Ngaba uyayazi iCholangiocarcinoma? Makhe sithethe ngayo ngokulula.

Ngaba wakha waba nentlungu engaqhelekanga kwicala lasekunene lesisu sakho, phantsi kweembambo zakho, ukutyheli kolusu lwakho namehlo (njenge-jaundice), okanye ukuziva nje ubuthathaka? Nangona ezi zinto zinokubonakala ngathi zizinto eziqhelekileyo, ngamanye amaxesha kunokubakho isizathu esinzulu emva kwazo. Namhlanje siza kuthetha ngohlobo lomhlaza olungaqhelekanga kodwa olunokuba yingozi kakhulu. Lo ngumhlaza we-bile duct, owaziwa ngokwezonyango njengeCholangiocarcinoma .

Ngamafutshane, yintoni i-cholangiocarcinoma?

Kulungile, masiqale sibone ukuba zeziphi ezi ducts zenyongo. Khawuthelekelele, isibindi sethu sivelisa ulwelo olubizwa ngokuba yi "bile". Oku kunceda kakhulu ekugayeni ukutya okunamafutha. Ngoko ke, inkqubo yeetyhubhu ezincinci ezithwala le nyongo ukusuka esibindini ukuya emathunjini ethu amancinci ibizwa ngokuba yi-bile ducts .

I-Cholangiocarcinoma ngumhlaza oqala kwiiseli zenkqubo ye-bile duct.

Olu luhlobo lomhlaza olunobundlongondlongo . Into ebuhlungu kukuba uninzi lwexesha, xa lo mhlaza ufunyaniswa, sele usasazeke ngaphaya kwemibhobho yenyongo. Kwimeko enjalo, unyango lunzima kakhulu, kwaye ingqikelelo ayilunganga. Kodwa ungakhathazeki, oogqirha kunye nososayensi bahlala befumana unyango olutsha olunokulawula ukusasazeka kwalo mhlaza kwaye lunike izigulane ubomi obungcono.

Ziziphi iintlobo eziphambili zalo mhlaza?

Umhlaza we-bile duct wahlulwe waba ziintlobo ezintathu eziphambili ngokusekwe kwindawo okuyo:

1. I-Intrahepatic cholangiocarcinoma: Oku kwenzeka kwimibhobho yenyongo emincinci esibindini .

2. I-Perihilar/hilar cholangiocarcinoma: Olu lolona hlobo luxhaphakileyo. Lukhula kufutshane ne-hilum, apho imibhobho yenyongo iphuma khona esibindini. Ikwabizwa ngokuba yi-Klatskin tumor .

3. I-Distal cholangiocarcinoma: Olu hlobo lukhula kwimibhobho yenyongo engaphandle kwesibindi, kufutshane namathumbu amancinci.

Zombini iintlobo 2 kunye no-3 zibizwa ngokuba zi- extrahepatic bile duct cancers . Oko kukuthi, ii-cancers ezikhula "ngaphandle kwesibindi."

Zingaba yintoni iimpawu zesi sifo?

Ixesha elininzi, akukho zimpawu zibonakalayo de umhlaza ube mkhulu kakhulu kwaye uvale umbhobho wenyongo. Xa kuvela iimpawu, unokubona izinto ezinje.

Kwinqanaba lokuqala, lo mhlaza awubangeli ntlungu. Nangona kunjalo, njengoko ithumba likhula, intlungu inokubakho kwicala lasekunene lesisu. Kwabanye abantu, le ntlungu inokusasazeka kwezinye iindawo zesisu okanye nangasemva.

Zithini izizathu kunye nezinto ezibangela ukuba kubekho lo mhlaza?

Unobangela ochanekileyo walo mhlaza awukafunyanwa. Nangona kunjalo, kukholelwa ukuba ukudumba okungapheliyo , oko kukuthi, iimeko zokudumba, kwimibhobho yenyongo, kunokuba yimbangela enkulu.

Ngamafutshane, umonakalo oqhubekayo unokonakalisa i-DNA yeeseli ze-bile duct. I-DNA ifana "nesicwangciso esiphambili" esixelela iiseli zethu indlela yokusebenza. Xa le DNA yonakele, iiseli zinokuqala ukwahlukana ngokungalawulekiyo, nto leyo ekhokelela ekudalweni kweethumba ezinomhlaza.

Kukho izinto ezininzi ezandisa umngcipheko woku:

• Izifo ezinxulumene nemijelo yenyongo: Iimeko ezinje ngamatye enyongo, amatye emijelo yenyongo, kunye ne-'Primary sclerosing cholangitis' (isifo apho imijelo yenyongo iba mxinwa ize ivaleke).
• Izifo zesibindi: I-Cirrhosis (ukudumba kwesibindi), i-Hepatitis B okanye i-Hepatitis C yosulelo lwentsholongwane.
• Ezinye iimeko zonyango: I-ulcerative colitis engapheliyo, isifo samathumbu esidumbileyo (IBD), isifo seswekile.
• Izinto ezibangela indlela yokuphila: ukusela utywala kakhulu, ukutyeba kakhulu, ukutshaya.
• Usulelo olubangelwa ziincukuthu: Usulelo olubangelwa ziincukuthu olubizwa ngokuba yi-'Clonorchiasis' luxhaphake kakhulu kumazwe akuMzantsi-mpuma we-Asia.
• Ukuvezwa kwiikhemikhali ezinobungozi: Ezinye iikhemikhali, ingakumbi ezo zisetyenziswa kwiifektri zerabha okanye zeemoto.

