Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) ni indwara y'akarande, ikomoka ku miryango, iterwa n'ikosa riri mu gene adenomatous polyposis coli (APC). Abantu benshi barazikomora ku babyeyi babo. Ariko kuri 25 kugeza kuri 30% by'abantu, impinduka ya gene iba ku bwayo. FAP itera ko imyanya y'inyongera (polyps) ikura mu ruhago runini (colon) no mu kibuno. Polyps zishobora kandi kugaragara mu myanya y'igogorwa yo hejuru, cyane cyane igice cyo hejuru cy'uruhago rwo hagati (duodenum). Niba itabyazwe, polyps ziri muri colon na rectum zishobora kuba kanseri iyo ugeze mu myaka 40. Abantu benshi bafite familial adenomatous polyposis amaherezo bakenera kubagwa kugira ngo bakureho uruhago runini kugira ngo birinde kanseri. Polyps ziri muri duodenum na zo zishobora gutera kanseri, ariko ubusanzwe zishobora gucungwa hakurikiwe neza no gukuraho polyps buri gihe. Bamwe mu bantu bafite ubwoko bworoheje bw'iyi ndwara, bita attenuated familial adenomatous polyposis (AFAP). Abantu bafite AFAP ubusanzwe bagira polyps nke za colon (moyenne ya 30) kandi kanseri ibazaza nyuma mu buzima.

Ikimenyetso nyamukuru cya FAP ni ama polyps amajana cyangwa ibihumbi byinshi bikura mu ruha rw'umwijima no mu kibuno, ubusanzwe bitangira mu myaka ya mirongo ine. Aya ma polyps afite amahirwe hafi 100% yo guhinduka kanseri y'umwijima cyangwa kanseri y'umubiri mu gihe ugeze mu myaka ya mirongo ine.

Adenomatosis ya polyposis iterwa n'ikosa riba mu gene, ikaba ikunze kuvanwa mu mubyeyi. Ariko hari bamwe bagira igene ritari ryo ritera iyi ndwara.

Iyo ufite umubyeyi, umwana, umuvandimwe cyangwa mushiki wahuye n'indwara ya familial adenomatous polyposis, ibyago byo kuyirwara biri hejuru.

Ururimi rw'ikinyarwanda:

Hejuru y'igicurane cya colon, indwara ya familial adenomatous polyposis ishobora gutera izindi ngaruka:

• Ibibyimba bya duodenal. Ibi bibyimba bikura mu gice cyo hejuru cy'umwijima wawe muto kandi bishobora kuba kanseri. Ariko, hakoreshejwe ubugenzuzi buhamye, ibibyimba bya duodenal bikunze kuboneka kandi bikavanwaho mbere y'uko kanseri itera.
• Ibibyimba bya periampullary. Ibi bibyimba bibaho aho inzira y'umusemburo n'inzira ya pancréas zinjirira mu muyoboro wa duodenum (ampulla). Ibibyimba bya periampullary bishobora kuba kanseri ariko bikunze kuboneka kandi bikavanwaho mbere y'uko kanseri itera.
• Ibibyimba bya gastric fundic. Ibi bibyimba bikura mu rwambari rw'igifu cyawe.
• Desmoids. Ibi bintu bidatera kanseri bishobora kuvuka ahantu hose mu mubiri ariko bikunze kuvuka mu gice cy'igifu (inda). Desmoids ishobora gutera ibibazo bikomeye niba ikura mu mitsi cyangwa mu mitsi y'amaraso cyangwa igashyira igitutu ku zindi nzego z'umubiri wawe.
• Kanseri izindi. Gake, FAP ishobora gutera kanseri mu gice cy'umwijima, mu mutwe, mu mitsi, mu mpyiko, mu kibuno cyangwa mu zindi nzego.
• Ububyimba bw'uruhu budatera kanseri (butera uburwayi).
• Ubwinshi bw'amagufwa butatera kanseri (osteomas).
• Kugira umubare munini w'ibintu by'umukara mu maso (CHRPE). Ibi ni impinduka z'umukara mu maso zidatatera kanseri.
• Ibibazo by'amenyo. Ibi birimo amenyo y'inyongera cyangwa amenyo adakura.
• Kugira umubare muke w'utubuto tw'amaraso atukura (anemia).

