{"id":9344,"date":"2019-05-09T10:13:25","date_gmt":"2019-05-09T03:13:25","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=9344"},"modified":"2019-05-12T10:15:53","modified_gmt":"2019-05-12T03:15:53","slug":"xet-nghiem-bieu-hien-gen-giup-xac-dinh-benh-nhan-khong-can-hoa-tri","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/xet-nghiem-bieu-hien-gen-giup-xac-dinh-benh-nhan-khong-can-hoa-tri\/","title":{"rendered":"X\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen gi\u00fap x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea7n h\u00f3a tr\u1ecb"},"content":{"rendered":"<h2>\u0110i\u1ec3m nghi\u00ean c\u1ee9u m\u1edbi c\u00f4ng b\u1ed1 (NEJM): X\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen gi\u00fap x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea7n h\u00f3a tr\u1ecb.<\/h2>\n<p>Li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft th\u00edch h\u1ee3p v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ung th\u01b0 v\u00fa m\u1ee9c \u0111\u1ed9 trung b\u00ecnh.<\/p>\n<p>Trong su\u1ed1t h\u00e0ng th\u1eadp k\u1ec9 qua, vi\u1ec7c ph\u00e2n lo\u1ea1i kh\u1ed1i u, quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh \u0111\u1ec1u d\u1ef1a tr\u00ean nghi\u00ean c\u1ee9u b\u1ec7nh h\u1ecdc m\u00f4 kh\u1ed1i u nh\u01b0ng v\u1edbi \u0111\u1ed9 ch\u00ednh x\u00e1c kh\u00e1c nhau. K\u0129 thu\u1eadt \u201cbi\u1ec3u hi\u1ec7n gen\u201d c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh c\u00e1c gen ho\u1ea1t \u0111\u1ed9ng (m\u00e3 h\u00f3a mARN v\u00e0 protein) \u1edf b\u1ea5t k\u00ec m\u00f4 n\u00e0o, bao g\u1ed3m c\u1ea3 m\u00f4 kh\u1ed1i u. Li\u1ec7u c\u00e1c x\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 th\u1ec3 cung c\u1ea5p ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p truy\u1ec1n th\u1ed1ng?<\/p>\n<p>\u00dd ngh\u0129a c\u1ee7a x\u00e9t nghi\u1ec7m ph\u1ed5 bi\u1ebfn \u0111\u00e1nh gi\u00e1 ho\u1ea1t \u0111\u1ed9ng 21 gen nh\u1eb1m d\u1ef1 \u0111o\u00e1n l\u1ee3i \u00edch c\u1ee7a h\u00f3a tr\u1ecb li\u1ec7u \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m ch\u1ee9ng tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n n\u1eef ung th\u01b0 v\u00fa c\u00f3 th\u1ee5 th\u1ec3 n\u1ed9i ti\u1ebft d\u01b0\u01a1ng t\u00ednh, th\u1ee5 th\u1ec3 y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng bi\u1ec3u m\u00f4-2 (HER2) \u00e2m t\u00ednh v\u00e0 h\u1ea1ch n\u00e1ch \u00e2m t\u00ednh. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u01b0\u1edbc cho th\u1ea5y, b\u1ec7nh nh\u00e2n c\u00f3 \u0111i\u1ec3m s\u1ed1 x\u00e9t nghi\u1ec7m cao n\u00ean \u0111i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t k\u1ebft h\u1ee3p li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft, b\u1ec7nh nh\u00e2n c\u00f3 \u0111i\u1ec3m s\u1ed1 th\u1ea5p ch\u1ec9 c\u1ea7n \u0111i\u1ec1u tr\u1ecb n\u1ed9i ti\u1ebft. Tuy nhi\u00ean, r\u1ea5t nh\u1ec1u b\u1ec7nh nh\u00e2n n\u1eef c\u00f3 s\u1ed1 \u0111i\u1ec3m trung b\u00ecnh. Nghi\u00ean c\u1ee9u m\u1edbi n\u00e0y \u0111\u00e3 t\u00ecm ra gi\u1ea3i ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u cho nh\u00f3m b\u1ec7nh nh\u00e2n tr\u00ean (NEJM JW Gen Med ng\u00e0y 15\/7 v\u00e0 N Engl J Med ng\u00e0y 12\/7; 379:111).