mate Lynch, kei ia o ō tamariki te 50% te tūponotanga o te whakawhiwhi mai i a koe.
He mea nui te mōhiotanga e noho ana enei rerekētanga mai te whānau, engari ko te mate pukupuku kaore e tupu tae noa ki te wā muri o te ora. Ko ngā rerekētanga e hanga ana i te tūmanako ki te mate pukupuku, kaore i te take i te mate tonu.
Me whakaaro koe ki te tohutohu ira me te whakamātautau mena kei a koe te hītori whānau kaha o ngā mate pukupuku colorectal, endometrial, rānei ētahi atu mate pukupuku e hono ana ki te mate Lynch. Ko te hītori whānau "kaha" e tikina ana ko te maha o ngā whānau e pā ana ki ēnei mate pukupuku, ina koa ki te whakatauhia i ngā tau iti ake.
Ko ngā āhuatanga motuhake e hiahia ana ki te tiaki hauora ko te whānau rua, neke atu rānei e pā ana ki ngā mate pukupuku e hono ana ki te mate Lynch, ngā mema whānau i whakatauhia te mate pukupuku colorectal, endometrial rānei i mua i te 50 tau, te mema whānau kua whakatauhia te mate Lynch.
Mena kei te pāngia koe e ngā tohu penei i ngā huringa pūnaha mau tonu, te mamae o te kopu kaore i te whakamārama, te toto ranei e kore e tika, kaua e tatari. Ahakoa he maha ngā take pea o ēnei tohu, e tika ana kia whakamātauhia tonu te hauora ahakoa te hītori whānau.
I tua atu, ki te whakatauhia koe ki te mate pukupuku colorectal, endometrial rānei, ka taea e tō taakuta te tūtohutia te whakamātautau mate ki te kite mena ka whakaatu i ngā tohu e rite ana ki te mate Lynch. Ka taea te whakamahi i tēnei mōhiohio mō tō maimoatanga me te whakarite hauora mō tō whānau.
Ko te take pāngarau matua mō te mate Lynch ko te whānau me te mate, no te mea he mate ira tuku iho. Ko te hītori whānau tonu te tohu tohu kaha, ina koa ka pā te maha o ngā whānau ki ngā mate pukupuku e hono ana ki te mate Lynch.
He maha ngā tauira hītori whānau e whakapiki ana i tō tūmanako ki te mate Lynch:
Ka whakaatu etahi iwi whenua ki te iti ake teitei o ngā mutuation motuhake, engari ko te mate Lynch syndrome e pā ana ki te iwi katoa. Kāo te āhua e whakaheke i runga i ngā take oranga penei i te kai, te whakakori tinana rānei, ahakoa ka pā ēnei take ki te tūponotanga o te mate pukupuku katoa.
He mea tika kia mōhio ko te 20% o te hunga e pangia ana e te mate Lynch syndrome kāore he hītori whānau marama o ngā mate pukupuku e hono ana. Ka taea tēnei ina hou te mutuation, ina kāore i te mohiotia te hītori hauora whānau, ina rānei i puta ngā mate pukupuku engari kāore i tuhia tika.
Ko te raruraru matua o te mate Lynch syndrome ko te tūponotanga nui ake o te whanaketanga o ngā mate pukupuku maha i roto i tō oranga. Ko te mārama ki ēnei tūponotanga ka āwhina i a koe me tō rōpū hauora ki te hanga i te mahere whakamātautau me te aukati e tika ana.
Ko te mate pukupuku colorectal te tūponotanga teitei rawa, me ngā tāngata e pangia ana e te mate Lynch syndrome he 20-80% te tūponotanga o te whanaketanga i roto i tō rātou oranga, i te whakataurite ki te 5% i roto i te taupori whānui. Ka rerekē te tūponotanga i runga i te ira motuhake e pā ana, me ngā mutuation MLH1 me MSH2 e mau ana i ngā tūponotanga teitei ake.
Mō ngā wāhine, ko te mate pukupuku endometrial he tūponotanga nui, me ngā tūponotanga o te oranga e tae atu ana ki te 15-60%. Ka meinga tēnei i te mate pukupuku endometrial tata ki te rite ki te mate pukupuku colorectal i ngā wāhine e pangia ana e te mate Lynch syndrome. Kua piki ake hoki te tūponotanga o te mate pukupuku ovarian, ahakoa he iti ake.
Ko ētahi atu mate pukupuku e hono ana ki te mate Lynch syndrome ko:
Ahakoa ka āta whakawehi ēnei tatauranga, kia mahara ko te piki o te tūponotanga kāore e whakaatu he mate pukupuku. He tokomaha ngā tāngata e pangia ana e te mate Lynch syndrome kāore i whānau te mate pukupuku, ā, ko te hunga e pangia ana e te mate pukupuku, ka whai hua i te kite wawe mā te whakamātautau.
