{"id":64426,"date":"2022-03-10T21:27:57","date_gmt":"2022-03-10T20:27:57","guid":{"rendered":"https:\/\/prizrenpost.com\/al\/?p=64426"},"modified":"2026-01-17T20:26:59","modified_gmt":"2026-01-17T17:26:59","slug":"trashegimia-ne-kancerin-e-zorres-se-trashe-dhe-personalizimi-i-mjekesise-ne-trajtimin-e-tij","status":"publish","type":"post","link":"https:\/\/prizrenpost.com\/al\/trashegimia-ne-kancerin-e-zorres-se-trashe-dhe-personalizimi-i-mjekesise-ne-trajtimin-e-tij\/","title":{"rendered":"Trash\u00ebgimia n\u00eb kancerin e zorr\u00ebs s\u00eb trash\u00eb dhe personalizimi i mjek\u00ebsis\u00eb n\u00eb trajtimin e tij"},"content":{"rendered":"<div id=\"attachment_64432\" style=\"width: 310px\" class=\"wp-caption alignleft\"><img decoding=\"async\" aria-describedby=\"caption-attachment-64432\" src=\"https:\/\/prizrenpost.com\/al\/wp-content\/uploads\/2022\/03\/egzonv.png\" alt=\"\" width=\"300\" height=\"\" class=\"alignnone size-full wp-image-93816\" srcset=\"https:\/\/prizrenpost.com\/al\/wp-content\/uploads\/2022\/03\/egzonv.png 714w, https:\/\/prizrenpost.com\/al\/wp-content\/uploads\/2022\/03\/egzonv-235x300.png 235w\" sizes=\"(max-width: 714px) 100vw, 714px\" \/><p id=\"caption-attachment-64432\" class=\"wp-caption-text\">Autor: <b>Dr. Egzon Avdullahi<\/b><\/p><\/div>\n<p>N\u00eb rast se nj\u00eb grua vjen tek ju n\u00eb t\u00eb nj\u00ebzetat, dhe tregon se babai i saj kishte vdekur nga kanceri i zorr\u00ebs s\u00eb trash\u00eb kur ai ishte 43 vje\u00e7, gj\u00ebja e par\u00eb q\u00eb duhet t\u00eb b\u00ebjm\u00eb n\u00eb nj\u00eb situat\u00eb si kjo \u00ebsht\u00eb t\u00eb pyesim detajet e historis\u00eb s\u00eb babait, historin\u00eb e n\u00ebn\u00ebs dhe t\u00eb kthehemi n\u00eb pjes\u00ebn tjet\u00ebr t\u00eb familjes, n\u00ebse ekziston histori e ndonj\u00eb kanceri ose ndonj\u00eb s\u00ebmundjeje tjet\u00ebr.<br \/>\nN\u00eb rast se zbulojm\u00eb se n\u00eb gjenealogjn\u00eb familjare ka; ta z\u00ebm\u00eb kancer t\u00eb mitr\u00ebs apo kancer t\u00eb zorr\u00ebs s\u00eb trash\u00eb, kjo p\u00ebr ne do t\u00eb jet\u00eb treguese se kemi t\u00eb b\u00ebjm\u00eb me nj\u00eb familje p\u00ebr t\u00eb cil\u00ebn duhet t\u00eb shqet\u00ebsohemi, mbase kemi t\u00eb b\u00ebjm\u00eb me nj\u00eb ndryshim gjenetik q\u00eb k\u00ebt\u00eb familje po e b\u00ebn t\u00eb ndjesh\u00ebm ndaj kancerit t\u00eb zorr\u00ebs s\u00eb trash\u00eb.