Sitikudziŵa chomwe chimayambitsa khansara ya khungu , koma zinthu zomwe zimayambitsa ngozi zingaphatikizepo mtundu wa khungu ndi fuko, kutentha kwa dzuwa ndi kutentha kwa dzuwa, kutentha kwa dzuwa ndi mankhwala, zinthu zina zamankhwala kapena chithandizo cha mankhwala, ndi kusuta. Mbiri ya banja la khansara ya khungu, komanso matenda enaake a chibadwa, ingayambitse chiopsezo, ndipo zimayambira kuti zibadwa zimathandiza kwambiri kuti chitukuko cha khansa ya khansa ya khansa ya khansa iwonongeke.
Powonjezereka, zakudya zowonjezera, monga zakudya zowonjezera zipatso ndi ndiwo zamasamba, zingachepetse chiopsezo.
Zowopsa
Zowopsa zingaphatikizepo kuwonetsetsa komwe kumawononga khungu mwachindunji, zomwe zimachititsa kusintha kwa DNA (gene mutations) zomwe zingayambitse khansa. Zina mwazinthu, monga kuponderezedwa kwa chitetezo cha m'thupi, zingachepetse mphamvu ya thupi kukonzanso maselo pambuyo powonongeka. Kufunika kwa zifukwa zina zomwe zimayambitsa chiopsezo zimasiyana chifukwa cha mtundu wa khungu, ndi zina. Zomwe zimachititsa kuti khansa ya khungu ikhale ndi izi:
Zaka
Kawirikawiri, khansa ya khungu yopanda khansa ya khansa (monga basal cell carcinomas ndi squamous cell carcinomas) imakula ndi ukalamba, ngakhale kuti khansa ya khansa imapezeka achinyamata.
Khungu lamtundu, Chikhalidwe, ndi Thupi
Mankhwala a khungu angakhale ndi chiwopsezo chachikulu pa chitukuko cha khansa ya khungu, ndipo anthu omwe ali ndi khungu lokongola amakhala ndi chiopsezo chachikulu. Chifukwa cha ichi ndikuti mtundu wa pigment (wotchedwa khungu la khungu) umatetezera ku mazira a ultraviolet (UV), ndipo anthu okhala ndi khungu lakuda ali ndi melanin yambiri.
Izi zikuti, anthu omwe ali ndi khungu lililonse akhoza kuyamba khansa ya khungu, ndipo ngakhale khansara ya khungu imakhala yodziwika kwambiri mwa azungu kusiyana ndi wakuda, wakuda amatha kufa ndi matendawa. Ndipo, monga momwe khansa ya melanoma ikuchulukira mwa azungu, ikuwonjezeka ku Latinos.
Anthu omwe ali ndi ziwalo za thupi zomwe zimakhudzidwa ndi chiopsezo chachikulu ndi awa:
- Anthu omwe ali ndi phokoso.
- Amene ali ndi zikopa za khungu.
- Anthu omwe samapewa kapena kufooka.
- Amene amawotcha mosavuta.
- Anthu omwe ali ndi maso okongola, monga aatali ndi a buluu.
- Anthu omwe ali ndi tsitsi lofiira kapena lofiira (ndi tsitsi lofiira amakhala ndi chiopsezo kuposa tsitsi la tsitsi).
Sun Exposure (Natural or Tanning Booths)
Kutentha kwa dzuwa ndilo vuto lalikulu la khansa ya khungu, koma kufunika kwake kumasiyana ndi mtundu wa khansara ya khungu. Squamous cell carcinoma ndi mtundu wa khansara ya khungu yomwe imagwirizana kwambiri ndi dzuwa. Kuchuluka kwa kuwala kwa UV ultraviolet (UV) kumadalira mphamvu ya kuwala (yomwe ingasinthasane ndi dzuwa), kutalika kwake, komanso ngati khungu linali lobvala kapena chovala cha dzuwa.
Kuwotcha kwambiri kwa dzuwa ali wamng'ono, ngakhale zitangochitika kamodzi, zingakhale zoopsa kwambiri ngakhale patapita zaka zambiri. Kutentha kwa dzuwa kumagwirizana kwambiri ndi khansa ya khansa, ndipo kutentha kwa dzuwa ku thunthu la thupi kumagwirizanitsidwa ndi chiopsezo chachikulu.
Ngakhale kutentha kwa dzuŵa kumawathandiza pa mitundu yonse yayikulu ya khansara ya khungu, mtundu wa khansara umasiyana ndi momwe zimaonekera. Squamous cell carcinoma ndi basal cell carcinoma zimagwirizana kwambiri ndi nthawi yaitali, ndipo omwe amathera nthawi yambiri pantchito kapena masewera ali ndi chiopsezo chachikulu.
