Sitikudziŵa zomwe zimayambitsa khansa ya chiwindi, koma ziopsezo zimaphatikizapo kumwa mowa mopitirira muyeso, kusuta fodya, matenda a chiwindi monga chiwindi cha hepatitis B ndi hepatitis C, zina zamankhwala ndi mabadwa, ndi zina. Popeza palibe kuyesa kansa ya chiwindi pakadali pano, kudziŵa zoopsa zanu komanso kudziwa zizindikiro ndi njira yabwino kwambiri yopezera khansa ya chiwindi m'mayendedwe akale, ochiritsira kwambiri.
Khansara ya chiwindi ingakhudze ana ndi akulu koma imapezeka nthawi zambiri mwa akuluakulu. Pali mitundu yambiri ya khansa ya chiwindi , koma zoopsa zomwe zili pansipa zimatengera khansa yaikulu ya chiwindi, yotchedwa hepatocellular carcinoma ndi kansa ya khansa (cholangiocarcinoma). Kafukufuku apeza kuti khansa ya chiwindi ndi khansara ya khansa ya padziko lapansi ikukula padziko lonse lapansi, ndipo imayambitsa matenda a khansa m'madera ena.
Zowopsa Zowopsa
Khansara imayamba pamene mndandanda wa majini a kusintha kwa jini amachititsa kuti selo likhale losalamulirika. Momwe izi zimachitikira khansa ya chiwindi sikutsimikiziridwa, koma njira zingapo zapangidwira. Chimene chikudziwika ndi chakuti zifukwa zingapo zimapangitsa munthu kutenga chiopsezo chotenga matendawa. Ena a iwo amachita zimenezi mozama, pamene ena akhoza kuika chiopsezo chochepa pokhapokha. Palinso zifukwa zina zomwe zingawonongeke, ngakhale akatswiri sakudziwa ngati alidi ofanana.
Ndikofunika kuzindikira kuti kukhala ndi chiopsezo cha khansa ya chiwindi sikukutanthauza kuti mudzakhala ndi matendawa.
Nthawi zambiri zimagwirizanitsa ntchito zomwe zimabweretsa chitukuko. Zomwe zingakhale zovuta zowonjezera zingakhale zowonjezereka, koma zingakhalenso kuchuluka, monga mowa ndi kusuta fodya kapena matenda a chiwindi ndi kusuta. Koma, anthu angakhalenso ndi khansa ya chiwindi pamene alibe zidziwitso zomwe zimadziwika kuti ndizoopsa.
Zizindikiro zomwe zimadziwika ndi izi:
Mipikisano ndi Kugonana
Anthu a ku Asia ndi Pacific akukhala ndi khansa ya chiwindi nthawi zambiri kusiyana ndi anthu a mafuko ena, makamaka chifukwa cha mliri wa chiwindi mwa zigawozi. Anthu a ku Caucasus amakhala ndi khansa ya chiwindi nthawi zambiri, koma matendawa akuwoneka akuwonjezeka. Khansara ya chiwindi ndi yowonjezereka kwambiri mwa amuna kuposa akazi, ngakhale zifukwa siziri zomveka bwino.
Matenda a Chiwindi A
Kudwala matenda a chiwindi ndi matenda a chiwindi ndi omwe amachititsa kuti chiwindi cha chiwindi chizikula komanso chimayambitsa khansa ya chiwindi ku Africa ndi Asia. Pafupifupi 95 peresenti ya anthu amachiza kachilombo kamene ali ndi kachirombo ka HIV, koma pafupifupi 5 peresenti amakhala odwala matendawa. Ndi anthu awa omwe ali pachiopsezo cha chiwopsezo cha khansa ya chiwindi, ngakhale anthu ena omwe ali ndi matenda aakulu a chiwindi a B ali pachiopsezo chachikulu kuposa ena.
Mankhwala amapezeka, koma anthu ambiri sakudziwa kuti ali ndi kachilomboka kapena amakhala m'dera limene chithandizo chamankhwala sichitha. Kwachidziwikire, othandizira matenda a chiwindi a B odwala matenda a chiwindi ndi maulendo 100 omwe amakhala ndi khansa ya chiwindi, ndipo 2.5 peresenti ya anthu omwe ali ndi matenda a chiwindi chifukwa cha chiwindi cha B (ndi 0.5 mpaka 1 peresenti ya anthu omwe alibe chiwindi) adzakula matendawa chaka chilichonse.
