Bundu zvechinguvana CA 19-9. Analysis pamusoro CA 19-9: wokuyera uye paakamutsa

Bundu zvechinguvana CA 19-9 munhu mukuru samolecular uremu glycoprotein. Zvinonzi zvinoberekwa masero ari epithelium pamusoro zvomudumbu hurongwa. Sezvo kuongorora nzira inoshandiswa immunohemilyuminestsentny kuongorora. CA 19-9 Rinobatanidzwa ne kenza pathologies.

Vhuṱanzi

Kudzidza chaivo zvinhu sezvo rinoshandiswa venous ropa. CA 19-9 - anobudirira bundu zvechinguvana. tsanangudzo Its rinoshandiswa nechirwere, vachiongorora uye mangwanani kuziva miedzo metastasis mudumbu, rwatata, chiropa, mudumbu (muura uye mugaranhoko). CA 19-9 nhanho akawedzera anenge varwere vose gastrointestinal namamota, kunyanya pakati rwatata. Zvibereko masero ari namamota, glycoprotein chinopinda munzvimbo systemic riparadzirwe. Vachiona uye vanoongorora zvirimo, penyanzvi mukana kutevera mukurwara. Analysis pamusoro CA19-9, mwero izvo mune utano munhu asina kupfuura 10 U / Rine mamiririta haina kushandiswa zvikuru zvawanikwa.

Chii pancreatic kenza? pfupiso

Izvi chirwere oncological zvevakomana kunobatanidzwa mazita pathologies zvikuru ngozi. About 90% wevarwere vanofa pagore chirwere rokutanga. Panguva nechirwere muna 80% wevarwere akawana kure kana emunharaunda metastases. Nyanzvi vanoti ichi kunonyanya pamwe akavanzwa pamusoro zvokurwara. The chirwere kazhinji yakazonyorwa sezvo chirwere anogumbura pezvakaitwa ari kuerera mapazi hepatopancreatoduodenal nhengo (cholelithiasis, cholecystitis, chirwere pfungwa nomuviri zvemwana asati). Maererano vanoda ichi nekukurumidza vaite imwe differential chirwere, dzakakudzingai kuvapo malignancy. Izviwo, achasarudza inonyatsobudirira kuchirapa urongwa echirwere ezvinhu izvi.

Antigen CA 19-9. ubindikiti

In nekenza rwatata pane mukuru azvipire glycoprotein. Analysis pamusoro CA19-9, rine pamusoro mutemo, zvinoda kuonekwa kuti carcinoma, vanoongorora mukana resection. At wevasungwa anopfuura 1000 U / Rine mamiririta neoplasm akaona operable 5 chete% wevarwere. Kana zviri pazasi akaratidza nemifananidzo, bundu kazhinji inogona kubviswa. Zvisinei, pashure kupindira munguva imwe mwedzi minomwe, pane mukana dzokororo. Bundu zvechinguvana CA 19-9 ndiyo kukosha mushure zvechinguvana CEA kuti Detective malignancy mudumbu. Mukuwedzera, kudzidza mamwe matunhu samolecular uremu glycoprotein basa Alpha-fetoprotein mu nechirwere uye richiona kurapwa kenza chiropa, biliary turakiti uye dundira.

Zvakawanikwa

Yakakwirira kwevari glycoprotein anogona kuonekwa pamusoro yaitwa siyana anogumbura uye benign pathologies iri pachiropa zvomudumbu gadziriro (kusvika 500, asi kazhinji kusvika 100 U / Rine mamiririta), uye cystic fibrosis. Muchiitiko chokutanga wevasungwa yakawanda 12% wevarwere. The kunonyanyisa pamwero uyu - hapana anopfuura 45 U / Rine mamiririta. Glycoprotein yabudiswa muna bile. Panyaya iyi, chero cholestasis angaperekedzwa kuwedzera zvayo kugutsikana. Muzviitiko zvakadaro zvinokosha kuitisa yokutsvakurudza panguva GGT (wegamma-glutamattransferazy) uye alkaline phosphatase. Inosimudzira wevasungwa kunogona kuonekwa pamusoro pakanyorwa dzimwe localizing anomera (mu colorectal kenza, ovarian kenza), chiropa chirwere (cirrhosis, hepatitis).

Kusavapo kana kuderedzwa chechetere

Vanotsvakurudza vakaona kuti chakaipa pfungwa asingadi haabatanidzi pamberi kenza mu rwatata. Muchiitiko chino, rinogona chirwere mangwanani Danho chirwere kana pamwero haasati akanga nguva kumukazve. Kudzidza varwere pakugamuchira marapirwo, achideredza zviri glycoprotein anogona kuratidza efficacy pakati kuchirapa kupindira.