<\/p>\n<p>Kanceri i zorr\u00ebs s\u00eb trash\u00eb \u00ebsht\u00eb shkaku i dyt\u00eb kryesor i vdekjes nga kanceri (me dallime t\u00eb shkall\u00ebs s\u00eb vdekshm\u00ebris\u00eb tek burrat dhe grat\u00eb). Kanceri i mushk\u00ebrive, p\u00ebr fat t\u00eb keq deri tani udh\u00ebheq n\u00eb list\u00ebn e shkall\u00ebs s\u00eb vdekshm\u00ebris\u00eb. N\u00ebse e specifikojm\u00eb m\u00eb tutje tek burrat, prostata dhe tek grat\u00eb, kanceri i gjirit vjen n\u00eb vendin e dyt\u00eb, gjersa kanceri kolorektal \u00ebsht\u00eb i treti p\u00ebr t\u00eb dy gjinit\u00eb. Pes\u00eb deri n\u00eb 10% t\u00eb pacient\u00ebve kan\u00eb ve\u00e7ori t\u00eb p\u00ebrbashk\u00ebta gjenetike, por n\u00eb nj\u00eb grup tjet\u00ebr pacient\u00ebsh q\u00eb kan\u00eb nj\u00eb histori familjare shum\u00eb t\u00eb fort\u00eb, nuk gjejm\u00eb nj\u00eb gjen, pastaj kemi edhe rastet sporadike me asnj\u00eb histori familjare.<\/p>\n<p>Sindromet kryesore q\u00eb predispozojn\u00eb kancerin e zorr\u00ebs s\u00eb trash\u00eb jan\u00eb sindromi Lynch, apo Sindroma e Polipoz\u00ebs Adenomatoze Familjare \u2013 FAP, dhe pastaj sindroma Gardner q\u00eb gjithashtu \u00ebsht\u00eb nj\u00eb variant i FAP. Sindroma Lynch, e em\u00ebruar m\u00eb 1966 nga Lynch p\u00ebrb\u00ebn 2 deri n\u00eb 3% t\u00eb t\u00eb gjith\u00eb kancereve kolorektal\u00eb. N\u00eb m\u00ebnyr\u00eb tipike shfaqet me polipe t\u00eb shumta n\u00eb zorr\u00ebn e trash\u00eb t\u00eb djatht\u00eb apo zorr\u00ebn e trash\u00eb asendane. \u00cbsht\u00eb nj\u00eb s\u00ebmundje autosomale dominante. Rreziku i kancerit gjat\u00eb gjith\u00eb jet\u00ebs \u00ebsht\u00eb 80%, gj\u00eb q\u00eb tregon se \u00ebsht\u00eb shum\u00eb penetrant. Kjo nuk do t\u00eb thot\u00eb q\u00eb ju do t\u00eb s\u00ebmureni n\u00eb mosh\u00ebn e hershme, por n\u00ebse jetoni deri n\u00eb 90 vje\u00e7 do t\u00eb keni nj\u00eb mund\u00ebsi t\u00eb lart\u00eb s\u00ebmurjeje. Ky lloj kanceri ka lidhje me shum\u00eb forma t\u00eb tjera t\u00eb kancerit, duke p\u00ebrfshir\u00eb kancerin endometrial, kancerin e stomakut ose kancerin e vezoreve dhe kanceret e tjera t\u00eb traktit gastrointestinal. Sindroma Lynch \u00ebsht\u00eb nj\u00eb s\u00ebmundje e mosfunksionimit si duhet e mekanizmit t\u00eb Mosp\u00ebrputhjes s\u00eb Riparimit t\u00eb D\u00ebmtimit t\u00eb ADN-s\u00eb (Mismatch Repair), k\u00ebshtu q\u00eb qelizat, kur shumohen, ndonj\u00ebher\u00eb nuk e marrin ADN-n\u00eb sakt\u00ebsisht t\u00eb replikuar mir\u00ebpo kan\u00eb mekanizma p\u00ebr ta rregulluar at\u00eb, e kjo \u00ebsht\u00eb nj\u00ebra nd\u00ebr to. P\u00ebr shembull, n\u00eb nj\u00eb pozicion t\u00eb caktuar te gjenit duhet t\u00eb jet\u00eb nj\u00eb Adenin\u00eb, por her\u00eb pas here rezulton n\u00eb vend t\u00eb saj nj\u00eb Guanin\u00eb. Trupi ka mekanizma p\u00ebr t\u00eb korigjuar at\u00eb Guanin\u00eb p\u00ebrs\u00ebri n\u00eb nj\u00eb Adenin\u00eb dhe p\u00ebr t\u00eb mos lejuar q\u00eb ai mutacion t\u00eb grumbullohet me koh\u00eb. Nj\u00eb nga gjenet q\u00eb p\u00ebrfshihet n\u00eb p\u00ebrmir\u00ebsimin e gabimit n\u00eb k\u00ebt\u00eb mekaniz\u00ebm quhet MSH6, i cili \u00ebsht\u00eb gjeni q\u00eb zakonisht p\u00ebson mutacion n\u00eb sindrom\u00ebn Lynch.