Asizi izizathu ezichanekileyo zesifo somhlaza wesibindi, kodwa iingozi ezibandakanya ukusetyenziswa kotywala ngokugqithiseleyo, ukutshaya, izifo zesibindi ezifana ne-hepatitis B kunye ne-hepatitis C, ezinye iimeko zonyango kunye nemfuzo kunye nezinye izinto ezixhalabisayo. Ekubeni akukho mvavanyo yokuhlola isifo somhlaza wesibindi ngeli xesha, ukuba uyazi ingozi yakho kwaye ukwazi izibonakaliso neempawu yindlela efanelekileyo yokufumana umdlavuza wesibindi ngaphambili, amanyathelo angaphantsi.
Umhlaza wesibindi ungathintela kubini nakubantu abadala kodwa kwenzeka ngokuqhelekileyo kubantu abadala. Kukho iintlobo ezininzi zesifo somhlaza wesibindi , kodwa iingozi ezingezantsi zibhekisele kumdlavuza wesibindi somntu omdala, obizwa ngokuba yi-hepatocellular carcinoma kunye nomdlavuza we-bile duct (cholangiocarcinoma). Izifundo ziye zafumanisa ukuba umdlavuza wesibindi kunye nomdlavuza we-bile ukhula emhlabeni wonke, kwaye iyona nto ibangela umdla wokufa komhlaza kwezinye iindawo.
Izinto ezinobungozi eziqhelekileyo
I-Cancer iqala xa uchungechunge lwezinto zoguquko lwezityalo lukhokela iseli ukuba lukhule ngaphandle kolawulo. Oku kwenzeka ntoni kumdlavuza wesibindi akuqinisekanga, kodwa iinkqubo ezininzi ziye zafakwa. Yintoni eyaziwayo kukuba izinto ezininzi zandisa umngcipheko wokuhlakulela isifo. Abanye babo benza njalo, ngelixa abanye bephakamisa umngcipheko kuphela. Kukho ezinye izinto ezijongene nobungozi ezicatshangelwayo, nangona iingcali aziqinisekanga ukuba zihlobene ngokwenene.
Kubalulekile ukuba uqaphele ukuba unomdla wobungozi besifo somhlaza asithethi ukuba uya kuphuhlisa eso sifo.
Ngokuqhelekileyo inxulumano yezinto ezisebenzisanayo eziphumela ekuphuhliseni isisu. Ukuhlanganiswa kwemingcipheko kunokuncedisa, kodwa kunokuphindaphindiweyo, njengokudibanisa utswala nokutshaya okanye i-hepatitis B kunye nokutshaya. Kodwa, abantu bangaphinda bahlakulele umdlavuza wesibindi xa bengenayo nayiphi na into eyaziwayo yengozi yesifo.
Izinto eziziwayo zengozi zibandakanya:
Uhlanga kunye noThabano
Abantu baseAsia nasePacific Islands bahlakulela umdlavuza wesibindi ngokuphindaphindiweyo kunabantu bezinye iintlanga, ikakhulu ngenxa yengozi ye-hepatitis phakathi kwezi ndawo. Abantu baseCaucasus bahlakulela isifo somhlaza wesibindi, kodwa isifo sibonakala sanda. Umdlavuza wesibindi kuxhaphake kakhulu kumadoda kunabesifazana, nangona izizathu azicaci ngokupheleleyo.
I-Hepatitis B Infection
Ukusuleleka kwe- hepatitis B engapheliyo yingozi enkulu ekuphuhliseni umdlavuza wesibindi kwaye iyona nto ibangela umdlavuza wesibindi e-Afrika kunye ne-Asia. Amaphesenti angama-95 abantu abacima intsholongwane xa sele benesifo, kodwa malunga nama-5 ekhulwini baba yizithuthi ezingapheliyo zesifo. Aba bantu basengozini ekuphuhliseni umdlavuza wesibindi, nangona abanye abantu abane-hepatitis B abangapheliyo basengozini ngakumbi kunezinye.
Unyango lukhona, kodwa abaninzi abantu abazi ukuba bane-virus okanye bahlala kwindawo apho unyango lwangonyango lungaphantsi. Ngokubanzi, izithuthi ze-hepatitis B ziphindwe ngama-100 amathuba okuba nomdlavuza wesibindi, kwaye i-2.5 ekhulwini labantu abane- cirrhosis ngenxa yesifo se-hepatitis B (kunye no-0.5 ukuya kwe-1 ekhulwini labantu abangenayo i-cirrhosis) baya kuhlakulela isifo unyaka ngamnye.