Ka uaua hoki te pānga hinengaro o te mōhio kei a koe te mate Lynch syndrome. Ka raru etahi i te manukanuka mō te tūponotanga o te mate pukupuku, kāore rānei i te whakama mō te tukunga atu pea o te āhuatanga ki ā rātou tamariki. He mea noa, he tika ēnei whakaaro.
No te mea he āhuatanga ira nā te whakatupuranga te mate Lynch syndrome, kāore e taea te ārai i te āhuatanga anō. Heoi, ka taea e koe te mahi i ngā mahi nui hei ārai i ngā mate pukupuku e hono ana ki a ia, kāore rānei hei hopu i a rātou i ō rātou wā tīmatanga, ngā wā tino māmā ki te whakaora.
Ko te whakamātautau auau te taputapu kaha rawa mō te ārai i te mate pukupuku. Mō te mate pukupuku colorectal, ko te tikanga tenei ko te tīmatanga o ngā colonoscopies i te tau 20-25, kāore rānei i te 2-5 tau i mua i te tāngata whānau iti rawa i whakatauhia, ko tēhea te mea tuatahi. Ka taea e ēnei whakamātautau te kimi me te tango i ngā polyps i mua i te mate pukupuku.
Mō ngā wāhine, ko te whakamātautau mate pukupuku endometrial pea ka uru ki ngā biopsies endometrial tau i te tīmatanga o te tau 30-35. Ka whiriwhiri etahi wāhine ki te tango i ō rātou kopu me ō rātou ovaries i muri i te whakaoti i ō rātou whānau, ka taea te whakaiti nui i te tūponotanga o te mate pukupuku.
Ka taea hoki e ngā whakarerekētanga noho te awhina i te whakaiti i tō tūponotanga mate pukupuku whānui:
E whakaatu ana etahi rangahau ko te aspirin i ia rā pea ka whakaiti i te tūponotanga o te mate pukupuku colorectal i ngā tāngata e pangia ana e te mate Lynch, ahakoa me kōrero tuatahi koe ki tō tākuta mō tēnei. Ko te whakatau e pā ana ki te taumaha i ngā painga pea me ngā tūponotanga pēnei i te toto.
Ko te whakatau i te mate Lynch te nuinga o te wā e whakauru ana i te whakamātautau ira, engari ko te tukanga te nuinga o te wā ka tīmata ma te aromatawai i tō hītori hauora whaiaro me tō whānau. Ka titiro tō kaiwhakarato hauora ki ngā tauira e whakaatu ana pea kei te noho te mate Lynch i roto i tō whānau.
Mena kua whakatauhia koe ki te mate pukupuku colorectal, endometrial rānei, pea ka whakamātautau tuatahi tō tākuta i te kōeke o tō mate mō ngā tohu e rite ana ki te mate Lynch. Kei roto i ēnei te tirotiro i te koretake o te microsatellite (MSI) me te whakamātautau i te whakaatu o te pūmua whakatikatika he.
Ko te tohutohu ira te nuinga o te wā ka tae mai i mua i te whakamātautau ira. Ka arotake te kaiwhakaako ira i tō hītori whānau, ka whakamārama i te tukanga whakamātautau, ā, ka āwhina i a koe ki te mārama ki te tikanga o ngā hua mōu me tō whānau. Ka whakarite tenei mahi kei te whakatau whakamārama koe mō te whakamātautau.
Ko te whakamātautau ira anō e whakauru ana i te hoatu i te tauira toto, waha rānei. Ka tātari te taiwhanga i tō DNA hei titiro ki ngā rerekētanga i roto i ngā ira e hono ana ki te mate Lynch: MLH1, MSH2, MSH6, PMS2, me EPCAM.
Ko ngā hua te nuinga o te wā ka roa ngā wiki kia hoki mai. Ko te hua pai e kī ana kei a koe te rerekētanga e pā ana ki te mate Lynch. Ko te hua kino pea ka kī kei te kore koe i te mate Lynch, kāore rānei pea kei a koe te rerekētanga e kore e taea te kitea e te whakamātautau o nāianei.
I etahi wā, ka whakaatu te whakamātautau ira ki tetahi \
Kei te rangahauhia te whakamātautau rongoā, ina koa te aspirin, hei huarahi hei whakaiti i te tūponotanga o te mate pukupuku ki ngā tāngata e pangia ana e te mate Lynch. Kei ētahi ngā tākua e tūtohutia ana te inu aspirin i ngā rā katoa, ahakoa me whakatau tēnei i runga i tō hauora whānui me ngā take tūponotanga.
Ko te ora pai me te mate Lynch ko te taurite i waenganui i te mataara me te koa ki tō oranga. Ko te matua ko te noho mahi tonu mō tō hauora, kaua e waiho te manukanuka kia kai te wheako o ia rā.