<br \/>\nPra, problemi n\u00eb sindrom\u00ebn Lynch \u00ebsht\u00eb nj\u00eb problem i Mosp\u00ebrputhjes s\u00eb Riparimit t\u00eb ADN-s\u00eb s\u00eb d\u00ebmtuar (Pra i mekanizmit Mismatch Repair). Ka shum\u00eb gjene t\u00eb tjera t\u00eb p\u00ebrfshira, por 90% e rasteve jan\u00eb shkaktuar nga mutacionet n\u00eb gjenet MSH6 ose MLH1. Karakteristika patologjike \u00ebsht\u00eb paq\u00ebndrueshm\u00ebria mikrosatelitore (microsatellite instability) e cila \u00ebsht\u00eb di\u00e7ka q\u00eb mund t\u00eb zbulohet nga gjeneticisti duke p\u00ebrdorur analiz\u00ebn e sekuencimit t\u00eb ADN-s\u00eb. Diagnostifikimi b\u00ebhet me an\u00eb t\u00eb testimit gjenetik gjermline t\u00eb MSH6, MLH1, apo gjeneve t\u00eb tjera t\u00eb lidhura me sindrom\u00ebn Lynch, ose me an\u00eb t\u00eb analiz\u00ebs s\u00eb vet\u00eb tumorit.<\/p>\n<p>N\u00ebse kthehemi tek shembulli i pacientit n\u00eb fillim, pyetja \u00ebsht\u00eb se a duhet t\u00eb b\u00ebhen n\u00eb rastet e tilla teste gjenetike p\u00ebr sindrom\u00ebn Lynch apo jo? Ekzistojn\u00eb kritere t\u00eb ashtuquajtura Amsterdam II, q\u00eb jan\u00eb p\u00ebrcaktuar p\u00ebr t\u00eb identifikuar pacient\u00ebt q\u00eb kan\u00eb nj\u00eb mund\u00ebsi t\u00eb madhe p\u00ebr t\u00eb pasur nj\u00eb test pozitiv. Ka kritere t\u00eb tjera q\u00eb jan\u00eb p\u00ebrshkruar. T\u00eb ashtuquajturat jan\u00eb kriteret 321. Pra, t\u00eb pakt\u00ebn tre t\u00eb af\u00ebrm me kancer t\u00eb lidhur me zorr\u00ebn e trash\u00eb ose sindrom\u00ebn Lynch. T\u00eb pakt\u00ebn dy breza t\u00eb nj\u00ebpasnj\u00ebsh\u00ebm. Dhe t\u00eb pakt\u00ebn nj\u00eb i af\u00ebrm i diagnostikuar para mosh\u00ebs 50 vje\u00e7. Ju duhet t\u00eb eliminoni diagnoz\u00ebn e Polipoz\u00ebs Adenomatoze Familjare dhe do t\u00eb ishte e p\u00eblqyeshme q\u00eb tumor\u00ebt t\u00eb verifikoheshin nga patologjia. Pra, diagnostifikimi i nj\u00eb pacienti si ky, nuk \u00ebsht\u00eb ndryshe nga nj\u00eb pacient me rrezik kardiomiopatie ose rrezik aritmie ose rrezik kanceri t\u00eb gjirit. Personi m\u00eb i p\u00ebrshtatshem t\u00eb cilit duhet t\u2019i b\u00ebjm\u00eb testimin gjenetik \u00ebsht\u00eb personi q\u00eb ka kancer. Dhe at\u00ebher\u00eb mund t\u00eb b\u00ebjm\u00eb pyetjen n\u00ebse i af\u00ebrmi \u00ebsht\u00eb n\u00eb rrezik apo jo sepse mund t\u00eb themi se i af\u00ebrmi ka mutacionin. N\u00eb k\u00ebt\u00eb rast t\u00eb ve\u00e7ant\u00eb, ne nuk e kemi at\u00eb mundesi sepse i af\u00ebrmi i pacientit ka vdekur nga kanceri i zorr\u00ebs s\u00eb trash\u00eb.