Ciwon daji na hanta

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Ciwon daji na hanta
Description (en) Fassara
Iri liver tumor (en) Fassara, liver disease (en) Fassara, rare hepatic and biliary tract tumor (en) Fassara, liver neoplasm (en) Fassara, hepatobiliary system cancer (en) Fassara
endocrine gland cancer (en) Fassara
Specialty (en) Fassara oncology (en) Fassara
Sanadi Cirrhosis
aflatoxins (en) Fassara
Symptoms and signs (en) Fassara Shawara, Ciwon ciki, weight loss (en) Fassara
hepatomegaly (en) Fassara
Physical examination (en) Fassara computed tomography (en) Fassara, medical ultrasonography (en) Fassara, magnetic-resonance imaging (en) Fassara, endoscopic retrograde cholangiopancreatography (en) Fassara, percutaneous transhepatic cholangiography (en) Fassara, magnetic resonance cholangiopancreatography (en) Fassara, liver biopsy (en) Fassara
blood test (en) Fassara
Identifier (en) Fassara
ICD-10-CM C22.9 da C22.0
ICD-9-CM 155.0 da 155.2
OMIM 114550
Disease Ontology ID DOID:3571

Ciwon daji na hanta, wanda kuma aka sani da ciwon hanta, shi ne kansar da ke farawa a cikin hanta.[1] Ciwon daji wanda ya yadu daga wani wuri zuwa hanta, wanda aka sani da hanta metastasis, ya fi kowa fiye da wanda ke farawa a cikin hanta.[2] Alamun ciwon daji na hanta na iya haɗawa da dunƙule ko ciwo a gefen dama a ƙasan hakarkarin haƙarƙari, kumburin ciki, fata mai launin rawaya, sauƙi mai laushi, asarar nauyi da rauni.[1]

Babban abin da ke haifar da ciwon hanta shine cirrhosis saboda hepatitis B, hepatitis C ko barasa.[3] Sauran abubuwan da ke haifar da cutar sun hada da aflatoxin, cutar hanta mai kitse ba ta barasa da murar hanta ba.[2] Mafi yawan nau'o'in ciwon daji na hanta (HCC), wanda ke da kashi 80% na lokuta, da cholangiocarcinoma. Nau'ukan da ba su da yawa sun haɗa da mucinous cystic neoplasm da intraductal papillary biliary neoplasm.[2] Ana iya samun goyan bayan ganewar asali ta gwajin jini da hoton likita, tare da tabbatarwa ta hanyar biopsy nama.[1]

Ƙoƙarin rigakafin sun haɗa da allurar rigakafin cutar hanta ta B da kuma kula da waɗanda suka kamu da cutar hanta ta B ko C.[2] Ana ba da shawarar yin gwaji a cikin masu fama da cutar hanta.[2] Zaɓuɓɓukan jiyya na iya haɗawa da tiyata, maganin da aka yi niyya da kuma maganin radiation.[1] A wasu lokuta, ana iya amfani da farfagandar zubar da ciki, maganin kumburin ciki ko dashen hanta.[1] Ana iya bin ƙananan kullu a cikin hanta a hankali.[1]

Ciwon daji na hanta na farko shine na shida a yawan ciwon daji a duniya (6%) kuma na biyun da ke haifar da mutuwa daga cutar kansa (9%).[2][4] A cikin 2018, ya faru a cikin mutane 841,000 kuma ya yi sanadiyar mutuwar 782,000.[5] A cikin 2015, mutane 263,000 sun mutu daga cutar kansar hanta ta hanyar hanta, 245,000 ga barasa da 167,000 zuwa hepatitis C.[6] Yawan ciwon hanta ya fi girma a inda cutar hepatitis B da C ke da yawa, ciki har da Asiya da Afirka kudu da Sahara.[2] Maza sun fi kamuwa da HCC fiye da mata.[2] Ganowa ya fi yawa a tsakanin masu shekaru 55 zuwa 65.[7] Adadin rayuwa na shekaru biyar shine 18.4 % a Amurka,[7] da 40.4% a Japan.[8] Kalmar "hepatic" ta fito ne daga kalmar Helenanci hêpar, ma'ana "hanta".[9]

Ganin cewa akwai dalilai daban-daban na cutar kansar hanta, akwai hanyoyi da yawa don rigakafin cutar kansar hanta. Wadannan yunƙurin sun haɗa da rigakafi da cutar hanta B, maganin hanta, maganin hanta na C, rage yawan amfani da barasa, rage kamuwa da aflatoxin a aikin gona, da kula da kiba da ciwon sukari . Ana ba da shawarar dubawa ga waɗanda ke da cututtukan hanta na yau da kullun . Misali, ana ba da shawarar cewa mutanen da ke da ciwon hanta na yau da kullun waɗanda ke cikin haɗarin kamuwa da cutar sankarar hanta a kowane watanni 6 ta amfani da hoton duban dan tayi.

