Ènya nu tso Cholangiocarcinoma ŋua? Mina míaƒo nu tso eŋu bɔbɔe.

Ðe vevesese wɔnuku aɖe nɔ ŋuwò kpɔ le wò dɔgbo ƒe ɖusime, wò akɔta te, wò ŋutigbalẽ kple ŋkuwo ƒe ɣie (abe jaundice ene), alo gbɔdzɔgbɔdzɔ ƒe seselelãme le afisiafi ko kpɔa? Togbɔ be nusiawo adze abe nusiwo bɔ ene hã la, ɣeaɖewoɣi la, susu vevi aɖe ate ŋu anɔ megbe na wo. Egbea míele nu ƒom tso kansa ƒomevi aɖe si mebɔ o gake ate ŋu anye afɔku gã aɖe ŋu. Emae nye ʋumenugbagbeviɣidɔ, si woyɔna le atikewɔwɔ me be Cholangiocarcinoma .

Kpuie ko la, nukae nye cholangiocarcinoma?

Enyo, mina míakpɔ nusiwo nye ʋumenugbagbeviɣidɔlékui siawo ɖa gbã. Bu eŋu kpɔ, míaƒe aklã wɔa tsi si woyɔna be "bile". Esia kpena ɖe ame ŋu ŋutɔ le nuɖuɖu siwo me ami le ɖuɖu me. Eyata woyɔa mɔ̃ suesuesue siwo tsɔa ʋumenugbagbeviɣi sia tso aklã me yia míaƒe dɔgbo suea me ƒe ɖoɖo be ʋumenugbagbeviɣimɔ̃wo .

Cholangiocarcinoma nye kansa si dzea egɔme tso ʋumenugbagbevi dzĩwo me.

Esia nye kansa ƒomevi aɖe si nu sẽ vie. Nublanuinyae nye be zi geɖe la, kaka woakpɔ kansa sia la, ekaka ɖe ʋukawo godo xoxo. Le nɔnɔme sia tɔgbe me la, atikewɔwɔ sesẽna ŋutɔ, eye ŋgɔdonya menyo o. Gake mègatsi dzi o, ɖɔktawo kple dzɔdzɔmeŋutinunyalawo le atike yeye siwo ate ŋu axe mɔ ɖe kansa sia ƒe kaka nu eye woana dɔnɔwo nanɔ agbe nyuie la dim ɣesiaɣi.

Nukawoe nye kansa sia ƒomevi vevitɔwo?

Woma ʋumenugbagbeviɣidɔlékuiwo ɖe hatsotso vevi etɔ̃ me le afisi wòle nu:

1. Intrahepatic cholangiocarcinoma: Esia dzɔna le ʋumenugbagbevi sue siwo le aklãa me me .

2. Perihilar/hilar cholangiocarcinoma: Esiae nye ƒomevi si bɔ wu. Etsina le hilum gbɔ, afisi ʋumenugbagbeviɣiwo dona le aklãa me le. Wogayɔnae be Klatskin ƒe dɔdzẽ .

3. Distal cholangiocarcinoma: Esia ƒomevi dzɔna le ʋuka siwo le aklãa godo, siwo te ɖe dɔgbo suea ŋu la me.

Woyɔa ƒomevi 2 kple 3 siaa be extrahepatic bile duct cancers . Eyae nye be kansa siwo dona "le aklãa godo."

Nukawoe ate ŋu anye dɔléle sia ƒe dzesiwo?

Zi geɖe la, dzesi aɖeke medzena le eŋu o vaseɖe esime kansa la lolo ŋutɔ eye wòxea ʋuka aɖe. Ne dzesiwo dze ƒã la, àte ŋu ade dzesi nu siawo tɔgbe.

Le eƒe gɔmedzedze la, kansa sia mesea veve o. Gake ne dɔdzẽa le tsitsim la, vevesese ate ŋu adzɔ le ƒodoa ƒe ɖusime. Le ame aɖewo gome la, vevesese sia ate ŋu akaka ɖe ƒodo ƒe akpa bubuwo alo akɔta gɔ̃ hã.

Nukawoe nye nusiwo gbɔ kansa sia xɔxɔ tsona kple afɔku siwo le eme?

Womeke ɖe nusi tututu gbɔ kansa sia tso ŋu haɖe o. Gake woxɔe se be dɔdzẽ si nɔa anyi didi , si nye dɔdzẽ ƒe nɔnɔmewo, le ʋumenugbagbeviɣiwo me ate ŋu anye nu vevitɔ si gbɔ wòtsona.

