Uyayazi i-Cholangiocarcinoma? Ake sixoxe ngayo kalula.

Wake waba nobuhlungu obungavamile ohlangothini lwesokudla lwesisu sakho, ngaphansi kwezimbambo zakho, ukuphuzi kwesikhumba sakho namehlo (njenge-jaundice), noma umuzwa nje wobuthakathaka? Nakuba lokhu kungase kubonakale njengezinto ezivamile, ngezinye izikhathi kungaba nesizathu esingathi sína ngemuva kwazo. Namuhla sizokhuluma ngohlobo lomdlavuza olungavamile kodwa olungase lube yingozi kakhulu. Lowo umdlavuza we-bile duct, owaziwa ngokwezokwelapha ngokuthi i-Cholangiocarcinoma .

Kalula nje, iyini i-cholangiocarcinoma?

Kulungile, ake siqale sibone ukuthi ziyini lezi zindlela zokugaya inyongo. Cabanga nje, isibindi sethu sikhiqiza uketshezi olubizwa ngokuthi "inyongo". Lokhu kusiza kakhulu ekugayeni ukudla okunamafutha. Ngakho-ke, uhlelo lwamapayipi amancane athwala lenyongo lusuka esibindini luye emathunjini ethu amancane lubizwa ngokuthi ama-ducts enyongo .

I-Cholangiocarcinoma umdlavuza oqala emaseli esistimu ye-bile duct.

Lolu uhlobo lomdlavuza olunolaka kakhulu. Into edabukisayo ukuthi isikhathi esiningi, ngesikhathi lo mdlavuza utholakala, usuvele usakazeke ngale kwemisele yenyongo. Esimweni esinjalo, ukwelashwa kunzima kakhulu, futhi isibikezelo asisihle. Kodwa ungakhathazeki, odokotela nososayensi bahlala bethola izindlela zokwelapha ezintsha ezingalawula ukusabalala kwalo mdlavuza futhi zinike iziguli impilo engcono.

Yiziphi izinhlobo eziyinhloko zalo mdlavuza?

Umdlavuza we-bile duct uhlukaniswe ngezinhlobo ezintathu eziyinhloko ngokuya ngendawo okuyo:

1. I-Intrahepatic cholangiocarcinoma: Lokhu kwakheka emigudwini yenyongo emincane esibindini .

2. I-Perihilar/hilar cholangiocarcinoma: Lolu uhlobo oluvame kakhulu. Lukhula eduze kwe-hilum, lapho imisele yenyongo iphuma khona esibindini. Lubizwa nangokuthi isimila se-Klatskin .

3. I-Distal cholangiocarcinoma: Lolu hlobo luvela emigudwini yenyongo engaphandle kwesibindi, eduze kwamathumbu amancane.

Zombili izinhlobo 2 no-3 zibizwa ngokuthi umdlavuza we-extrahepatic bile duct . Okusho ukuthi, umdlavuza okhula "ngaphandle kwesibindi."

Yiziphi izimpawu zalesi sifo?

Esikhathini esiningi, azikho izimpawu kuze kube yilapho umdlavuza usumkhulu kakhulu futhi uvimba umsele wenyongo. Uma izimpawu zivela, ungase uqaphele izinto ezinjengalezi.

Ezigabeni zokuqala, lo mdlavuza awubangeli ubuhlungu. Kodwa-ke, njengoba isimila sikhula, ubuhlungu bungase buvele ohlangothini lwesokudla lwesisu. Kwabanye abantu, lobu buhlungu bungasakazekela kwezinye izingxenye zesisu noma ngisho nasemhlane.

Yiziphi izimbangela kanye nezici eziyingozi zokuthuthukisa lo mdlavuza?

Imbangela eqondile yalo mdlavuza ayikatholakali okwamanje. Kodwa-ke, kukholelwa ukuthi ukuvuvukala okungapheli , okungukuthi, izimo zokuvuvukala, emigudwini ye-bile kungaba yimbangela enkulu.

Kalula nje, umonakalo oqhubekayo ungalimaza i-DNA yamaseli e-bile duct. I-DNA ifana "nohlelo oluyinhloko" olutshela amaseli ethu ukuthi asebenze kanjani. Lapho le DNA yonakele, amaseli angaqala ukuhlukana ngokungalawuleki, okuholela ekwakhekeni kwezimila ezinomdlavuza.

Kunezici eziningana ezandisa ingozi yalokhu:

• Izifo ezihlobene nemifudlana ye-bile: Izimo ezifana namatshe enyongo, amatshe emifudlana ye-bile, kanye ne-'Primary sclerosing cholangitis' (isifo lapho imifudlana yenyongo iba mincane futhi ivaleke).
• Izifo zesibindi: I-Cirrhosis (izibazi zesibindi), ukutheleleka ngegciwane le-Hepatitis B noma i-Hepatitis C.
• Ezinye izimo zezokwelapha: I-ulcerative colitis engapheli, isifo samathumbu esivuvukalayo (IBD), isifo sikashukela.
• Izici zendlela yokuphila: ukuphuza utshwala ngokweqile, ukukhuluphala ngokweqile, ukubhema.
• Ukutheleleka kwezinambuzane: Ukutheleleka kwezinambuzane okubizwa ngokuthi 'i-Clonorchiasis' kuvame kakhulu emazweni aseNingizimu-mpumalanga ye-Asia.
• Ukuchayeka kumakhemikhali anobuthi: Amanye amakhemikhali, ikakhulukazi lawo asetshenziswa ezimbonini zerabha noma zezimoto.

Udokotela usithola kanjani lesi sifo?