Mosiyana ndi zimenezi, khansa ya khansa imakhudzidwa ndi kuwala kwa dzuwa kosayembekezereka (kuganiza: kumapeto kwa nyengo yotentha).
Zakudya Zachilengedwe
Kuwonetsa mankhwala ndi zinthu zina kunyumba kapena kuntchito, kungapangitse ngozi ya khansa yapakhungu. Zinthu zomwe zimagwiridwa ndi chiopsezo chowonjezereka ndizo:
- Arsenic: Kuchokera ku madzi osamwa (makamaka zitsime zapadera) komanso kuntchito.
- Tar (monga ogwira ntchito zapamsewu).
- Parafini (sera): Mafinara amagwiritsidwa ntchito popanga magalimoto.
- Zosungunuka, makamaka zonunkhira ndi zotsekemera zowonjezera: Mwachitsanzo, ogwira ntchito zitsulo ndi omwe amapezeka kuzipinda zosindikizira, zosakaniza ndi zoyeretsa.
- Vinyl kloride (monga mafakitale omwe amapanga zinthu zowonjezera).
Kusuta
Kusuta kumagwirizanitsa ndi chiopsezo chowonjezeka cha squamous cell carcinomas khungu, koma osati basal cell carcinomas. Kafukufuku wa 2017 anapeza kuti chiopsezo cha khansa ya khansa yapachilombochi kwenikweni inali yotsika kwambiri kwa osuta fodya, koma amaganiza kuti izi zikhoza kukhala chifukwa cha kukondera (ofufuza angapeze khansa zomwe zikanadapezeka mosazindikira mwa munthu osati mu phunziro). Mosiyana ndi khansa monga khansara yamapapo, chiopsezo cha khansa yapakhungu omwe poyamba ankasuta chimataya mpaka cha osuta konse atasiya.
Khungu Matenda kapena Chithandizo Chapa Khungu
Pali zikopa zambiri za khungu zomwe zingapangitse chiopsezo chokhala ndi khansara ya khungu, kapena imawoneka kuti ndi yotetezeka. Kuphatikizanso, njira zina zochiritsira zingawononge chiopsezo cha khansa. Zina mwazo ndizo:
- Actinic keratosis : Actinic keratoses (keratoses ya dzuwa) ndi zilonda zapakhungu zofala kwambiri zomwe zimawoneka ngati zowawa, zotupa, zofanana ndi chigamba pa khungu lomwe lingakhale lofiira, lofiira, kapena lofiira. Amapezeka kwambiri m'zigawo za thupi. Sikuti onse amachititsa keratoses kuti apite ku squamous cell carcinoma khungu (ambiri samatero), koma amaganiza kuti 20 mpaka 40 peresenti ya khansa ya khungu yotchedwa squinous keratinosis imayamba ngati actinic keratosis. Ndemanga ya 2018 inanena kuti actinic keratoses m'madera ena a thupi ndizovuta kusintha kwa khansa ya khungu. Izi zimaphatikizapo keratoses pamsana kwa manja, ziwalo, miyendo, kapena maso, milomo, kapena mphuno. Mankhwala a actinic amadziwika kuti ndi ofunika kwambiri, ndipo, kwenikweni, akatswiri ena a dermatologists amakhulupirira kuti actinic keratoses angakhale mtundu wa squamous cell carcinoma wa khungu. Anthu omwe ali ndi keratoses ambiri amachitanso kuti apange kansalu ya carcinoma kapena melanoma.
- Kukhala ndi moles ambiri (oposa 50).
- Dysplastic moles (zachilendo kuoneka moles).
- Congenital melanocytic nevi: Iyi ndi yaikulu "timadontho" timene timakhalapo pamene tiberekera, ndipo khansa ya khansa ya khansa imatha kukhala pafupifupi 10 peresenti ya zilonda izi (makamaka nevi yaikulu).
- Mbiri ya kutentha kwakukulu kapena kutupa kwa khungu nthawi zina kumabweretsa khansa ya khungu.
- Psoralens kapena ultraviolet (UV) mankhwala opangira psoriasis kapena eczema angapangitse chiopsezo chokhala ndi kansa ya khungu yosalekeza.
Zinthu Zamankhwala ndi Zochiritsira
Matenda ena ali ndi chiopsezo chachikulu chokhala ndi khansara ya khungu. Izi zingaphatikizepo:
- Mbiri yakale ya khansa ya khungu. Anthu omwe ali ndi khansara ya khungu lachilombo yomwe siili ndi khansa, amakhala oposa kasanu ndi kawiri kuposa omwe amatha kupanga imodzi mwa khansa. Anthu amene ali ndi khansa ya khansa ya khansa imakhala ndi mwayi wokwanira kukhala ndi kansa ya khungu yosalekeza.
