{"id":7978,"date":"2018-09-16T11:09:54","date_gmt":"2018-09-16T04:09:54","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/hieu-ve-duoc-ly-hoc-di-truyen\/"},"modified":"2018-09-16T11:09:54","modified_gmt":"2018-09-16T04:09:54","slug":"hieu-ve-duoc-ly-hoc-di-truyen","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/hieu-ve-duoc-ly-hoc-di-truyen\/","title":{"rendered":"Hi\u1ec3u v\u1ec1 d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #000000;\"><em>Ng\u01b0\u1eddi d\u1ecbch: <strong>TS BS Tr\u1ecbnh Xu\u00e2n Th\u1eafng<\/strong><\/em><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #000000;\"><em>Hi\u1ec7u \u0111\u00ednh: <strong>TS Phan Minh Li\u00eam (Vi\u1ec7n Y Sinh Vi\u1ec7t Nam \u2013 Hoa K\u1ef3) vs TS.BS. L\u00ea Th\u1ecb Thanh Th\u1ee7y<\/strong><\/em><\/span><\/p>\n<p style=\"text-align: justify;\">D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n nghi\u00ean c\u1ee9u v\u1ec1 c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c gi\u1eefa thu\u1ed1c v\u00e0 c\u00e1c gen di truy\u1ec1n. L\u0129nh v\u1ef1c n\u00e0y bao g\u1ed3m c\u01a1 ch\u1ebf c\u00e1c gen di truy\u1ec1n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1ch th\u1ee9c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a thu\u1ed1c \u0111\u1ed1i v\u1edbi t\u1eebng ng\u01b0\u1eddi. S\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 di truy\u1ec1n c\u00f3 ngh\u0129a l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 an to\u00e0n cho m\u1ed9t ng\u01b0\u1eddi nh\u01b0ng l\u1ea1i c\u00f3 h\u1ea1i cho ng\u01b0\u1eddi kh\u00e1c. M\u1ed9t ng\u01b0\u1eddi c\u00f3 th\u1ec3 ch\u1ecbu t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng t\u1eeb m\u1ed9t lo\u1ea1i thu\u1ed1c, nh\u01b0ng ng\u01b0\u1eddi kh\u00e1c l\u1ea1i kh\u00f4ng b\u1ecb nh\u01b0 v\u1eady, ngay c\u1ea3 n\u1ebfu ng\u01b0\u1eddi \u0111\u00f3 d\u00f9ng thu\u1ed1c v\u1edbi li\u1ec1u t\u01b0\u01a1ng t\u1ef1.<\/p>\n<h2 style=\"text-align: justify;\">S\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n v\u00e0 x\u00e9t nghi\u1ec7m di truy\u1ec1n<\/h2>\n<p style=\"text-align: justify;\"><strong>X\u00e9t nghi\u1ec7m di truy\u1ec1n chu\u1ea9n. <\/strong>X\u00e9t nghi\u1ec7m di truy\u1ec1n chu\u1ea9n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u1eb1m ph\u00e1t hi\u1ec7n m\u1ed9t s\u1ed1 gen nh\u1ea5t \u0111\u1ecbnh, v\u00ed d\u1ee5 nh\u01b0 gen <em>BRCA1<\/em> v\u00e0 <em>BRCA2<\/em>. \u0110\u1ed9t bi\u1ebfn \u1edf c\u00e1c gen n\u00e0y l\u00e0m t\u0103ng nguy c\u01a1 ung th\u01b0 v\u00fa v\u00e0 ung th\u01b0 bu\u1ed3ng tr\u1ee9ng. X\u00e9t nghi\u1ec7m di truy\u1ec1n chu\u1ea9n c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba. C\u00e1c b\u01b0\u1edbc ph\u00f2ng ng\u1eeba bao g\u1ed3m:<\/p>\n<ul style=\"text-align: justify;\">\n<li>S\u00e0ng l\u1ecdc ung th\u01b0 th\u01b0\u1eddng xuy\u00ean h\u01a1n.<\/li>\n<li>Thay \u0111\u1ed5i v\u1ec1 l\u1ed1i s\u1ed1ng.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n.<\/strong> D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n l\u00e0 m\u1ed9t lo\u1ea1i x\u00e9t nghi\u1ec7m di truy\u1ec1n nh\u1eb1m t\u00ecm ki\u1ebfm c\u00e1c bi\u1ebfn th\u1ec3 nh\u1ecf trong gen. C\u00e1c bi\u1ebfn th\u1ec3 n\u00e0y c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn vi\u1ec7c li\u1ec7u c\u00e1c gen s\u1ebd k\u00edch ho\u1ea1t hay v\u00f4 hi\u1ec7u ho\u00e1 c\u00e1c thu\u1ed1c nh\u1ea5t \u0111\u1ecbnh. K\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n s\u1ebd gi\u00fap b\u00e1c s\u0129 ch\u1ecdn l\u1ef1a lo\u1ea1i thu\u1ed1c v\u00e0 li\u1ec1u thu\u1ed1c