Matenda a Chiwindi a Chiwindi
Chiwindi cha matenda a chiwindi ndichinthu chachikulu chomwe chimayambitsa chiwindi cha khansa ya chiwindi ndipo panopa chimayambitsa khansa ya chiwindi ku United States, Europe, ndi Japan. Mosiyana ndi matenda a hepatitis B, anthu ambiri samatulutsa kachilomboka, ndipo amakhala matenda opitirira. Pafupifupi 10 mpaka 30 peresenti ya anthu omwe ali ndi kachirombo ka HIV amayamba kukhala ndi chiwindi.
N'zomvetsa chisoni kuti anthu ambiri sakudziwa kuti ali ndi kachilombo ka HIV, ndipo akulimbikitsidwa kuti akuluakulu onse a ku America omwe anabadwa pakati pa 1945 ndi 1965 ayesedwe. Pamene matenda a hepatitis C amapezeka komanso amachiritsidwa ndi mankhwala oletsa tizilombo toyambitsa matenda, chiopsezo cha matenda a chiwindi, ndipo mwina khansa ya chiwindi ingachepe kwambiri.
Matenda Osakhala Oledzera Matenda a Chiwindi (NAFLD)
Matenda omwe si oledzeretsa a chiwindi ndi chikhalidwe chofanana ndi chiwindi cha chiwindi, koma amachititsa mafuta ochuluka m'chiwindi (mafuta) chiwindi mwa njira yosiyana. Zimaganiziridwa kuti ndi matenda omwe amachititsa kuti thupi likhale lokha. Ndi NAFLD, chiopsezo cha khansa ya chiwindi chimakhala chapamwamba kwambiri kuposa anthu ambiri. Matenda ofanana kwambiri, amadzimadzi angakhalenso chiwopsezo cha khansa ya chiwindi.
Kugonjetsa
Kugonjetsa anthu kumawonjezera chiopsezo cha khansa ya chiwindi, komanso khansa zina. Kukhala ndi HIV / Edzi kumagwirizanitsidwa ndi chiopsezo chachikulu chokhala ndi khansa ya chiwindi. Kuwombola kwa thupi kumakhala kowonjezera kaŵirikaŵiri kokhala ndi khansa ya chiwindi monga anthu ambiri, ndipo chiopsezo chimakhala chokwanira kwambiri kwa iwo omwe alandira chiwindi cha chiwindi.
Lupus ( Lupus Erythematosus )
Chifukwa chake sichidziwika, koma anthu omwe ali ndi lupus ndi opitirira kawiri kuti akhoza kukhala ndi khansa ya chiwindi.
Matenda a shuga
Anthu omwe ali ndi shuga amakhala ndi chiopsezo cha khansa ya chiwindi kawiri kapena katatu kusiyana ndi anthu ambiri. Chochititsa chidwi, zikuwoneka kuti mankhwala a shuga a glucophage (metformin) angachepetse ngoziyi.
Maonekedwe a Chemical (ndi Occupational Risk)
Mankhwala ambiri amachititsa kuti chiwerengero cha khansa ya chiwindi chizikulirakulira ndipo akhoza kukhala ndi khansa .
Chiwonetsero chimodzi chomwe anthu ambiri angakumane nacho ndi arsenic m'madzi abwino. Zochita zapantchito zimakhudzidwanso, kuphatikizapo kupezeka kwa vinyl chloride (yomwe imapezeka m'mapulasitiki), acrylamide, PFOA kapena perfluorooctanoic acid (yomwe imapezeka njira zowuma), mabiphenyls amadzimadzimadzi (PCBs), mankhwala opangidwa ndi mafuta opangira mafuta (PFCs), benzo (a) pyrene ( BaP), ndi trichlorethylene.
Sclerosing Cholangitis
Sclerosing cholangitis ndi matenda aakulu a chiwindi omwe amawoneka ndi kutupa kwa m'mimba (monga Crohn's disease yomwe imaphatikizapo colon ndi ulcerative colitis). Sclerosing cholangitis imayambitsa kutupa ndi kupweteka kwa mankhwala a bile monga kuti bile amatha kulowa m'chiwindi chomwe chimapweteka pamenepo. Zimaganiziridwa kuti 10 peresenti mpaka 15 peresenti ya anthu omwe ali ndi matendawa adzakhala ndi cholangiocarcinoma (kansa ya khansa).