- Mankhwala ena omwe amachititsa kuti dzuwa lisamve mphamvu (photosensitivity), kuphatikizapo mankhwala enaake ochepetsa tizilombo toyambitsa matenda, kuthamanga kwa magazi kwambiri hydrochlorothiazide, ndi mankhwala enaake a mankhwala.
- Matenda a ma radiation apitala kwa khansa. Kuwonjezeka kwa chiopsezo kulipo pokhapokha m'madera omwe ma radiation analandiridwa.
- Anthu omwe ali ndi zofooka za m'thupi, kaya ali ndi cholowa kapena ali ndi HIV / AIDS.
- Matenda a papillomavirus ( HPV ). Mavuto ena a HPV angapangitse khansa m'magazi a genitalia, anus, ndi khungu kuzungulira zikhomo.
Zakudya
Ngakhale sitinadziwe za zakudya zomwe zimayambitsa khansa yapakhungu, tili ndi umboni wakuti zakudya zina zimakhala ndi chiopsezo chochepa. Kudya kwambiri zipatso ndi ndiwo zamasamba kungachepetse chiopsezo chokhala ndi khansara ya khungu .
Genetics
Mphamvu yomwe majeremusi amachititsa pakukula kwa khansa yapakhungu imatha kusiyana ndi mtundu womwewo. Zingakhale zovuta kupatulira chiopsezo chokhudzana ndi majini, ndi makhalidwe obadwa monga khungu la khungu. Kafukufuku wofanana amasonyeza kuti pafupifupi theka la chiopsezo cha munthu cha basal cell ndi squamous cell carcinomas amayamba chifukwa cha majini. Ngakhale kuti zodziwika kuti genetic mutations zidasinthika zimangokhala pafupifupi 1 peresenti ya ma melanomas, kufufuza kwa 2016 kunanena kuti mpaka 58 peresenti ya vuto la khansa ya khansa ya chiwindi imakhudzana ndi zinthu zobadwa.
Sitikukayikira ndendende momwe kukhala ndi mbiri ya banja la khansara ya khungu imayambitsa ngozi, ngakhale kuti squamous cell carcinoma ku Sweden imawoneka ngati 2 mpaka 3 pafupipafupi ngati muli ndi chiwerengero choyamba (kholo, mbale, kapena mwana ) yemwe ali ndi khansara ya khungu. Mbiri ya banja ya atypical nevus syndrome imayambitsa chiopsezo cha khansa ya khansa.
Pali syndromes yambiri yomwe imapangitsa munthu kutenga khansa yapakhungu. Zina mwazofala ndizo:
- Basal cell carcinomas: Anthu omwe ali ndi basal cell nevus syndrome ali ndi chiopsezo chachikulu chokhala ndi basal cell carcinomas (PTCH1 ndi PTCH2).
- Squamous cell carcinomas (SCC): Vuto la SCC likuwonjezeka kwa omwe ali ndi xeroderma pigmentosum, oculocutaneous albinism, epidermolysis bullosa, ndi Fanconi magazi.
- Melanoma: Matenda osokoneza bongo amtundu wa CDKN2A amachititsa pafupifupi 40 peresenti ya ma melanoma a m'banja.
> Zotsatira:
> Dusingize, J., Olsen, C., Pandeva, N. et al. Kusuta Fodya ndi Kuopsa kwa Basal Cell Carcinoma ndi Squamous Cell Carcinoma. Journal of Investigational Dermatology . 2017. 137 (8): 1700-1708.
> Mucci, L., Hjelmborg, J., Harris, J. et al. Kuopsa kwadzidzidzi komanso kufooka kwa khansa pakati pa mapasa awiri m'mayiko a ku Nordic. JAMA . 315 (1): 68-76.
> National Cancer Institute. Genetics of Cancer Cancer (PDQ) -Health Professional Version. Kusinthidwa 02/22/18.
> Ng, C., Yen, H., Hsiao, H., ndi S. Su. Zakudya za Phytochemicals mu Khansara Yopeweratu ndi Chithandizo: Zomwe Zasinthidwa. International Journal of Molecular Sciences . 2018. 19 (4) .pii: E941.
> Richard, M., Amici, J., Basset-Seguin, N. et al. Kulamulira kwa Actinic Keratosis M'malo Odziwika Amodzi Pakati pa Odwala Pangozi Zambiri za Zilonda za Carcinoma: Zogwirizana ndi akatswiri a AKTeam of Expert Clinicians. Journal of European Academy of Dermatology and Venereology . 2018. 32 (3): 339-346.