Kpuie ko la, nusiwo gblẽa nu le ame ŋu atraɖii ate ŋu agblẽ nu le ʋumenugbagbevi dzĩwo ƒe DNA ŋu. DNA le abe "ɖoɖo gã" si gblɔa alesi míaƒe lãmenugbagbeviwo awɔ dɔe ene. Ne DNA sia gblẽ la, lãmenugbagbeviwo ate ŋu adze mama gɔme le mɔ si dzi womate ŋu aɖu o nu, si ana kansa ƒe dɔdzẽwo nado.

Nu geɖe li siwo nana esia ƒe afɔkua dzina ɖe edzi:

• Dɔléle siwo do ƒome kple ʋumenugbagbeviɣiwo: Nɔnɔmewo abe ʋumenugbagbeviɣiwo, ʋumenugbagbeviɣiwo ƒe kpewo, kple `Primary sclerosing cholangitis` (dɔléle si me ʋumenugbagbeviɣiwo va le kpuie eye woxena).
• Aklãdɔlélewo: Cirrhosis (aklã ƒe abi), Hepatitis B alo Hepatitis C dɔlékuiwo ƒe dɔlékuiwo.
• Atikewɔwɔ ƒe nɔnɔme bubuwo: Dɔgbo ƒe dɔléle si nɔa anyi didi, Dɔgbo ƒe dɔléle (IBD), Suklidɔ.
• Agbenɔnɔ ƒe nɔnɔmewo: ahatsunono fũ, lolo akpa, atamanono.
• Dɔlékuiwo ƒe dɔlékuiwo: Dɔlékuiwo ƒe dɔléle si woyɔna be `Clonorchiasis` bɔ vevietɔ le Anyieheɣedzeƒe Asia dukɔwo me.
• Atike siwo me aɖi le ƒe amedzidzedze: Atike aɖewo, vevietɔ esiwo wozãna le rababa alo ʋuwɔƒewo.

Aleke ɖɔkta awɔ anya dɔléle siae?

Ne èyi ɖɔkta gbɔ la, aɖo to wò dzesiwo nyuie gbã, awɔ wò atikewɔwɔ ŋutinya, eye wòado wò ŋutilã kpɔ. Emegbe ne wosusu be kansa le ame ŋu la, woate ŋu aɖo aɖaŋu be woawɔ dodokpɔ geɖe, abe:

Ʋudodokpɔwo

• Aklã ƒe dɔwɔwɔ dodokpɔ: Esiawo ate ŋu ana woakpɔ alesi aklãa le dɔ wɔm nyuie. Ne ʋukawo xe la, enzyme aɖewo (`aklã ƒe enzymes`) ƒe agbɔsɔsɔ le ʋua me adzi ɖe edzi.
• Tumor marker tests: Dodokpɔ siwo dzidzea nu aɖewo (tumor markers) siwo dzina ɖe edzi le ʋua me ne kansa le ame ŋu. `CA 19-9` kple `CEA` nye dzesi eve siwo ateŋu adzi ɖe edzi le kansa ƒomevi sia me.

Nɔnɔmetatawo Ƒe Dodokpɔwo

• Zi geɖe la, wowɔa ƒodo ƒe ultrasound scan gbã.
• Tsɔ kpe ɖe eŋu la, woate ŋu awɔ CT scan alo MRI scan . Magnetic resonance cholangiopancreatography (MRCP) nye MRI ƒomevi tɔxɛ aɖe si te ŋu kpɔa ʋukawo ƒe dɔwɔwɔ nyuie.

Dodokpɔ Siwo Wowɔna To Dɔlékuiwo Me

Esia bia be nàde mɔ̃ tsɛ aɖe si te ŋu trɔna bɔbɔe (endoscope) si me fotoɖemɔ̃ le to wò nu me, atsɔe ato wò dɔgbo me ayi wò dɔgbo suea me, afisi ʋumenugbagbeviɣiwo ʋuna le, eye nàlé ŋku ɖe teƒea ŋu nyuie. Woana atike si naa ame ƒe dzi dzea eme le dɔ sia wɔwɔ me, eyata màse veve aɖeke o. Endoscopic retrograde cholangiopancreatography (ERCP) nye dodokpɔ si bɔ.