Aflatoxin Exposure
Ngakhale kuti chiopsezo chachikulu ku United States, ichi ndi chofunikira kwambiri padziko lonse lapansi. Aflatoxin B1 ndi poizoni wopangidwa ndi bowa (wa mtundu wa Aspergillus) womwe umamera pa zakudya monga tirigu, nkhanu, mtedza wina, soya, ndi chimanga. Toxin imawononga p53 jini mu maselo a chiwindi- chotupa chogonjetsa jini chomwe chimathandiza kukonza DNA yowonongeka ndi kulepheretsa kukula kwa maselo owopsa. Kafukufuku akupitirirabe ndipo maphunziro akufufuza ngati aflatoxin imayambitsa kansa ya chiwindi yekha kapena ngati yogwirizana ndi matenda a chiwindi.
Malamulo ndi zakudya zoyesa kudya zimakhala zosavuta kuwonetsa izi ku United States, kupyolera poyera ndi poizoni ndizofala padziko lonse lapansi. Poizoni nthawi zambiri amapezeka mu zakudya zosasungidwa bwino, kawirikawiri m'madera otentha ndi otentha. Anthu oyenda ku America kupita kumadera otere sayenera kudandaula, komabe-akuganiza kuti kuwonetsetsa kwa nthawi yaitali kumachititsa khansa ya chiwindi.
Genetics
Khansara ya chiwindi ikhoza kuyenda m'mabanja (ngakhale popanda matenda odziwika bwino), ndipo kukhala ndi wachibale ndi matenda (kumbali zonse) kumawonjezera chiopsezo chanu. Chiopsezo chachikulu kwambiri ngati chiri choyambirira cha digiri monga kholo, mbale, kapena mwana.
Matenda ena omwe amadziwika kuti ali ndi matenda amtunduwu amakhudzanso zoopsa, monga:
Hemochromatosis
Hereditary hemochromatosis (matenda achitsulo chowopsa) ndi chikhalidwe chomwe chimawoneka kuti thupi limakula ndi kusungirako chitsulo, nthawi zambiri m'chiwindi. M'kupita kwa nthaŵi, matendawa amachititsa kuti matenda a chiwindi ndi chiwindi asagonje (komanso mavuto ena azachipatala).
Kuopsa kwa chiwindi cha chiwindi mwa anthu omwe ali ndi hemochromatosis nthawi makumi asanu ndi limodzi kuposa anthu ambiri. Kuchiza (nthawi ndi nthawi kuchotsa magazi) kungachepetse mavuto, koma anthu ambiri sadziwa kuti ali ndi vuto mpaka atakula. Zikuganiza kuti anthu 1 miliyoni ku United States amakhudzidwa ndi mtundu umodzi wa hemochromatosis.
Kuchulukitsa kwapakati pa Biliary Cirrhosis
Matenda oyambirira a biliary cirrhosis ndi chikhalidwe chomwe chikuwoneka kuti chiri ndi chigawo choyambirira, monga chimayambira m'mabanja. Ndi matenda opitirira, omwe amadzimadzimadzi omwe amakhala ndi chiwindi, omwe amachititsa kuti chiwindi chiwonongeke komanso kuwonongeka kwa chiwindi. Matenda oyambirira a biliary cirrhosis amagwiritsidwa ntchito ndi chiopsezo chachikulu cha khansa ya chiwindi, yofanana ndi yomwe imapezeka mwa anthu omwe ali ndi matenda a chiwindi a C.
Matenda a Wilson
Matenda a Wilson ndi matenda osadziwika a majeremusi omwe amadziwika ndi kusungunula mkuwa m'thupi ndipo amalingalira kuti ndi chiwopsezo cha khansa ya chiwindi.
Matenda Ena Osungulumwa
Matenda ena obadwa nawo omwe angapangitse chiopsezo cha khansa ya chiwindi ndi alpha-1 antitrypsin yosowa, tyrosinemia, porphyria cutanea tarda, ndi matenda osungirako glycogen.
Zochitika Zowopsa Kwamoyo
Zochitika pa moyo ndizofunikira pakukula kwa khansa ya chiwindi. Ngakhale simungathe kulamulira zinthu zambiri zomwe zimatchulidwa pamwambapa, muli ndi mphamvu zowononga izi.