Hāngai ki tō kaupapa whakamātautau. Ahakoa ka raru pea ēnei whakatau, te manukanuka rānei, koinei tō parekura pai rawa atu ki te mate pukupuku. Whakaarohia te whakarite i ētahi wā kia noho hei mahi auau, kaua hei take manukanuka.
Whakaritea he oranga hauora e tautoko ana i tō oranga whānui. Aro atu ki te kai i te nui o ngā hua, ngā huawhenua, me ngā witi katoa, me te whakaiti i ngā kai whakamahia. Kāore anake te whakakori tinana i te tautoko i tō hauora tinana, engari ka āwhina hoki ki te whakahaere i te manukanuka mō tō tūponotanga mate pukupuku.
Hangaia he hononga kaha ki tō rōpū hauora. Rapua ngā tākua e mārama ana ki te mate Lynch, ā, e whai ana ki te noho hou me ngā rangahau me ngā tohutohu hou. Kaua e whakaroa ki te uiui, ki te rapu rānei i ētahi atu whakaaro ina hiahiatia.
Whakaarohia te hono atu ki ngā rōpū tautoko, ki ngā whakahaere ipurangi rānei mō ngā tāngata e pangia ana e te mate Lynch. Ko te kōrero ki ētahi atu e mārama ana ki tō wheako ka whakawhiwhia te tautoko hinengaro me ngā tohutohu whai hua mō te whakahaere i te mate.
Tūturu ngā rēkōta hauora mōu ake, me te whakawhāiti i ngā korero e tika ana ki ngā mema o te whānau. Ka whai hua pea tō wheako ki te whakamātautau me te whakahaere i te mate Lynch ki ngā whānau e pangia ana hoki e te mate.
Kia tupato hoki ki tō hauora hinengaro. He mea noa te awangawanga mō te tūponotanga o te mate pukupuku, te whakama hoki kei pā te mate Lynch ki ō tamariki. Whakaarohia te tohutohu mena ka nui rawa enei āwangawanga, kāore rānei e taea te ora o ia rā.
Ko te whakarite mō ngā hui e pā ana ki te mate Lynch te tino whakapūmau ka whiwhi koe i te painga nui mai i tō wā me ngā kaiwhakarato hauora. Tīmatahia mā te kohikohi i ngā mōhiohio whānui mō te hītori hauora o tō whānau, tae atu ki ngā momo mate pukupuku, ngā tau i te whakatau, me ngā hua whakamātautau ira.
Hangaia he rākau whānau taipitopito e whakauru ana i te toru whakatupuranga iti rawa atu ki te taea. Tākina ngā mate pukupuku, ina koa ko te mate pukupuku o te kōroke, te endometrium, te ovaries, te puku, tetahi atu rānei o ngā mate pukupuku e hono ana ki te mate Lynch. Whakauruhia ngā tau i te whakatau me te noho ora tonu rānei o te tangata.
Tuhia ō pūrongo i mua. Ka hiahia pea koe ki te uiui mō ngā kaupapa whakamātautau, ngā whakarerekētanga noho ora, ngā whakaaro whānau, te aha rānei ngā tohu e tika ai te tiaki hauora tonu. Ko te tuhi i ngā pūrongo ka whakarite kia kaua e wareware ki ngā kaupapa nui i te wā o te hui.
Kawe mai i te rārangi katoa o ō rongoā o nāianei, tae atu ki ngā taapiri-ā-tauhokohoko. Ka taea e ētahi rongoā, tetahi atu rānei taapiri te pānga ki ngā maimoatanga, te pānga rānei ki te tūponotanga o te mate pukupuku, na reira e hiahia ana tō taakuta ki te whakaahua katoa.
Mena kei te kite koe i tētahi taakuta hou, kawe mai i ngā kape o ngā hua whakamātautau ira o mua, ngā ripoata pathology mai i ngā mate pukupuku, tetahi atu rānei biopsies, me ngā hua whakamātautau matawai. Ka āwhina tēnei mōhiohio i tō taakuta hou ki te mārama ki tō hītori me te whakarite i ngā tūtohu tika.
Whakaarohia te kawe mai i tētahi hoa whakawhirinaki, tetahi mema whānau rānei ki ngā hui nui. Ka taea e rātou te āwhina i a koe ki te maumahara ki ngā mōhiohio i kōrerotia me te whakarato i te tautoko hinengaro i ngā kōrero pea ka pā te ahotea.
Whakamahia te wā ki te whakarite i ō ngākau mō te whakatau. He mea noa te manukanuka ki te kōrero mō te tūponotanga o te mate pukupuku, te rongoā rānei. Whakaarohia ngā tikanga whakahaere e pai ana ki a koe, ahakoa ko te manawa hohonu, te kōrero whakatenatena ki a koe anō, te whakarite rānei i tētahi mea harikoa i muri i te whakatau.