an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 nh\u1ea5t cho ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p style=\"text-align: justify;\">D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n l\u00e0 l\u0129nh v\u1ef1c ph\u00e1t tri\u1ec3n li\u00ean t\u1ee5c. C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u ti\u1ebfp t\u1ee5c x\u00e1c \u0111\u1ecbnh c\u00e1c bi\u1ebfn th\u1ec3 gen \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1ch th\u1ee9c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a thu\u1ed1c. Khi y h\u1ecdc c\u00e1 nh\u00e2n ho\u00e1 ph\u00e1t tri\u1ec3n, vi\u1ec7c x\u00e9t nghi\u1ec7m c\u00e1c bi\u1ebfn th\u1ec3 gen c\u00f3 th\u1ec3 tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn h\u01a1n.<\/p>\n<h2 style=\"text-align: justify;\">T\u1ea1i sao thu\u1ed1c l\u1ea1i t\u00e1c \u0111\u1ed9ng kh\u00e1c nhau tr\u00ean m\u1ed7i ng\u01b0\u1eddi?<\/h2>\n<p style=\"text-align: justify;\"><strong>S\u1ef1 k\u00edch ho\u1ea1t thu\u1ed1c.<\/strong> Nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ea7n \u0111\u01b0\u1ee3c ho\u1ea1t ho\u00e1. Ho\u1ea1t ho\u00e1 qu\u00e1 tr\u00ecnh c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201ck\u00edch ho\u1ea1t\u201d. C\u00e1c protein \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 enzyme gi\u00fap \u0111\u1ea9y nhanh c\u00e1c ph\u1ea3n \u1ee9ng ho\u00e1 h\u1ecdc trong c\u01a1 th\u1ec3. \u0110i\u1ec1u n\u00e0y gi\u00fap ho\u1ea1t ho\u00e1 thu\u1ed1c \u0111\u1ec3 thu\u1ed1c c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng.<\/p>\n<p style=\"text-align: justify;\"><strong>M\u1ed7i ng\u01b0\u1eddi th\u1eeba h\u01b0\u1edfng c\u00e1c bi\u1ebfn th\u1ec3 enzyme kh\u00e1c nhau.<\/strong> C\u00e1c bi\u1ebfn th\u1ec3 n\u00e0y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ed1c \u0111\u1ed9 m\u1ed9t lo\u1ea1i thu\u1ed1c chuy\u1ec3n th\u00e0nh d\u1ea1ng ho\u1ea1t \u0111\u1ed9ng. V\u00ed d\u1ee5, m\u1ed9t s\u1ed1 ng\u01b0\u1eddi chuy\u1ec3n ho\u00e1 thu\u1ed1c ch\u1eadm. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a r\u1eb1ng s\u1eed d\u1ee5ng li\u1ec1u ti\u00eau chu\u1ea9n c\u1ee7a thu\u1ed1c c\u00f3 th\u1ec3 s\u1ebd kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3.<\/p>\n<p style=\"text-align: justify;\"><strong>V\u00f4 hi\u1ec7u ho\u00e1 thu\u1ed1c.<\/strong> Thu\u1ed1c c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c v\u00f4 hi\u1ec7u ho\u00e1 nh\u1eb1m h\u1ea1n ch\u1ebf thu\u1ed1c ti\u1ebfp x\u00fac v\u1edbi c\u00e1c m\u00f4 kho\u1ebb m\u1ea1nh. S\u1ef1 v\u00f4 hi\u1ec7u ho\u00e1 l\u00e0 qu\u00e1 tr\u00ecnh \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201ct\u1eaft \u0111i\u201d.<\/p>\n<p style=\"text-align: justify;\"><strong>M\u1ed9t s\u1ed1 ng\u01b0\u1eddi c\u00f3 enzyme ho\u1ea1t \u0111\u1ed9ng ch\u1eadm.<\/strong> K\u1ebft qu\u1ea3 l\u00e0 thu\u1ed1c v\u1eabn t\u1ed3n t\u1ea1i v\u1edbi n\u1ed3ng \u0111\u1ed9 cao trong c\u01a1 th\u1ec3 nh\u1eefng ng\u01b0\u1eddi n\u00e0y. \u0110i\u1ec1u n\u00e0y ngh\u0129a l\u00e0 h\u1ecd c\u00f3 th\u1ec3 ph\u1ea3i ch\u1ecbu nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 t\u1eeb thu\u1ed1c h\u01a1n.<\/p>\n<p style=\"text-align: justify;\">B\u00ean c\u1ea1nh d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n, c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea3n \u1ee9ng c\u1ee7a m\u1ed9t ng\u01b0\u1eddi \u0111\u1ed1i v\u1edbi m\u1ed9t lo\u1ea1i thu\u1ed1c:<\/p>\n<ul style=\"text-align: justify;\">\n<li>Tu\u1ed5i v\u00e0 gi\u1edbi t\u00ednh.<\/li>\n<li>Giai \u0111o\u1ea1n c\u1ee7a b\u1ec7nh ung th\u01b0.