Domin ciwon hanta laima ce ga nau'ikan ciwon daji da yawa, alamu da alamun sun dogara ne akan irin nau'in ciwon daji. Alamun na iya zama m da fadi. Cholangiocarcinoma yana hade da gumi, jaundice, ciwon ciki, asarar nauyi da haɓaka hanta . [9] Cutar sankarau tana hade da ciwon ciki, ciwon ciki, emesis, anemia, ciwon baya, jaundice, itching, asarar nauyi da zazzabi .[10]

Zaɓuɓɓukan magani na iya haɗawa da tiyata, maganin da aka yi niyya da kuma maganin radiation . A wasu lokuta, ana iya amfani da farfagandar zubar da jini, embolization therapy ko dashen hanta .

Dalilai da abubuwan haɗari[gyara sashe | Gyara masomin]

Kamuwa da cuta[gyara sashe | Gyara masomin]

Wannan micrograph na lantarki yana nuna ƙwayar cutar hanta ta B "Dane particles", ko virions.

Kamuwa da cuta tare da cutar hanta ta C (HCV) ko cutar Hepatitis B (HBV) ita ce babban abin da ke haifar da ciwon hanta a duniya a yau, wanda ke da kashi 80% na HCC.[11][12][13] Maza masu HCV ko HBV na yau da kullum sun fi kamuwa da HCC fiye da matan da ke da HCV ko HBV; duk da haka, ba a san dalilan wannan bambancin jinsi ba. Cutar HBV kuma tana da alaƙa da cholangiocarcinoma . [14] Matsayin ƙwayoyin cuta banda HCV ko HBV a cikin ciwon hanta ba shi da kyau sosai, kodayake akwai wasu shaidun cewa kamuwa da cutar HBV da cutar hanta D na iya ƙara haɗarin HCC.[15]

HBV da HCV na iya haifar da HCC, saboda waɗannan ƙwayoyin cuta suna haifar da kumburi mai yawa, fibrosis, kuma cirrhosis na ƙarshe yana faruwa a cikin hanta.[16] Bugu da ƙari, yawancin canje-canjen kwayoyin halitta da na epigenetic suna samuwa a cikin ƙwayoyin hanta a lokacin HCV da HBV, wanda shine babban mahimmanci wajen samar da ciwace-ciwacen hanta. Kwayoyin cuta suna haifar da mummunan canje-canje a cikin sel ta hanyar canza kwayar halitta methylation, da tasiri akan maganganun kwayoyin halitta, da haɓaka ko murkushe hanyoyin watsa siginar salula. Ta hanyar yin wannan, ƙwayoyin cuta na iya hana ƙwayoyin cuta yin tsarin tsarin mutuwar kwayar halitta ( apoptosis ) kuma suna haɓaka kwafi da juriya.[17]

HBV da HCV suma suna haifar da muggan canje-canje ta hanyar haifar da lalacewar DNA da rashin zaman lafiyar kwayoyin halitta . Wannan shine ta hanyar ƙirƙirar nau'in oxygen mai amsawa, sunadaran sunadaran da ke tsoma baki tare da gyaran enzymes na DNA, kuma HCV yana haifar da kunna enzyme mutator .[18][19]

Cirrhosis[gyara sashe | Gyara masomin]

Babban haɓaka micrograph na hanta tare da cirrhosis. Trichrome tabo. Mafi yawan abin da ke haifar da cirrhosis a yammacin duniya shine rashin amfani da barasa - dalilin cirrhosis a cikin wannan yanayin.

Baya ga cirrhosis mai alaƙa da ƙwayoyin cuta da aka bayyana a sama, wasu abubuwan da ke haifar da cirrhosis na iya haifar da HCC. Shan barasa yana da alaƙa da haɗarin HCC, kuma haɗarin ya fi girma a cikin mutane masu hanta cirrhotic mai haifar da barasa.[20] Akwai ƴan cututtuka waɗanda aka san suna haifar da cirrhosis kuma suna haifar da ciwon daji, gami da hemochromatosis na gado da kuma cirrhosis na biliary na farko .[21]

Aflatoxin[gyara sashe | Gyara masomin]