Usulelo lwe-Hepatitis C
I-Hepatitis C yinto ebalulekileyo yengozi ekuphuhliseni umdlavuza wesibindi kwaye okwangoku kubangela umdlavuza wesibindi eMelika, eYurophu naseJapan. Ngokungafani ne-hepatitis B, abaninzi abantu abayikucima intsholongwane, kwaye iya kuba sisifo esiqhubekayo. Phantse kwi-10 ukuya kuma-30 ekhulwini abantu abanesifo banokusulela ukuphuhlisa i-cirrhosis.
Ngokudabukisayo, abaninzi abantu abakwaziyo ukuba banesifo, kwaye kuyacetyiswa ukuba bonke abadala baseMerika abazalwa phakathi ko-1945 no-1965 bavavanywe. Xa i-hepatitis C ifumaneka kwaye iphathwe ngemishanguzo ye-anti-virus, umngcipheko we-cirrhosis, kwaye mhlawumbi umhlaza wesibindi unokuncitshiswa kakhulu.
Izifo ezingabonakaliyo utywala (ii-NAFLD)
Isifo esingasinxilisayo sesibindi sesibindi sinesimo esifana nesifo sesibindi sesibindi, kodwa kubangela ukuqokelela kwamafutha enesibindi (isibindi esinamafutha) ngeendlela ezahlukeneyo. Kucingelwa ukuba yisifo esizimelayo (apho umzimba wenza izixhobo zokulwa nezicatshulwa ngokwawo) kwaye unokuba nenxalenye yezofuzo. Ngama-NAFLD, umngcipheko wesifo somhlaza wesibindi ujikeleze ngokuphindwe kane ngaphezu kobonke abantu. Ukuxhomekeka ngokusondeleyo, isifo se- metabolism sinokuba ngumngcipheko wesifo somhlaza.
Ukunyuswa kwamagciwane
Ukunyuswa kwama-immunosuppression kwandisa umngcipheko wesifo somhlaza, kunye nezinye i-cancer. Ukuba ne- HIV / AIDS idibaniswa nomngcipheko omkhulu wokuba nomdlavuza wesibindi. Abafakeli bezinto zokufakelwa komzimba banokuphindwa kabili ukuba banomdlavuza wesibindi njengabantu abaninzi, kwaye ingozi iphezulu nakwabo bafumene ukufakelwa kwesibindi.
I-Lupus (i- Lupus Erythematosus )
Isizathu asiqinisekanga, kodwa abantu abane-lupus banokuphindwa kabini ukuba banomdlavuza wesibindi.
Sikashukela
Abantu abanesifo sikashukela banomngcipheko wesibeleko sesibindi ezimbini ukuya kathathu ngaphezulu kunabantu bonke. Inomdla, kubonakala ukuba isifo sesifo sikashukela seGlucophage (metformin) sinokunciphisa lo mngcipheko.
Iimpawu zeMichiza (kunye neengozi zemisebenzi)
Inani elithile leemichiza liye ladibaniswa nokuphuhliswa kwesifo somhlaza kunye nokuba kunokwenzeka ukuba i- carcinogens .
Ukuboniswa komntu omnye umntu angabonisana nayo yi-arsenic emanzini amanzi. Ukuchithwa kwemisebenzi kukwaxhalabisa, kubandakanywa nokuvelela kwi-vinyl chloride (efumaneka kwiiplastiki), i-acrylamide, i-PFOA okanye i-perfluorooctanoic acid (efumaneka kwiindlela zokucoca ezomileyo), i-biphenyls ene-polychlorine (i-PCBs), iikhemikhali ezicwangcisiweyo (PFCs), i-benzo (a) i-pyrene ( BaP), kunye ne-trichlorethylene.
Sclerosing Cholangitis
I-sclerosing cholangitis iyisifo esingasasigxina esinesifo esiphathelene nesifo sesisu (njengesifo sikaCrohn esibandakanya i-colon nesilceritis colitis). I-sclerosing cholangitis ibangela ukuvuvukala kunye nokutshatyalaliswa kwamadada enobumba njengokuba ibhala libuyela kwisibindi esibangela ukutshabalalisa apho. Kucinga ukuba iipesenti ezili-10 ukuya kwi-15 ekhulwini zabantu abanesi sifo ziya kuba ne-cholangiocarcinoma (umdlavuza we-bile duct).