He āhuatanga ira tuku iho e taea te whakahaere te mate Lynch, e hiahia ana ki te tiaki ora katoa, engari e kore e tika kia whakatau i tō oranga. Ahakoa ka piki ake te tūponotanga o te mate pukupuku, kua tino whai hua ngā rautaki kimi wawe me te aukati i te whakaiti i taua tūponotanga me te whakapai ake i ngā hua.
Ko te mea nui rawa atu e taea e koe ko te pupuri tonu i te tirotiro auau. Ka taea e ēnei whakamātautau te hopu i ngā huringa i mua i te mate pukupuku, i ngā mate pukupuku tīmatanga wawe rānei i te wā e tino taea ana te whakaora. He tokomaha ngā tāngata e pangia ana e te mate Lynch e ora ana i ngā oranga tino pai, hauora, kaore rawa e whanake te mate pukupuku.
He kaha te mātauranga ina tae mai ki te mate Lynch. Ko te mārama ki tō āhuatanga ka whakatenatena koe ki te whakatau whakamārama mō te tirotiro, ngā whiringa noho, me te whakatōpūtanga whānau. Ka āwhina hoki i a koe ki te tautoko i te tiaki hauora tika me te pupuri i ngā whakawhanaketanga hou i roto i te rongoā me te aukati.
Kia mahara ko te mate Lynch ka pā ki tō whānau katoa. Ko te whakawhitiwhiti kōrero mō tō whakatau ka taea te āwhina i ngā whānau ki te whakatau whakamārama mō te whakamātautau ira me te tirotiro mate pukupuku. Ko tēnei huarahi whānau ki te whakahaere i te mate Lynch ka āhei te arahi ki ngā hua pai ake mō te katoa.
Ehara te mate o Lynch i te ngaro atu i ngā whakatupuranga, engari ka puta mai te ahua o te ngaro. Nō te mea he āhuatanga ira tōrangapū whakahaere, he 50% te tūponotanga o ia tamaiti o te mātua e pā ana ki te whiwhi. I etahi wā ka whiwhi te tangata i te rerekētanga, engari kāore e whāiti te mate pukupuku, ka puta mai te ahua kua ngaro atu te āhuatanga i a rātou. I tua atu, pea kāore ngā mate pukupuku i te whakatau tika, i te tuhi rānei i ngā whakatupuranga tawhito, ka puta mai te ahua o te ngaro o ngā whakatupuranga.
He tino tika te whakamātautau ira mō te mate o Lynch ina kitea he rerekētanga e puta ai te mate. Heoi, ehara i te tikanga katoa kaore koe e pā ki te mate o Lynch mēnā he hua kore te whakamātautau. Pea ka ngaro ngā rerekētanga e etahi whakamātautau o nāianei, kāore rānei koe e whiwhi i te rerekētanga i roto i te ira kaore ano kia kitea. Koinei te take he mea nui te tohutohu ira i mua i te whakamātautau, i muri i te whakamātautau.
Ko te nuinga o ngā tohunga e tūtohutia ana kia tatū te whakamātautau ira kia tae ra ano ngā tamariki ki te 18 tau te pakeke, kāore he take hauora motuhake hei whakamātautau i mua atu. Ka taea e ēnei tāne, wahine taitamariki te whakatau whakamārama mō te whakamātautau. Heoi, mēnā kei a koe te mate o Lynch, me mōhio ngā tamariki ki te hītori whānau, me whakaaro ki te whakamātautau i mua i te tīmatanga o te whakamātautau.
I te United States, ka whakakore te Genetic Information Nondiscrimination Act (GINA) i te whakakahorenga hauora me te mahi e whakahaeretia ana e ngā korero ira. Heoi, kāore te GINA e kapi i te inihua ora, te inihua whakahaere, te inihua tiaki roa. Ka whiriwhiri etahi tangata ki te whiwhi i ēnei momo inihua i mua i te whakamātautau ira. He mea tika te kōrero ki te kaiwhakaako ira mō ngā pānga pea.
Ahakoa kaore e taea te whakakore i tō tupono nui ake ki te mate pukupuku mā ngā huringa noho ora anake, ka taea e ngā tikanga hauora te whakaiti i tō tupono whānui. Ko te whakakori tinana auau, te kai e whai hua me ngā huawhenua, te pupuri i te taumaha hauora, te karo i te wāhakahuka, me te whakaiti i te waipiro, ka taea katoa te whakauru ki ngā hua hauora pai ake. E whakaatu ana etahi rangahau pea ka āwhina te aspirin ki te aukati i te mate pukupuku colorectal i roto i te hunga e whai mate Lynch syndrome ana, engari me kōrero tuatahi tēnei ki tō tākuta.