Biopsy ƒe dɔwɔwɔ

Le afisia la, woɖea lãkusi sue aɖe ŋutɔ tso teƒe si ŋu ɖikeke le eye wodonɛ kpɔ le nusuekpɔmɔ̃ me. Woate ŋu akpɔ lãkusi sia le ERCP ƒe dɔwɔwɔ me. Woate ŋu ado lãkusi sia kpɔ gɔ̃ hã be domenyiŋusẽfianu ƒe tɔtrɔ (biomarkers) le kansa lãmenugbagbeviwo me hã. Esia ate ŋu akpe ɖe ame ŋu hã be woanya nenye be woate ŋu ana "atikewɔwɔ si ŋu woɖo taɖodzinu ɖo" koŋ ame aɖewo.

Nukae nye kansa ƒe afɔɖeɖewo kple eƒe atikewɔwɔ?

Ne wonya de dzesi dɔlélea ko la, míenyaa afisi kansa la le be míanya afisi wòkaka ɖo le ŋutilãa me. Esia le vevie ŋutɔ le ɖoɖowɔwɔ ɖe atikewɔwɔ ŋu me. Zi geɖe la, wodae ɖe akpa 0 va ɖo 4. Akpa 4 lia fia be kansa la kaka to ʋukawo me yi ŋutilã ƒe akpa siwo le didiƒe (metastatic).

Wokpɔa atikewɔwɔmɔnu si woazã le afisi kansa la le, afisi wòle, kple dɔnɔa ƒe lãmesẽ bliboa dzi.

• Amekoko: Ne kansa mekaka o la, amekokoe nye atike nyuitɔ kekeake si dzi woato aɖe kansa la kple lãmenugbagbevi siwo ƒo xlãe ɖa keŋkeŋ. Ɣeaɖewoɣi la, wozãa amekoko hã tsɔ dea ʋuka si me ʋu sina tona be ʋuka si xe la nanɔ ʋuʋu ɖi.
• Aklã dodo: Aklã dodo nye mɔnukpɔkpɔ nyui aɖe be woada kansa aɖewo siwo le perihilar ƒe gɔmedzedze.
• Kekeli ƒe atikewɔwɔ: Ezãa keklẽŋusẽ si me ŋusẽ geɖe le tsɔ tsrɔ̃a kansa lãmenugbagbeviwo alo ɖea dɔdzẽwo dzi kpɔtɔna.
• Atikewɔwɔ: Atike siwo wua kansadɔlékuiwo nana ŋutilãa.
• Atikewɔwɔ si woɖo taɖodzinu na: Esia bia be woana atike siwo tɔa ŋku protein tɔxɛ siwo kpena ɖe kansa lãmenugbagbeviwo ŋu be woatsi eye woadzudzɔ woƒe dɔwɔwɔ.
• Dɔlélenutsiŋutete ƒe atikewɔwɔ: Atike siwo doa ŋusẽ míaƒe ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete eye wokpena ɖe eŋu wòwɔa avu kple kansa lãmenugbagbeviwo nana.

Ðe mɔ aɖewo li siwo dzi nàto akpɔ ɖokuiwò ta tso dɔléle sia mea?

Mɔ aɖeke meli si dzi woato axe mɔ ɖe kansa sia ƒe dzɔdzɔ nu 100% o. Gake míate ŋu aɖe afɔkua dzi akpɔtɔ ne míena míaƒe aklã kple ʋumenugbagbeviɣiwo nanɔ lãmesẽ me.

• Takpɔ ɖokuiwò ta tso dɔlékuiwo abe Aklãdɔléle B, Aklãdɔléle C, kple HIV dɔlékuiwo me (e.g., xɔ Aklãdɔléle B ƒe atike, wɔ ɖe dedienɔnɔ ƒe ɖoɖowo dzi)
• Ƒo asa na ahanono fũu akpa.
• Na wò kpekpeme nanɔ lãmesẽ me.
• Ƒo asa na atamanono keŋkeŋ.

Enye nyateƒe be cholangiocarcinoma nye dɔléle sesẽ aɖe ŋutɔ. Gake ne míenyae, míenya nu tso afɔku siwo ate ŋu ado tso eme ŋu ne woli, eye ne míeyi ɖɔkta gbɔ ne dzesi ɖesiaɖe si mebɔ o do mo ɖa ko la, doa ŋusẽ mí ŋutɔ be míawɔ avu kple dɔléle sia. Wò ɖɔktae nye amesi ate ŋu aɖo aɖaŋu kple atikewɔwɔ nyuitɔ kekeake na wò.