Kugwiritsa Ntchito Mowa Mopitirira Muyeso, Kwa Nthawi Yaitali
Kuwonjezera mowa, kumwa mowa kwa nthawi yaitali kungayambitse matenda ambiri a chiwindi, kuphatikizapo chiwindi cha chiwindi ndi matenda a chiwindi. M'kupita kwa nthawi, matenda a chiwindi amayamba ndi chifuwa chachikulu cha chiwindi, ndipo nthawi zambiri chiwindi chimatha. Khansa ya chiwindi imakhudzana kwambiri ndi kumwa mowa kwambiri, kapena kumwa zakumwa zopitirira zitatu tsiku ndi tsiku, ngakhale kuti kuchepera kwapang'ono kungayambitse matenda aakulu a chiwindi.
Mowa mwauchidakwa, ngakhale kuti sagwirizanitsidwa ndi khansa ya chiwindi pamapeto pake, ukhoza kuonjezera chiopsezo cha makhalidwe omwe akupezeka ndi matenda a hepatitis B kapena C.
Kusuta
Kusuta ndi chinthu choopsa kwa khansa zambiri , komanso khansa ya chiwindi ndi yosiyana. Kafukufuku wambiri amasonyeza kugwirizana pakati pa kusuta ndi khansa ya chiwindi, ndipo onse amene amasuta ndi kumwa kwambiri amakhala ndi chiopsezo chachikulu cha matendawa.
Ana omwe abadwa ndi makolo amene amasuta ngakhale asanakhalepo kapena pamene ali ndi pakati ali pangozi yowopsa ya khansa ya chiwindi yotchedwa hepatoblastoma.
Kunenepa kwambiri
Udindo wa kunenepa kwambiri mu khansa ya chiwindi sikutsimikizirika ndi wekha, koma kunenepa kumawonjezera chiopsezo chokhala ndi matenda osabisa chiwindi, omwe amachititsa katatu chiopsezo cha khansa ya chiwindi, komanso matenda a shuga, omwe amakhala ndi chiwopsezo katatu.
Kugwiritsa Ntchito Saboid Anabolic
Ma steroids a antibolic, monga omwe amagwiritsidwa ntchito ndi weightlifters, ndiwo chiwopsezo cha matenda a chiwindi ndi khansa ya chiwindi.
Kuthamanga Betel Quid
Kawirikawiri ku United States, kutcha betel quid ndi chiwopsezo cha khansa ya chiwindi m'madera momwe izi zimachitika.
Zinthu Zowopsa Kwambiri
Pali umboni wina wosonyeza kuti kuchotsa ndulu (cholecystectomy) kumawonjezera ngozi, ngakhale asayansi sakudziwa za kugwirizana kwake.
Lamuloli likuwonanso ngati pali chiopsezo chachikulu chokhudzana ndi kugwiritsa ntchito mapiritsi oletsa kubereka.
Zikuganiza kuti pali zoopsa zina zogwiritsidwa ntchito ndi mankhwala omwe amawopsa kwambiri (monga CT scans of the stoma), koma chiopsezo choterechi chikhoza kuchepetsedwa kwambiri ndi ubwino wa mankhwalawa.
Tizilombo toyambitsa matenda tomwe timayambitsa matenda a schistosomiasiti taphunzira kuti akhoza kutenga khansa ya chiwindi. M'malo mokhala chiopsezo, zimaganiziridwa kuti ndizogwirizana pa khansa ya chiwindi yokhudzana ndi matenda a hepatitis B ndi C.
> Zotsatira:
> American Cancer Society. Kodi Timadziwa Chimene Chimachititsa Khansa? Kusinthidwa 04/28/16. https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/what-causes.html
> Erkekoglu, P., Oral, D., Chao, M., ndi B. Kocer-Gumusel. Hepatocellular Carcinoma ndi Zomwe Zingatheke Zachilengedwe ndi Zachilengedwe Zomwe Zimayambitsa: Kubwereza. Journal of Environmental Pathology, Toxicology, ndi Oncology . 2017. 36 (2): 171-190.
> Jiang, K., ndi B. Centeno. Matenda a Chiwindi Chapachiyambi, Gawo 2: Njira Zowonjezera ndi Carcinogenesis. Kansa Control . 2018. 2191): 10732748177444658.
> National Cancer Institute. Primary Primary Cancer Treatment (PDQ) -Health Professional Version. Kusinthidwa -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
Smith, J., Kroker-Lobos, M., Lazo, M. et al. Aflatoxin ndi Viral Hepatitis Exposures ku Guatemala: Maselo Amadzimadzi Amatsenga Zinthu Zowopsa Kwambiri ku Chigawo cha High Liver Cancer Incidence. PLoS One . 2017. 12 (12): e0189255.