<\/p>\n<p>B\u1ec7nh nh\u00e2n n\u1eef c\u00f3 s\u1ed1 \u0111i\u1ec3m trung b\u00ecnh trong x\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn ng\u1eabu nhi\u00ean \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p h\u00f3a ch\u1ea5t v\u00e0 n\u1ed9i ti\u1ebft ho\u1eb7c ch\u1ec9 \u0111i\u1ec1u tr\u1ecb n\u1ed9i ti\u1ebft. Sau 9 n\u0103m, c\u1ea3 hai nh\u00f3m \u0111\u1ec1u c\u00f3 t\u1ec9 l\u1ec7 kh\u00f4ng ph\u00e1t tri\u1ec3n b\u1ec7nh x\u00e2m l\u1ea5n, kh\u00f4ng t\u00e1i ph\u00e1t (t\u1ea1i ch\u1ed7\/ l\u00e2n c\u1eadn v\u00e0 c\u00e1c v\u1ecb tr\u00ed xa) v\u00e0 t\u1ec9 l\u1ec7 s\u1ed1ng ngang nhau. \u0110i\u1ec1u \u0111\u00f3 cho th\u1ea5y x\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen \u0111\u00e3 gi\u00fap x\u00e1c \u0111\u1ecbnh m\u1ed9t l\u01b0\u1ee3ng l\u1edbn b\u1ec7nh nh\u00e2n n\u1eef kh\u00f4ng c\u1ea7n h\u00f3a tr\u1ecb. K\u1ebft qu\u1ea3 ph\u00e2n t\u00edch th\u1ee9 c\u1ea5p cho k\u1ebft qu\u1ea3, ph\u1ee5 n\u1eef d\u01b0\u1edbi 50 tu\u1ed5i h\u01b0\u1edfng nhi\u1ec1u l\u1ee3i \u00edch h\u01a1n t\u1eeb ph\u01b0\u01a1ng ph\u00e1p h\u00f3a tr\u1ecb, tuy nhi\u00ean \u0111i\u1ec1u n\u00e0y v\u1eabn c\u1ea7n ki\u1ec3m ch\u1ee9ng th\u00eam.<\/p>\n<p>Nghi\u00ean c\u1ee9u tr\u00ean m\u1edbi \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u1edf m\u1ed9t ph\u00e2n nh\u00f3m b\u1ec7nh nh\u00e2n, trong m\u1ed9t lo\u1ea1i b\u1ec7nh ung th\u01b0. D\u00f9 v\u1eady, c\u00f9ng v\u1edbi nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c, n\u00f3 g\u00f3p ph\u1ea7n ch\u1ee9ng minh r\u1eb1ng x\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen \u0111ang \u0111\u00f3ng m\u1ed9t vai tr\u00f2 ng\u00e0y c\u00e0ng l\u1edbn trong ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n ung th\u01b0, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1 th\u1ec3 h\u00f3a trong \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u1ea3i thi\u1ec7n \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh.<\/p>\n<p>Ngu\u1ed3n: T\u00e1c gi\u1ea3 Anthony L. Komaroff, MD<\/p>\n<p><a href=\"https:\/\/www.jwatch.org\/na48078\/2018\/12\/27\/nejm-journal-watch-general-medicine-year-review-2018\" rel=\"noopener\">https:\/\/www.jwatch.org\/na48078\/2018\/12\/27\/nejm-journal-watch-general-medicine-year-review-2018<\/a><\/p>\n<p>Ng\u01b0\u1eddi t\u1ed5ng h\u1ee3p: Nguy\u1ec5n Th\u1ecb Thu H\u00e0 &#8211; \u0110o\u00e0n Ph\u01b0\u01a1ng Th\u1ea3o &#8211; Trung T\u00e2m C\u1ea3nh Gi\u00e1c D\u01b0\u1ee3c Qu\u1ed1c Gia.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110i\u1ec3m nghi\u00ean c\u1ee9u m\u1edbi c\u00f4ng b\u1ed1 (NEJM): X\u00e9t nghi\u1ec7m bi\u1ec3u hi\u1ec7n gen gi\u00fap x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea7n h\u00f3a tr\u1ecb. Li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft th\u00edch h\u1ee3p v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ung th\u01b0 v\u00fa m\u1ee9c \u0111\u1ed9 trung b\u00ecnh. Trong su\u1ed1t h\u00e0ng th\u1eadp k\u1ec9 qua, vi\u1ec7c ph\u00e2n lo\u1ea1i kh\u1ed1i u, quy\u1ebft \u0111\u1ecbnh [&#8230;]\n","protected":false},"author":1,"featured_media":8328,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9344","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9344","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=9344"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9344\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/8328"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=9344"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=9344"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=9344"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}