Aflatoxin Exposure
Nangona iimeko ezinobungozi ngokungaqhelekanga eUnited States, oku kubaluleke kakhulu emhlabeni jikelele. I-Aflatoxin B1 yi-toxin eyenziwa yi-fungi (ye-genus Aspergillus) ekhula kwizinto ezifana nengqolowa, i-peanuts, amanye amanqatha, i-soybe, kunye nengqolowa. I-toxin ibangela umonakalo kwi- gene ye-p53 kwiiseli zesibindi- isifo sokuxhatshazwa kwesisu esinceda ukulungisa i-DNA eyonakalisiweyo kwaye inqande ukukhula kweeseli eziyingozi. Uphando luqhubeka kwaye uphando luhlola ukuba i-aflatoxin ibangela umdlavuza wesibindi ngokwawo okanye njenge-co-factor xa idibene ne-hepatitis B.
Imimiselo eqinile yokutya kunye nokuvavanya kwenza ukuba okungaqhelekanga ku-United States, ngokutyhila kunye nokutyhefuza kuqhelekileyo kwihlabathi jikelele. I-toxin ibonakala ifumaneka ekudleni okungagcinwanga kakuhle, ngokuqhelekileyo kwiindawo ezifudumele kunye neendawo ezitshatayo. Abahambi baseMelika baye kwiindawo ezinjalo akufanele bakhathazeke, nangona-becinga ukuba ukutyhila kwexesha elide kuyadingeka ukuba kubangele umdlavuza wesibindi.
Genetics
Umhlaza wesibindi ungasebenza kwiintsapho (nangona kungekho isifo sofuzo esaziwa), nokuba nesisifo nesifo (ngapha nangapha) sandisa ingozi yakho. Umngcipheko omkhulu xa unesidanga sokuqala esimalunga nomzali, umntakwabo, okanye umntwana.
Ezinye izifo zofuzo eziyaziwayo zichaphazela umngcipheko, kubandakanya:
Hemochromatosis
Uhlobo lwe-hemochromatosis (i-iron overload disease) yimeko ephawulwe ngokunyuswa komzimba kunye nokugcinwa kwesinyithi, rhoqo kwisibindi. Ekuhambeni kwexesha, imeko imele iholele kwisifo se-cirrhosis kunye nokungaphumeleli kwesibindi (kunye nezinye iingxaki zonyango).
Umngcipheko wesifo somhlaza wesibindi kubantu abanesifo se-hemochromatosis ngamaxesha angaphezu kwama-20 angaphezulu kwelo lonke uluntu. Unyango (ukukhupha ngegazi ngexesha) kunganciphisa umngcipheko weengxaki, kodwa abantu abaninzi abazi ukuba baneimeko baze bahlakulele iingxaki. Kucinga ukuba abantu abayizigidi ezi-1 baseUnited States bachaphazeleka ngenye yeentlobo ze-hemochromatosis.
Bharary Cirrhosis
I-cirrhosis yebhiliyari yeprayimari yimeko ebonakala ngathi ine-genetic component, njengoko ihamba kwiintsapho. Yisifo esiqhubekayo, esizimelayo, apho i-bile ekwakhiwa kwisibindi, eyonakalisa iindawo ezinobungozi kwaye ibangela ukulimala kwesibindi kunye ne-cirrhosis. I-cirrhosis yebhiliyari yeprayimari inxulumene nomngcipheko ophezulu wesifo somhlaza, esifana neleyo efunyenwe kubantu abane-hepatitis C. engapheliyo.
Izifo zikaWilson
Isifo sikaWilson sisifo esingaqhelekanga se-genetic esichazwe ngokuqokelela ubhedu emzimbeni kwaye kucatshangelwa ukuba yingozi yobunzima besifo.
Ezinye izifo eziNgciniweyo
Ezinye izifo eziza kubangela umngcipheko wesifo somhlaza, zibandakanya i-alpha-1 antitrypsin, i-tyrosinemia, i-porphyria cutanea tarda, ne-glycogen izifo zokugcina.
Izinto zokuPhila kweengozi
Impilo yokuphila ibalulekile ekuphuhliseni umdlavuza wesibindi. Ngelixa ungeke ukwazi ukulawula ezininzi zeengxaki eziqhelekileyo ezikhankanywe ngasentla, unokukwazi ukuchaphazela ezi.