<\/li>\n<li>C\u00e1c y\u1ebfu t\u1ed1 l\u1ed1i s\u1ed1ng, nh\u01b0 h\u00fat thu\u1ed1c l\u00e1 v\u00e0 u\u1ed1ng r\u01b0\u1ee3u.<\/li>\n<li>C\u00e1c b\u1ec7nh l\u00fd kh\u00e1c.<\/li>\n<li>C\u00e1c lo\u1ea1i thu\u1ed1c m\u00e0 ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd tr\u01b0\u1edbc \u0111\u00e2y.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify;\">L\u1ee3i \u00edch c\u1ee7a d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n<\/h2>\n<p style=\"text-align: justify;\">D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 l\u1ee3i \u00edch c\u1ee7a d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n:<\/p>\n<p style=\"text-align: justify;\"><strong>C\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n s\u1ef1 an to\u00e0n cho b\u1ec7nh nh\u00e2n.<\/strong> \u01af\u1edbc t\u00ednh ph\u1ea3n \u1ee9ng thu\u1ed1c nghi\u00eam tr\u1ecdng khi\u1ebfn kho\u1ea3ng 120.000 ng\u01b0\u1eddi ph\u1ea3i nh\u1eadp vi\u1ec7n m\u1ed7i n\u0103m. D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n c\u00f3 th\u1ec3 ng\u0103n ng\u1eeba \u0111i\u1ec1u n\u00e0y th\u00f4ng qua vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ph\u1ea3n \u1ee9ng thu\u1ed1c.<\/p>\n<p style=\"text-align: justify;\"><strong>C\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n chi ph\u00ed v\u00e0 hi\u1ec7u qu\u1ea3 ch\u0103m s\u00f3c s\u1ee9c kho\u1ebb.<\/strong> D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh c\u00e1c lo\u1ea1i thu\u1ed1c v\u00e0 li\u1ec1u thu\u1ed1c ph\u00f9 h\u1ee3p m\u1ed9t c\u00e1ch nhanh ch\u00f3ng.<\/p>\n<h2 style=\"text-align: justify;\">C\u00e1c th\u00e1ch th\u1ee9c \u0111\u1ed1i v\u1edbi d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n<\/h2>\n<p style=\"text-align: justify;\">D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 th\u00e1ch th\u1ee9c trong vi\u1ec7c ph\u00e1t tri\u1ec3n v\u00e0 \u00e1p d\u1ee5ng d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n v\u00e0o l\u00e2m s\u00e0ng:<\/p>\n<ul style=\"text-align: justify;\">\n<li>Gi\u00e1 th\u00e0nh cao, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m y t\u1ebf chi tr\u1ea3.<\/li>\n<li>M\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m c\u00f3 th\u1ec3 kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n \u1edf m\u1ed9t s\u1ed1 n\u01a1i.<\/li>\n<li>Hi\u1ec7n v\u1eabn t\u1ed3n t\u1ea1i m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 v\u1ec1 quy\u1ec1n ri\u00eang t\u01b0, m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 lu\u1eadt ch\u1ed1ng ph\u00e2n bi\u1ec7t \u0111\u1ed1i x\u1eed li\u00ean bang. Nh\u1eefng lu\u1eadt n\u00e0y c\u1ea5m ph\u00e2n bi\u1ec7t \u0111\u1ed1i x\u1eed d\u1ef1a tr\u00ean th\u00f4ng tin v\u1ec1 m\u1eb7t di truy\u1ec1n.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify;\">D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n trong l\u00e2m s\u00e0ng<\/h2>\n<p style=\"text-align: justify;\">D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 v\u00ed d\u1ee5 v\u1ec1 x\u00e9t nghi\u1ec7m d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n trong l\u0129nh v\u1ef1c ung th\u01b0:<\/p>\n<p style=\"text-align: justify;\"><strong>Ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng.<\/strong> Irinotecan (Camptosar) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ho\u00e1 tr\u1ecb th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i tr\u00e0ng. \u1ede m\u1ed9t s\u1ed1 ng\u01b0\u1eddi, c\u00e1c bi\u1ebfn th\u1ec3 di truy\u1ec1n g\u00e2y thi\u1ebfu h\u1ee5t emzyme UGT1A1. Enzyme n\u00e0y ch\u1ecbu tr\u00e1ch nhi\u1ec7m chuy\u1ec3n ho\u00e1 irinotecan. Qu\u00e1 tr\u00ecnh chuy\u1ec3n ho\u00e1 l\u00e0 ph\u1ea3n \u1ee9ng ho\u00e1 h\u1ecdc gi\u00fap c\u01a1 th\u1ec3 x\u1eed l\u00fd thu\u1ed1c.