Izvo zvinoda kutsvakurudza

Kuongororwa bundu zvechinguvana CA 19-9 unodiwa kuongorora kubudirira kuchirapa kupindira kuti pancreatic kenza, uyewo mangwanani vasabatwa chirwere dzokororo. Kudzidza kunoita differential chirwere kuti malignancy nevamwe zvirwere (semuenzaniso, pfungwa nomuviri zvemwana asati). Chakarurama CA 19-9 inoratidza kuwanda akaipa kwacho, kuvapo kenza iri pakanyorwa metastases zviri chirwere kure.

Mune zvimwe zviitiko, basa kudzidza

Kuongororwa bundu zvechinguvana CA 19-9 inokurudzirwa kuratidzwa zviratidzo nekenza rwatata: svoto, marwadzo mudumbu, jaundice, uremu. Nguva nenguva basa Varwere kudzidza ane pakutanga yakakwirira Kuwanda glycoprotein nokugamuchira kurapwa. Analysis pachii vanofungidzirwa kenza ari gallbladder kana bile ducts, chiropa, mudumbu kana muura. Saka Research raitongwa akabatana nemimwe miedzo.

inopangidza

The bhuku ukoshi siyana zvinofanira pamwero antigen - 0-35 U / Rine mamiririta. Sezvambotaurwa pamusoro, muprista Kuwanda glycoprotein kunoratidza kuvapo malignancy mu rwatata. The yepamusoro zvirimo, zvikuru azara chirwere. Kunwisa siyana anoratidza bundu metastasis.

anokosha mashoko

Test kugutsikana vaiona glycoprotein kunonyanya kukosha mukutanga kuziva miedzo metastatic kupararira kenza mu rwatata. About 7-10% vanhu havana majini kuti inofananidzira yakakwirira samolecular uremu glycoprotein. Nokudaro, muna muviri pane nemagene nezvaanogona kuti synthesize ari antigen CA 19-9. Saka, kunyange nechirwere pamusoro malignancy pamwero glycoprotein haina kuona ari serum.

Kuti uwane mamwe mashoko,

Usati dhoneta ropa, nyanzvi dzinokurudzira kuti varege kusvuta kuti hafu yeawa. The chirwere kukosha bvunzo kunowedzera, apo chidzidzo musi CEA. Pamusoro pokumisa rakarurama kupfuura chirwere uye yakakodzera nokugadzwa anodiwa kurapwa yakarumbidza miedzo nokuda CA 72-4, zvachose bilirubin, CA 242. Laboratory zvidzidzo gadzai nyanzvi dzakadai hepatologist, internist, chiremba kana oncologist.

mhedziso

Nyanzvi dzinoti kenza nhasi rwatata vari kuramba mune varwere pashure pemakore 30. zvokurwara Uyu ndomumwe chaizvo havaratidzi dzakaonekwa uye havaratidzi amenable mushonga. Panyaya iyi, zvikuru vasanonoka nemiedzo inodiwa kuziva izvozvo. Zvinosuruvarisa kudzidza antigen wevasungwa hazvigoni kushandiswa kutanga kuziva dambudziko racho pamusoro chirwere pechikuva. Kunyange zvakadaro, muedzo uyu ndiyo inoshanda uye idzidzise zvekuongorora kubudirira pakurapwa, kuonekwa yepakutangatanga zvokukura metastasis kenza. Pasina mubvunzo, nyanzvi mune muongororo anoshandisa migumisiro siyana chirwere dzokuvhiya. Kuwedzera murabhoritari, murwere anogadzwa uye richishanda kuferefeta. The kupfuura nyore izvi zvino US. In kuitisa nyanzvi ake anogona kuziva bundu kukura kubva masendimita maviri. Kujekesa kukura, chinzvimbo, uye kupararira malignancy varayire imwe CT scan. Tichishandisa nzira iyi, unogona kuonekwa kubva bundu saizi matatu masendimita. Zvinofanira akati kuti unhu CT zvakabatana kubereka mumwe dose pakati X-ray. Naizvozvo, kudzidza ichi haina akaita kakawanda kana sezvo prophylaxis. Kunetseka pamusoro muviri murwere rinopa MRI. Asi kutsvakurudza mhando iyi haisi kuitwa vanhu vane chero esimbi anodyara. Vose chirwere matanho aya, pamwe miedzo ropa rinogona kuona tanga kenza budiriro kana metastasis mu rwatata.