<br \/>\nZakonisht p\u00ebrballemi me testimin e njer\u00ebzve tek t\u00eb cil\u00ebt nuk ka akoma kancer dhe tek t\u00eb cil\u00ebt n\u00ebse gjejm\u00eb nj\u00eb mutacion nuk jemi kurr\u00eb t\u00eb sigurt\u00eb n\u00ebse ai mutacion mund t\u00eb jet\u00eb nj\u00eb bash\u00ebkrend\u00ebs p\u00ebrgjegj\u00ebs apo mund t\u00eb jet\u00eb nj\u00eb mutacion shkaktues. Pra, p\u00ebrs\u00ebri, ky \u00ebsht\u00eb problemi me t\u00eb cilin p\u00ebrballemi n\u00eb nj\u00eb familje si kjo. Pra, menaxhimi n\u00eb k\u00ebt\u00eb rast t\u00eb ve\u00e7ant\u00eb \u00ebsht\u00eb testimi gjenetik n\u00eb individin e prekur, n\u00ebse \u00ebsht\u00eb e mundur. N\u00ebse jo, at\u00ebher\u00eb kjo grua e re duhet t\u00eb b\u00ebj\u00eb teste gjenetike bazuar n\u00eb kriteret e Amsterdamit II. Dhe n\u00ebse ka nj\u00eb mutacion q\u00eb dihet se \u00ebsht\u00eb patogjen n\u00eb nj\u00ebr\u00ebn nga ato dy gjene t\u00eb sindrom\u00ebs Lynch ose t\u00eb tjerat at\u00ebher\u00eb ju mund ta diagnostikoni lidhur me rritjen e ndjeshm\u00ebris\u00eb ndaj kancerit. Pra, n\u00ebse testimi gjenetik \u00ebsht\u00eb pozitiv, at\u00ebher\u00eb preferohet kolonoskopia \u00e7do vit ose dy duke filluar n\u00eb mosh\u00eb shum\u00eb t\u00eb re. Mosha p\u00ebr k\u00ebt\u00eb \u00ebsht\u00eb 20-25 vje\u00e7 ose dhjet\u00eb vjet m\u00eb her\u00ebt se rasti m\u00eb i hersh\u00ebm i kancerit t\u00eb zorr\u00ebs s\u00eb trash\u00eb n\u00eb familje. Pra, rasti m\u00eb i hersh\u00ebm i kancerit t\u00eb zorr\u00ebs s\u00eb trash\u00eb n\u00eb k\u00ebt\u00eb familje ishte 47, k\u00ebshtu q\u00eb ky person do t\u00eb fillonte kolonoskopin\u00eb n\u00eb mosh\u00ebn 37 ose 25 vje\u00e7, cilado q\u00eb t\u00eb jet\u00eb m\u00eb e hershme, pra mosha 20 ose 25. Dhe p\u00ebr shkak se ky person \u00ebsht\u00eb nj\u00eb grua dhe ekziston rreziku i kancerit t\u00eb mitr\u00ebs gjithashtu duhet nisur ekzaminimet gjinekologjike, p\u00ebrfshir\u00eb ekografi trans-vaginale ose testimin e sh\u00ebnuesve t\u00eb kancerit q\u00eb qarkullojn\u00eb n\u00eb gjak (Ca125), duke filluar p\u00ebrs\u00ebri n\u00eb nj\u00eb mosh\u00eb relativisht t\u00eb re, p\u00ebr t\u00eb zbuluar her\u00ebt dhe p\u00ebr t\u00eb trajtuar her\u00ebt kancerin eventual.