Bayyanar Aflatoxin na iya haifar da haɓakar HCC.[22] Aflatoxins rukuni ne na sinadarai da fungi Aspergillus flavus (sunan ya fito daga A. flavus toxin) da A. parasiticus . Gurɓatar abinci daga fungi yana haifar da shiga cikin sinadarai, waɗanda suke da guba sosai ga hanta. Abubuwan abinci na yau da kullun da suka gurɓata da guba sune hatsi, gyada, da sauran kayan lambu. Adadin (dose) da tsawon lokacin (lokacin) da mutum ke hulɗa da aflatoxin yana da alaƙa da HCC. Gurbacewar abinci ya zama ruwan dare a Afirka, Kudu maso Gabashin Asiya, da China. Hanyar da aflatoxins ke haifar da ciwon daji shine ta hanyar maye gurbi da sauye-sauye na epigenetic . Aflatoxins suna haifar da nau'in maye gurbi,[23][24] ciki har da a cikin kwayar cutar ciwon tumor p53, wanda shine maye gurbin da ake gani a yawancin nau'in ciwon daji. Maye gurbi a cikin p53, mai yiwuwa tare da wasu sauye-sauyen da ke haifar da aflatoxin da sauye-sauye na epigenetic, [25] yana iya zama sanadin gama gari na aflatoxin-induced carcinogenesis .

steatohepatitis mara barasa (NASH) da kuma hanta mai kitse (NAFL)[gyara sashe | Gyara masomin]

NASH da NAFL an fara kiran su da haɗari ga ciwon hanta, musamman HCC.[26] A cikin 'yan shekarun nan, an sami karuwar dashen hanta ga HCC wanda aka danganta ga NASH. Ana buƙatar ƙarin bincike a wannan yanki da NASH/NAFL.

Sauran abubuwan haɗari a cikin manya[gyara sashe | Gyara masomin]

  • High grade dysplastic nodules su ne precancerous raunuka na hanta. A cikin shekaru biyu, akwai haɗarin ciwon daji da ke tasowa daga waɗannan nodules na 30-40%.[27]
  • Kiba da ciwo na rayuwa sun fito a matsayin muhimmiyar haɗari, saboda suna iya haifar da steatohepatitis .[28]
  • Ciwon sukari yana ƙara haɗarin HCC.
  • Shan taba yana ƙara haɗari ga HCC idan aka kwatanta da masu shan taba da masu shan taba a baya.
  • Akwai kusan kashi 5-10% na haɗarin rayuwa na cholangiocarcinoma a cikin mutanen da ke da sclerosing cholangitis na farko .[29]
  • Kwayar cutar hanta yana ƙara haɗarin cholangiocarcinoma, kuma wannan shine dalilin da yasa Thailand ke da yawan adadin wannan ciwon daji. [30]
  • Choledochal cysts, cutar Caroli, da fibrosis na hanta na hanta suna hade da ci gaban cholangiocarcinoma.[31]
  • Halin kwayoyin halitta : hemochromatosis na gado wanda ba a kula da shi ba, rashi na alpha-1-antitrypsin, cututtuka na ajiya na glycogen, porphyria cutanea tarda, cutar Wilson, tyrosinemia duk an danganta su da ci gaban HCC.
  • Kwayar hana daukar ciki ta baka : Babu isassun shaida don lakabi maganin hana haihuwa a matsayin abin haɗari. Duk da haka, binciken da aka yi kwanan nan ya gano cewa shan maganin hana haihuwa na baki fiye da shekaru 5 yana da alaƙa da HCC.

Yara[gyara sashe | Gyara masomin]

Ciwon hanta na yara ba a saba gani ba.[32] Nau'in ciwon daji na hanta da aka fi gani a cikin yara sune hepatoblastoma, hepatocellular carcinoma, embryomal sarcoma na hanta, jarirai choriocarcinoma na hanta, da biliary rhabdomyosarcoma. Ƙara haɗarin ciwon hanta a cikin yara na iya haifar da ciwon Beckwith-Wiedemann (wanda ke da alaƙa da hepatoblastoma),[33][34] iyali adenomatous polyposis (wanda ke hade da hepatoblastoma), ƙananan nauyin haihuwa (wanda ke hade da hepatoblastoma),[35] Ci gaban iyali cholestasis intrahepatic cholestasis (wanda ke hade da HCC)[36] Trisomy 18 (wanda ke hade da hepatoblastoma).

Rabewa[gyara sashe | Gyara masomin]

Ciwon daji na hanta zai iya fitowa daga parenchyma na hanta da kuma wasu sifofi a cikin hanta kamar su bile duct, jini da ƙwayoyin rigakafi . Akwai ƙananan nau'ikan ciwon daji na hanta, waɗanda aka fi sani da su a ƙasa.

Manazarta[gyara sashe | Gyara masomin]

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