Ugqirha uxilonga njani esi sifo?

Xa ubona ugqirha, uya kuqala amamele ngononophelo iimpawu zakho, athathe imbali yakho yezonyango, aze enze uvavanyo lomzimba. Emva koko, ukuba kukho umhlaza orhanelwayo, banokucebisa uvavanyo oluninzi, olufana nolu:

Uvavanyo lwegazi

• Uvavanyo lokusebenza kwesibindi: Olu vavanyo lunokunika umbono wokuba isibindi sisebenza kakuhle kangakanani. Ukuba imibhobho yenyongo ivaliwe, amanqanaba eeenzyme ezithile ('iienzyme zesibindi') egazini aya kunyuka.
• Uvavanyo lweempawu zethumba: Uvavanyo olulinganisa izinto ezithile (izimpawu zethumba) ezinyuka egazini xa kukho umhlaza. `CA 19-9` kunye ne`CEA` zizibonakaliso ezimbini ezinokwanda kolu hlobo lomhlaza.

Uvavanyo lokuFanekisa

• I- ultrasound yesisu idla ngokwenziwa kuqala.
• Ukongeza, kunokwenziwa i -CT scan okanye i-MRI scan . I-Magnetic resonance cholangiopancreatography (MRCP) luhlobo olukhethekileyo lwe-MRI olunokuyibona ngokucacileyo inkqubo ye-bile duct.

Uvavanyo lwe-Endoscopic

Oku kuquka ukufaka ityhubhu encinci neguquguqukayo (i-endoscope) enekhamera enamathele emlonyeni wakho, uyidlulise esiswini sakho uye emathunjini amancinci, apho imibhobho yenyongo ivuleka khona, kwaye uhlolisise indawo ngononophelo. Uza kuthomalaliswa ngexesha lale nkqubo, ukuze ungaziva ungonwabanga. I-Endoscopic retrograde cholangiopancreatography (ERCP) luvavanyo oluqhelekileyo.

I-Biopsy

Apha, kuthathwa iqhekeza elincinci kakhulu lesicubu kwindawo ekrokrisayo lize lihlolwe phantsi kwe-microscope. Eli qhekeza lesicubu lingafunyanwa ngexesha lenkqubo ye-ERCP. Le sampuli yesicubu inokuvavanywa notshintsho lwemfuza (ii-biomarkers) kwiiseli zomhlaza. Oku kunokunceda ekuqinisekiseni ukuba abantu abathile banokunikwa "unyango olujoliswe kulo" oluthile.

Zithini izigaba kunye nonyango lomhlaza?

Xa isifo sifunyenwe, sifumanisa inqanaba lomhlaza ukuze sifumanise ukuba usasazeke kangakanani emzimbeni. Oku kubaluleke kakhulu ekucwangciseni unyango. Ngokuqhelekileyo luhlulwahlulwa lube ngamanqanaba ukusuka ku-0 ukuya ku-4. Inqanaba lesi-4 lithetha ukuba umhlaza usasazeke ngaphaya kwemibhobho yenyongo ukuya kwiindawo ezikude zomzimba (i-metastatic).

Indlela yonyango imiselwa yindawo yomhlaza, inqanaba lawo, kunye nempilo iyonke yesigulana.

• Utyando: Ukuba umhlaza awukasasazeka, utyando lolona nyango lungcono lokususa ngokupheleleyo umhlaza kunye nezicwili ezingqongileyo. Ngamanye amaxesha utyando lukwasetyenziselwa ukubeka i-stent ukugcina umbhobho wenyongo ovaliweyo uvulekile.
• Ukufakelwa kwesibindi: Ukufakelwa kwesibindi lithuba elihle lokunyanga ezinye iintlobo zomhlaza we-perihilar ezikwinqanaba lokuqala.
• Unyango ngemitha: Isebenzisa imitha enamandla aphezulu ukutshabalalisa iiseli zomhlaza okanye ukunciphisa iithumba.
• Unyango lweKhemotherapy: Ukunika umzimba amayeza abulala iiseli zomhlaza.
• Unyango olujoliswe kulo: Oku kuquka ukunika amayeza ajolise kwiiproteni ezithile ezinceda iiseli zomhlaza zikhule kwaye ziyeke ukusebenza kwazo.
• Unyango lwe-Immunotherapy: Ukunika amayeza avuselela inkqubo yomzimba wethu yokuzikhusela kwaye ayincede ekulweni neeseli zomhlaza.

Ngaba zikho iindlela zokuzikhusela kwesi sifo?

Akukho ndlela yokuthintela ngokupheleleyo uphuhliso lwalo mhlaza. Nangona kunjalo, singawunciphisa umngcipheko ngokugcina isibindi sethu kunye nemibhobho yenyongo isempilweni.

• Zikhusele kwiintsholongwane ezifana neHepatitis B, Hepatitis C, kunye neHIV (umz., fumana ugonyo lweHepatitis B, landela amanyathelo okhuseleko)
• Kuphephe ukusela utywala kakhulu.
• Gcina ubunzima bomzimba busempilweni.
• Kuphephe ukutshaya ngokupheleleyo.

Liyinyaniso elokuba i-cholangiocarcinoma yimeko enzulu kakhulu. Nangona kunjalo, ukuyiqonda, ukuyiqonda imiba enobungozi ukuba ikhona, nokubona ugqirha kwangoko xa kuvela iimpawu ezingaqhelekanga, kusinika amandla amakhulu okulwa nesi sifo. Ugqirha wakho ngumntu onokukunika icebiso nonyango olungcono.