<\/p>\n<p>S\u00ebmundja tjet\u00ebr q\u00eb \u00ebsht\u00eb shum\u00eb m\u00eb e rrall\u00eb, por q\u00eb ka nj\u00eb fenotip klinik t\u00eb ndryshuesh\u00ebm \u00ebsht\u00eb Polipoza Adenomatoze Familjare. Kjo \u00ebsht\u00eb nj\u00eb s\u00ebmundje autosomale dominante, rrjedhimisht nj\u00eb mutacion i vet\u00ebm i gjenit do ta shkaktoj\u00eb k\u00ebt\u00eb s\u00ebmundje. Dhe mutacioni \u00ebsht\u00eb n\u00eb nj\u00eb gjen t\u00eb quajtur APC, i cili \u00ebsht\u00eb nj\u00eb gjen shtyp\u00ebs i tumorit (Tumor supresor\u00eb). Pra, kemi nj\u00eb mutacion n\u00eb nj\u00eb gjen supresor t\u00eb tumorit q\u00eb anulon funksionin e kancerizimit. Gjith\u00e7ka q\u00eb nevojitet q\u00eb t\u00eb shfaqet s\u00ebmundja \u00ebsht\u00eb nj\u00eb mutacion n\u00eb alelin tjet\u00ebr t\u00eb gjenit supresor t\u00eb tumorit.<br \/>\nKarakteristika patologjike ose klinike e k\u00ebsaj s\u00ebmundjeje \u00ebsht\u00eb mbulimi i mukoz\u00ebs s\u00eb zorr\u00ebs s\u00eb trash\u00eb nga polipet. Personi q\u00eb \u00ebsht\u00eb bart\u00ebs i mutacionit FAP p\u00ebrcillet me sigmoidoskopi, q\u00eb fillon n\u00eb nj\u00eb mosh\u00eb shum\u00eb t\u00eb re dhe sapo zbulohen polipet, ndoshta edhe mund t\u00eb p\u00ebrfundoj\u00eb me nj\u00eb kolektomi profilaktike me rrezikun gjithmon\u00eb q\u00eb t`i kushtoni v\u00ebmendje pjes\u00ebs ileale t\u00eb zorr\u00ebs dhe mbetjes rektale. P\u00ebr t\u2019u siguruar q\u00eb k\u00ebta pacient\u00eb nuk po zhvillojn\u00eb polipe n\u00eb ato zona dhe gjithashtu nuk kan\u00eb rrezik kanceri duhet b\u00ebr\u00eb endoskopia e GI-s\u00eb s\u00eb sip\u00ebrme duke filluar n\u00eb mosh\u00ebn 25 vje\u00e7 dhe pas k\u00ebsaj duhet b\u00ebr\u00eb edhe tek foshnjat dhe f\u00ebmij\u00ebt shqyrtimin e hepatoblastom\u00ebs deri n\u00eb mosh\u00ebn pes\u00eb vje\u00e7 me ultratinguj dhe me nj\u00eb matje alfa-fetoproteine n\u00eb endoplazm\u00eb.<\/p>\n<p>P\u00ebrs\u00ebri, kanceri i zorr\u00ebs s\u00eb trash\u00eb \u00ebsht\u00eb nj\u00eb nga shkaqet kryesore t\u00eb vdekshm\u00ebris\u00eb. K\u00ebtu ne jemi p\u00ebrq\u00ebndruar n\u00eb personalizimin e mjek\u00ebsis\u00eb, por \u00ebsht\u00eb edhe nj\u00eb aspekt tjet\u00ebr q\u00eb \u00ebsht\u00eb mjekimi parandalues dhe \u00e7far\u00eb b\u00ebni p\u00ebr parandalimin e kancerit t\u00eb zorr\u00ebs s\u00eb trash\u00eb, nj\u00eb shkak kryesor i vdekjes, shkaku kryesor i parandaluesh\u00ebm i vdekjes. Parashtrojm\u00eb at\u00eb q\u00eb duhet t\u00eb b\u00ebni n\u00eb drejtim t\u00eb shqyrtimit t\u00eb njer\u00ebzve p\u00ebr rrezikun gjenetik, rrezikun e lart\u00eb, rrezikun mesatar dhe at\u00eb t\u00eb ul\u00ebt. Njer\u00ebzit q\u00eb jan\u00eb n\u00eb rrezik