<\/p>\n<p style=\"text-align: justify;\"><strong>Vi\u1ec7c thi\u1ebfu h\u1ee5t enzyme UGT1A1 khi\u1ebfn cho irinotecan t\u1ed3n t\u1ea1i v\u1edbi n\u1ed3ng \u0111\u1ed9 cao trong c\u01a1 th\u1ec3.<\/strong> \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn t\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng \u0111e do\u1ea1 t\u00ednh m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh. Li\u1ec1u thu\u1ed1c c\u00e0ng cao th\u00ec c\u00e1c nguy c\u01a1 c\u00e0ng l\u1edbn.<\/p>\n<p style=\"text-align: justify;\"><strong>B\u00e1c s\u0129 c\u00f3 th\u1ec3 d\u00f9ng m\u1ed9t x\u00e9t nghi\u1ec7m d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n g\u1ecdi l\u00e0 x\u00e9t nghi\u1ec7m UGT1A1.<\/strong> X\u00e9t nghi\u1ec7m n\u00e0y gi\u00fap x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n n\u00e0o mang bi\u1ebfn th\u1ec3 di truy\u1ec1n n\u00f3i tr\u00ean. Sau \u0111\u00f3 b\u00e1c s\u0129 c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh irinotecan v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n. Th\u00f4ng th\u01b0\u1eddng, d\u00f9ng thu\u1ed1c irinotecan v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n v\u1eabn c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u1edf c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p style=\"text-align: justify;\"><strong>B\u1ec7nh b\u1ea1ch c\u1ea7u t\u0103ng lympho b\u00e0o c\u1ea5p t\u00ednh (ALL). <\/strong>B\u00e1c s\u0129 s\u1eed d\u1ee5ng x\u00e9t nghi\u1ec7m d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n cho tr\u1ebb em m\u1eafc b\u1ec7nh ALL. T\u1ec9 l\u1ec7 ng\u01b0\u1eddi mang bi\u1ebfn th\u1ec3 di truy\u1ec1n g\u00e2y thi\u1ebfu h\u1ee5t enzyme thiopurine methyltransferase (TPMT) l\u00e0 10%. Enzyme TPMT ch\u1ecbu tr\u00e1ch nhi\u1ec7m chuy\u1ec3n ho\u00e1 thu\u1ed1c ho\u00e1 tr\u1ecb d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ALL.<\/p>\n<p style=\"text-align: justify;\"><strong>B\u1ec7nh nhi c\u00f3 n\u1ed3ng \u0111\u1ed9 enzyme TPMT th\u1ea5p h\u01a1n b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c ho\u00e1 tr\u1ecb v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n.<\/strong> \u0110i\u1ec1u n\u00e0y gi\u00fap ng\u0103n ng\u1eeba c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.<\/p>\n<p style=\"text-align: justify;\"><strong>C\u00e1c b\u1ec7nh ung th\u01b0 kh\u00e1c.<\/strong> Fluorouracil (5-FU) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ho\u00e1 tr\u1ecb \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u lo\u1ea1i b\u1ec7nh ung th\u01b0 nh\u01b0 ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng, ung th\u01b0 v\u00fa, ung th\u01b0 d\u1ea1 d\u00e0y v\u00e0 ung th\u01b0 tuy\u1ebfn tu\u1ef5.<\/p>\n<p style=\"text-align: justify;\">M\u1ed9t s\u1ed1 ng\u01b0\u1eddi mang bi\u1ebfn th\u1ec3 di truy\u1ec1n l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 enzyme dihydropyrimidine dehydrogenase (DPD). Enzyme DPD gi\u00fap c\u00f3 th\u1ec3 chuy\u1ec3n ho\u00e1 fluorouracil.<\/p>\n<p style=\"text-align: justify;\">B\u00e1c s\u0129 c\u00f3 th\u1ec3 d\u00f9ng x\u00e9t nghi\u1ec7m d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh bi\u1ebfn th\u1ec3 n\u00e0y. N\u1ebfu \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh thu\u1ed1c fluorouracil v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n s\u1ebd gi\u00fap ng\u0103n ng\u1eeba c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng.<\/p>\n<h2 style=\"text-align: justify;\">C\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n trao \u0111\u1ed5i v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf<\/h2>\n<p style=\"text-align: justify;\">B\u1ea1n h\u00e3y trao \u0111\u1ed5i v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf v\u1ec1 c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb. B\u1ea1n c\u00f3 th\u1ec3 h\u1ecfi h\u1ecd c\u00e1c c\u00e2u h\u1ecfi d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<ul style=\"text-align: justify;\">\n<li>C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u00e0nh cho t\u00f4i l\u00e0 g\u00ec?<\/li>\n<li>B\u00e1c s\u0129 khuy\u1ebfn c\u00e1o bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb n\u00e0o cho t\u00f4i? T\u1ea1i sao b\u00e1c s\u0129 l\u1ea1i khuy\u1ebfn c\u00e1o c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u1ea5y?<\/li>\n<li>C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y c\u00f3 t\u00e1c \u0111\u1ed9ng kh\u00e1c nhau \u1edf nh\u1eefng ng\u01b0\u1eddi kh\u00e1c nhau hay kh\u00f4ng? N\u1ebfu l\u00e0 nh\u01b0 v\u1eady, c\u00f3 x\u00e9t nghi\u1ec7m n\u00e0o gi\u00fap x\u00e1c \u0111\u1ecbnh \u0111i\u1ec1u n\u00e0y kh\u00f4ng?<\/li>\n<li>T\u00f4i c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0o?<\/li>\n<li>H\u1ec7 gen c\u1ee7a t\u00f4i c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 t\u00f4i v\u1edbi thu\u1ed1c hay kh\u00f4ng?<\/li>\n<li>C\u00f3 c\u00e1ch n\u00e0o \u0111\u1ec3 ti\u00ean l\u01b0\u1ee3ng ph\u1ea3n \u1ee9ng c\u1ee7a t\u00f4i v\u1edbi thu\u1ed1c hay kh\u00f4ng? C\u0169ng nh\u01b0 \u0111\u1ec3 ti\u00ean l\u01b0\u1ee3ng li\u1ec7u t\u00f4i c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng?<\/li>\n<li>N\u1ebfu b\u1ec7nh ung th\u01b0 c\u1ee7a t\u00f4i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c th\u00ec c\u00f3 l\u1ef1a ch\u1ecdn n\u00e0o kh\u00e1c kh\u00f4ng? Ho\u1eb7c n\u1ebfu t\u00f4i g\u1eb7p ph\u1ea3i t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng?<\/li>\n<li>T\u00f4i n\u00ean trao \u0111\u1ed5i v\u1edbi ai n\u1ebfu c\u00f3 th\u1eafc m\u1eafc ho\u1eb7c g\u1eb7p ph\u1ea3i c\u00e1c v\u1ea5n \u0111\u1ec1?<\/li>\n<\/ul>\n<h2 style=\"text-align: justify;\"><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/h2>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/www.cancer.net\/navigating-cancer-care\/how-cancer-treated\/personalized-and-targeted-therapies\/understanding-pharmacogenomics\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cancer.net\/navigating-cancer-care\/how-cancer-treated\/personalized-and-targeted-therapies\/understanding-pharmacogenomics<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n nghi\u00ean c\u1ee9u v\u1ec1 c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c gi\u1eefa thu\u1ed1c v\u00e0 c\u00e1c gen di truy\u1ec1n. S\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 di truy\u1ec1n s\u1ebd c\u00f3 \u0111\u00e1p \u1ee9ng thu\u1ed1c kh\u00e1c nhau<\/p>\n","protected":false},"author":408,"featured_media":4945,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2808,2611],"tags":[2928,2929,2930,2931],"series":[1654],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hi\u1ec3u v\u1ec1 d\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"D\u01b0\u1ee3c l\u00fd h\u1ecdc di truy\u1ec1n nghi\u00ean c\u1ee9u v\u1ec1 c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c gi\u1eefa thu\u1ed1c v\u00e0 c\u00e1c gen di truy\u1ec1n. 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