Uma ubona udokotela, uzoqala alalele ngokucophelela izimpawu zakho, athathe umlando wakho wezokwelapha, bese enza ukuhlolwa ngokomzimba. Ngemuva kwalokho, uma kusolwa ukuthi umdlavuza ukhona, bangase batuse ukuhlolwa okuningana, okufana nalokhu:

Ukuhlolwa Kwegazi

• Ukuhlolwa kokusebenza kwesibindi: Lokhu kunganikeza umbono wokuthi isibindi sisebenza kahle kangakanani. Uma imigudu ye-bile ivinjiwe, amazinga ama-enzyme athile (`ama-enzyme esibindi`) egazini azokwanda.
• Ukuhlolwa kwezimpawu zesisu: Ukuhlolwa okulinganisa izinto ezithile (izimpawu zesisu) ezikhula egazini uma kukhona umdlavuza. `CA 19-9` kanye ne-`CEA` kuyizinkomba ezimbili ezingakhula kulolu hlobo lomdlavuza.

Ukuhlolwa Kwezithombe

• Ngokuvamile kwenziwa ukuhlolwa kwe-ultrasound yesisu kuqala.
• Ngaphezu kwalokho, kungenziwa i -CT scan noma i-MRI scan . I-Magnetic resonance cholangiopancreatography (MRCP) uhlobo olukhethekile lwe-MRI olungabona ngokucacile uhlelo lwe-bile duct.

Ukuhlolwa kwe-Endoscopic

Lokhu kuhilela ukufaka ithubhu elincane neliguquguqukayo (i-endoscope) elinekhamera exhunywe emlonyeni wakho, ulidlulisele esiswini sakho nasemathunjini akho amancane, lapho imisele yenyongo ivuleka khona, bese uhlola indawo ngokucophelela. Uzolaliswa phakathi nale nqubo, ngakho ngeke uzizwe ungakhululekile. I-Endoscopic retrograde cholangiopancreatography (ERCP) iyisivivinyo esivamile.

Ukuhlolwa kwebhayoloji

Lapha, kuthathwa ingxenye encane kakhulu yezicubu endaweni esolisayo bese ihlolwa ngaphansi kwe-microscope. Le ngxenye yezicubu ingatholakala ngesikhathi senqubo ye-ERCP. Le sampula yezicubu ingahlolwa ngisho nokushintsha kwezakhi zofuzo (ama-biomarker) emaseli omdlavuza. Lokhu kungasiza futhi ekunqumeni ukuthi abantu abathile banganikezwa "ukwelashwa okuqondiwe" okuthile.

Yiziphi izigaba kanye nokwelashwa komdlavuza?

Uma lesi sifo sesitholakele, sinquma isigaba somdlavuza ukuze sithole ukuthi ususakazeke kangakanani emzimbeni. Lokhu kubaluleke kakhulu ekuhleleni ukwelashwa. Ngokuvamile kuhlukaniswa ngezigaba 0 kuya ku-4. Isigaba 4 sisho ukuthi umdlavuza ususakazeke ngale kwemisele yenyongo waya ezingxenyeni ezikude zomzimba (i-metastatic).

Indlela yokwelapha inqunywa indawo yomdlavuza, isigaba sawo, kanye nempilo yesiguli iyonke.

• Ukuhlinzwa: Uma umdlavuza ungakasabalali, ukuhlinzwa kuyindlela engcono kakhulu yokwelapha ukususa ngokuphelele umdlavuza nezicubu ezizungezile. Ngezinye izikhathi ukuhlinzwa kusetshenziselwa nokufaka i-stent ukugcina umgudu wenyongo ovalekile uvulekile.
• Ukufakelwa kwesibindi: Ukufakelwa kwesibindi kuyithuba elihle lokwelashwa kweminye imidlavuza ye-perihilar esesigabeni sokuqala.
• Ukwelashwa ngemisebe: Kusebenzisa imisebe enamandla amakhulu ukubhubhisa amangqamuzana omdlavuza noma ukunciphisa izimila.
• Ukwelashwa ngamakhemikhali: Ukunikeza umzimba imithi ebulala amangqamuzana omdlavuza.
• Ukwelashwa okuqondiwe: Lokhu kuhilela ukunikeza imithi eqondisa amaprotheni athile asiza amangqamuzana omdlavuza ukuba akhule futhi ayeke ukusebenza kwawo.
• Ukwelashwa Ngezifo Ezingalawuleki: Ukunikeza imithi evuselela amasosha omzimba wethu futhi isize ekulweni namaseli omdlavuza.

Zikhona yini izindlela zokuzivikela kulesi sifo?

Ayikho indlela yokuvimbela ngokuphelele ukukhula kwalo mdlavuza. Kodwa-ke, singanciphisa ingozi ngokugcina isibindi sethu kanye nemigudu yenyongo iphilile.

• Zivikele kumagciwane afana ne-Hepatitis B, i-Hepatitis C, kanye ne-HIV (isib., thola umuthi wokugomela i-Hepatitis B, landela izinyathelo zokuphepha)
• Gwema ukuphuza utshwala ngokweqile.
• Gcina isisindo somzimba siphilile.
• Gwema ukubhema ngokuphelele.

Kuyiqiniso ukuthi i-cholangiocarcinoma iyisimo esibi kakhulu. Kodwa-ke, ukuqaphela, ukuqaphela izici eziyingozi uma zikhona, nokubona udokotela ngokushesha nje lapho kuvela izimpawu ezingavamile, kusinika amandla amakhulu okulwa nalesi sifo. Udokotela wakho ungumuntu ongakunikeza iseluleko nokwelashwa okungcono kakhulu.