p\u00ebrb\u00ebjn\u00eb shumic\u00ebn d\u00ebrrmuese t\u00eb vdekjeve nga kanceri i zorr\u00ebs s\u00eb trash\u00eb. Edhe n\u00ebse i plot\u00ebsojm\u00eb kriteret p\u00ebr testimin gjenetik, prap\u00ebseprap\u00eb ekziston rreziku nj\u00eb n\u00eb 16 gjat\u00eb jet\u00ebs p\u00ebr t\u00eb zhvilluar kancer kolorektal. <\/p>\n<p>K\u00ebshtu q\u00eb rekomandimet p\u00ebr shqyrtimin gjenetik jan\u00eb t\u00eb r\u00ebnd\u00ebsishme dhe pjes\u00eb e personalizimit t\u00eb mjek\u00ebsis\u00eb, por ne duhet ta kemi parasysh faktin se kjo \u00ebsht\u00eb nj\u00eb s\u00ebmundje me t\u00eb v\u00ebrtet\u00eb shum\u00eb e p\u00ebrhapur dhe n\u00ebse menaxhohet n\u00eb m\u00ebnyr\u00eb korrekte \u00ebsht\u00eb plot\u00ebsisht ose n\u00eb mas\u00eb t\u00eb madhe e parandalueshme, t\u00eb pakt\u00ebn p\u00ebrsa i p\u00ebrket vdekjeve.<\/p>\n<p>Pra, s\u00eb fundmi edhe nj\u00eb her\u00eb, personalizimi i mjek\u00ebsis\u00eb \u00ebsht\u00eb i r\u00ebnd\u00ebsish\u00ebm.<\/p>\n<p><b>Autori \u00ebsht\u00eb mjek i Gjenetik\u00ebs Humane n\u00eb Ankara, Turqi.<\/b> <\/p>\n","protected":false},"excerpt":{"rendered":"<p>N\u00eb rast se nj\u00eb grua vjen tek ju n\u00eb t\u00eb nj\u00ebzetat, dhe tregon se babai i saj kishte vdekur nga kanceri i zorr\u00ebs s\u00eb trash\u00eb kur ai ishte 43 vje\u00e7, gj\u00ebja e par\u00eb q\u00eb duhet t\u00eb b\u00ebjm\u00eb n\u00eb nj\u00eb situat\u00eb si kjo \u00ebsht\u00eb t\u00eb pyesim detajet e historis\u00eb s\u00eb babait, historin\u00eb e n\u00ebn\u00ebs dhe t\u00eb [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":93820,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,5],"tags":[1946,6521],"class_list":["post-64426","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-opinione","category-shendetesi","tag-egzon-avdullahi","tag-sponsored"],"_links":{"self":[{"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/posts\/64426","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/comments?post=64426"}],"version-history":[{"count":8,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/posts\/64426\/revisions"}],"predecessor-version":[{"id":93817,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/posts\/64426\/revisions\/93817"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/media\/93820"}],"wp:attachment":[{"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/media?parent=64426"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/categories?post=64426"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/prizrenpost.com\/al\/wp-json\/wp\/v2\/tags?post=64426"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}