Kwirinda FAP ntibishoboka, kuko ari indwara iherwa mu muryango. Ariko rero, niba wowe cyangwa umwana wawe uri mu kaga ko guhura na FAP kubera umuntu wo mu muryango ufite iyo ndwara, uzakenera kwipimisha imyanya ndangagitsina no kugirwa inama n'abaganga. Niba ufite FAP, uzakenera kwipimisha buri gihe, ukakurikirwa n'abaganga, hanyuma ukabagwa niba ari ngombwa. Kubagwa bishobora gufasha mu kwirinda ko kanseri y'umwijima cyangwa izindi ndwara zikomeye zidakura.

Urifite umubyeyi, umwana, umuvandimwe cyangwa mushiki wahuye n'iyi ndwara, uri mu kaga ko kwandura adenomatous polyposis y'umuryango. Niba uri mu kaga, ni ngombwa ko uba ugenzurwa kenshi, uhereye mu bwana. Ibizamini bya buri mwaka bishobora kugaragaza ukura kw'ibintu bimeze nk'ibiti (polyps) mbere y'uko bihinduka kanseri.

• Sigmoidoscopy. Ututi tworoshye turashyirwa mu kibuno cyawe kugira ngo harebwe igice cy'inyuma cy'umwijima (rectum) na sigmoid - ibice bibiri bya nyuma by'umwijima. Ku bantu bafite ibizamini byerekana FAP cyangwa abo mu muryango bafite ibyago batarakoze ibizamini bya gene, American College of Gastroenterology iragira inama yo gukora sigmoidoscopy buri mwaka, guhera ku myaka 10 kugeza kuri 12.
• Colonoscopy. Ututi tworoshye turashyirwa mu kibuno cyawe kugira ngo harebwe umwijima wose. Iyo habonetse ibintu bimeze nk'ibiti (polyps) mu mwijima wawe, ugomba gukora colonoscopy buri mwaka kugeza ubwo ukozweho igikorwa cyo gukuraho umwijima wawe.
• Esophagogastroduodenoscopy (EGD) na side-viewing duodenoscopy. Ubwoko bubiri bw'ututi bukoreshwa mu kureba umuyoboro w'ibiryo, igifu n'igice cyo hejuru cy'umwijima muto (duodenum na ampulla). Muganga ashobora gukuraho igice gito cy'umubiri (biopsy) kugira ngo akore ubundi bushakashatsi.
• CT cyangwa MRI. Amashusho y'inda n'igice cyo hasi cy'umubiri ashobora gukoreshwa, cyane cyane mu gusuzuma ibintu bimeze nk'ibiti (desmoid tumors).

Isuzuma ry'amaraso rishobora kugaragaza niba ufite gene idasanzwe itera FAP. Ibizamini bya gene bishobora kandi kugaragaza niba uri mu kaga ko kugira ingaruka za FAP. Muganga wawe ashobora kugutekerezaho gukora ibizamini bya gene niba:

• Ufite abo mu muryango bafite FAP
• Ufite bimwe, ariko atari byose, ibimenyetso bya FAP

Kureka FAP birinda abana bari mu kaga imyaka myinshi yo gukorerwa ibizamini no guhangayika. Ku bana bafite iyi gene, igenzura n'ubuvuzi bikwiye bigabanya cyane ibyago bya kanseri.

Muganga wawe ashobora kugutekerezaho gukora ibizamini by'umwijima w'umusemburo (thyroid) n'ibindi bizamini kugira ngo harebwe ibindi bibazo by'ubuzima bishobora kubaho niba ufite FAP.