Ukusetyenziswa ngokweqile, Ukusetyenziswa kotywala kwexesha elide
Ukugqithisa ngokwexesha elide, ukusetyenziswa kotywala ixesha elide kunokudala izifo zesibindi, kubandakanywa nesifo sobushushu nesifo sesibindi sokunxila. Ngokuhamba kwexesha, i-cirrhosis iqala ukutyalwa kwesibindi, kwaye kaninzi, ukuhluleka kwesibindi. Umdlavuza wesibindi kuhambelana nokusela kakhulu, okanye ukungenisa iziphuzo ezingaphezu kwethathu imihla ngemihla, nangona ixabiso elincinci linokubangela isifo esibalulekileyo nesingenakunyuswa.
Utywala obunxilisayo, nangona ungahambelani nomdlavuza wesibindi ngaphezu kwexesha elifutshane, kunokunyusa ingozi yokuziphatha ehambelana nokufumana i-hepatitis B okanye uC.
Ukutshaya
Ukutshaya kuyingozi yeengcingo ezininzi , kwaye umhlaza wesibindi awukho. Izifundo eziliqela zibonisa ukuxhamla phakathi kokutshaya nomhlaza wesibindi, kwaye abo bashushu nabokusela banomngcipheko omkhulu wesifo.
Abantwana abazalelwe kubazali abaye bavutha phambi okanye ngexesha lokukhulelwa banomngcipheko owandayo wokuba nomdla wesifo sesibindi esibizwa ngokuba yi-hepatoblastoma.
Ukunyanya
Indima yokunyamezela kumdlavuza wesibindi ayiqinisekanga ngokwayo, kodwa ukunyanya kunomngcipheko wokuphuhlisa isifo sesibindi esingaselunxilisayo, imeko ephindaphinda umngcipheko wesifo somhlaza, kunye nesifo sikashukela, esidibene nomngcipheko kathathu.
Ukusetyenziswa kwe-Anabolic Steroid
I-Anabolic steroids, njengalezo ezisetyenziselwa i-weightlifters, iyingozi yeso sifo nesifo somhlaza.
Ukufuna i-Betel Quid
Ngokuqhelekileyo eUnited States, ukuhlafuna i-betel quid yinto ebangela ingozi yomhlaza wesibindi kwimimandla apho oku kuqhutyelwa khona.
Izinto ezinobungozi ezinokwenzeka
Kukho ubungqina bokuba ukususwa kwe-gallbladder (cholecystectomy) kwandisa ubungozi, nangona abaphandi bengenakunyaniseka ngokuxhamla.
I-jury iyaphuma nokuba ingaba ininzi ingozi ehambelana nokusetyenziswa kwamapilisi okulawula ukuzalwa.
Kucingelwa ukuba kukho umngcipheko ochaphazelekayo olwabiwo lwezonyango (ezifana ne-CT scans zesisu), kodwa le mngcipheko mhlawumbi ikhululeke kakhulu kwiingeniso ezinjalo zonyango.
I-parasite eyenza i- schistosomias ifundelwe inxaxheba yayo kwimhlaza yesibindi. Esikhundleni sokuba ngumngcipheko, kucingelwa ukuba yintsebenziswano kumdlavuza wesibindi ohlobene nokutheleleka kwe-hepatitis B kunye no-C.
> Imithombo:
> I-American Cancer Society. Ngaba Siyazi Yintoni Ebangelwa Ngomhlaza Weengqumbo? Ukuhlaziywa 04/28/16. https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/iyo-html.html
> Erkekoglu, P., Oral, D., Chao, M., no B. Kocer-Gumusel. I-Hepatocellular Carcinoma kunye Nezizathu Zezixhobo Zezolimo kunye Nezizathu Zezinto Eziphilayo: Ukuhlaziywa. Umbhalo we-Environmental Pathology, i-Toxicology kunye ne-Oncology . 2017. 36 (2): 171-190.
> Jiang, K., no B. B. Amanqaku angama-Cancer angundoqo, iNxalenye yesi-2: Indlela yokuqhubela phambili kunye neCarcinogenesis. Ulawulo lweCancer . 2018. 2191): 10732748177444658.
> INational Cancer Institute. Ukwelashwa kweNtsholongwane yeMhlaza yePilisi (PDQ) -I-Professional Professional Version. Ukuhlaziywa -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
> Smith, J., Kroker-Lobos, M., Lazo, M. et al. I-Aflatoxin kunye ne-Viral Hepatitis Exposures eGuatemala: I-Molecular Biomarkers iveza iNgqobhoko eyingqayizivele yezinto ezinobungozi kwiNgingqi ye-High Liver Cancer Incidence. PLoS One . 2017. 12 (12): e0189255.