Isifo sesifo sofuba , noma i-IBD, sihlanganisa nesifo sofuba se-ulcerative nesifo sikaCrohn. Zombili lezi zifo ezingelapheki ezingapheli zomuthi wamathumbu. Zombili zinezokwelapha ezinganciphisa ukuhlinzeka nokuhlinzeka ngezibhedlela.
Ukuba ne-IBD nokuphathwa ngayo kuhloswe ngengozi ethile yokwanda kwe-lymphoma, kanti izingozi zihluka nezinye izinto ngaphandle kokuphathwa nje.
Izifo Ze-Bowel Inflammatory
I-IBD iqala ngenxa yokuvuvukala emathunjini, okungabangela ukuphuma kwegazi, umkhuhlane, ukuphakama kwesibalo segazi elimhlophe , kanye nesifo sohudo nokwephula ubuhlungu besisu. Ukungahle kwenzeke ku-IBD kuvame ukukhona ekufundiseni izithombe ezifana ne-CT scan, noma isibonelo se-colonoscopy.
I-Lymphoma Risk
Abantu abane-IBD abaphathwe ngezindlela ezithile zokwelapha - njengama-anti-TNF nama-modifiers omzimba- bangengozi enkulu yezinye umdlavuza ezibandakanya amangqamuzana egazi amhlophe we-lymphocyte , ngokusho kwezifundo eziningana. Kunokunye ukungaqiniseki mayelana nokuthi ingozi enkulu kangakanani, noma kunjalo.
I-Lymphoma ingumdlavuza oqala emangqamuzaneni amhlophe egazi lymphocyte, okuyingxenye yesistimu yomzimba yomzimba. Izigaba ezimbili eziyinhloko ze-lymphoma yi- Hodgkin non-Hodgkin lymphoma (NHL) . Kunezinhlobo eziningi kanye nama-subtypes . Kuye kwaphawula ukuthi i-NHL ibonakala ephakeme kunezilinganiso ezilindelekile ezifweni eziningi ezidinga ukucindezelwa kwamagciwane, njenge-IBD.
Izingozi ze-lymphoma azifani naso wonke umuntu onayo i-IBD. Izingozi ziyahlukahluka ngokusho ngezici ezifana nobudala, ubulili, nezinye izinto ezihlukile. Ukuhlola izingozi kanye nezinzuzo ze-IBD zokwelapha nodokotela wakho yingxenye ebalulekile yesinqumo sokwelashwa. Ngokuvamile, kunqunywa ukuthi inzuzo enkulu yalezi zindlela zokwelapha ihluke kakhulu engozini encane kakhulu ekhona.
Ukuphathwa kwe-IBD
Ukusebenzisa imishanguzo yokulwa nokuvuvukala ye-IBD ukudala ukuhanjiswa okulandelwe ukwelashwa kwesondlo nemithi yokuzivikela imishanguzo namanje kuyindlela esemqoka yokwelapha. Ama-thiopurines - afana ne-azathioprin - asetshenziselwa kakhulu ukwelashwa kwesifo sesifuba esivuvukala esingapheli.
Ezigulini ezine-IBD eziphathwe ngama-thiopurines, kukhona ingozi eyandayo yezinye izinhlobo zomdlavuza wegazi, kodwa inani lamanqamu akhule ngenxa yomuthi likholelwa ukuthi lincane kakhulu. Kubantu abazitholayo, i-NHL ehlobene nokucindezelwa ngokuzivikela komzimba kubizwa ngokuthi i-post-transplant disorder lymphoproliferative, futhi okunye okwaziwa ngeengozi ye-lymphoma kuvela kuleli qembu leziguli.
Amaphethini akhethekile we-lymphoma abonwe ngamagciwane aguquguqukayo asetshenziswe ku-IBD. I-Lymphoma emva kokufakelwa ingenye yazo. Kungenzeka ukuthi i-lymphoma ngemva kokuba ne-mononucleosis, noma i-mono, futhi leli fomu lithinta amadoda angaphansi kweminyaka engama-35. Ngokuvamile, i-hepatosplenic T-cell lymphoma ingase ikhule, futhi ijwayele ukuthuthukisa ngemva kweminyaka emibili yokwelapha inhlanganisela ye-thiopurines ne-anti-tumor necrosis factor factor, noma ama-thiopurines kuphela.
- I-Azathioprin yayihlotshaniswa no-2.40 x engozini ye-lymphoma esenzweni eshicilelwe "ku-American Journal of Epidemiology."
- Ukuhlanganiswa kwe- azathioprine no-6-mercaptopurine kunengozi ye-4.92 yokuphakama kwe-lymphoma kubantu abano-IBD, ngokusho kocwaningo olushicilelwe "ku-Clinical Gastroenterology neHepatology."
Okuncane kangako kwaziwa nge-methotrexate ne-lymphoma engozini ye-IBD. Ngama-anti-TNF ama-agent, isifundo se-2009 sathola ukuthi ingozi ye-lymphoma ne-anti-TNF + immunomodulator yayingaphezu kwe-immunomodulator yedwa.
Ngaphansi
Kunezinkinga eziningi ezingaphenduliwe mayelana nengozi ye-lymphoma kumongo we-IBD therapy. Uma unayo i-IBD futhi udinga ukwelashwa, kungcono ukuxoxa nganoma yikuphi ukukhathazeka ongase ube nakho mayelana nezingozi nodokotela wakho, ongasiza ukubeka izinto ngendlela efanele futhi usize ukulinganisa amaqiniso nezibalo esimweni sakho esithile.
Ngaphandle kokwelashwa okufanelekile, iziguli ezine-Crohn's disease kanye nesifo sochungechunge lwe-ulcerative colitis zingaba nemfanelo enkulu yokuphila. Abanye odokotela baqokomisa ukuthi kungenzeka ukuthi sibhekene nenani elincane kakhulu lamacala engeziwe e-lymphoma phakathi kwezigidi zeziguli, futhi iminyaka eminingi esisiholela ekuphethweni ngezingozi.
Enye into eqinisekile: ukukhathazeka ngokweqile nokucindezeleka okungapheli kuhlotshaniswa nazo zonke izinhlobo zezinkinga zezempilo, ngakho-ke uma wena nodokotela wakho ninqume ukuthi udinga ukwelashwa, akusizi ngalutho ukukhathazeka.
Imithombo:
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Kotlyar DS, Lewis JD, Beaugerie L, et al. Ingozi ye-Lymphoma ezigulini ezinezifo ezibangelwa ukuvuvukala ezibhekene ne-Azathioprin ne-6-Mercaptopurine: Ukuhlaziywa kwe-Meta. I-Clin Gastroenterol Hepatol. 2015; 13 (5) 847-858.e4.
I-Bär F, Sina C, i-Fellermann K. Thiopurines isifo sesifuba esivuvukalayo siphindaphindiwe. I-World J Gastroenterol. 2013; 19 (11): 1699-1706.
I-Sokol H, i-Beaugerie L. Isifo sesifo sofuba kanye nezifo ezingenalo i-lymphoproliferative: uthuli luqala ukuxazulula. Gut . 2009 Oct; 58 (10): 1427-36.
U-Kandiel A, uFraser AG, uKorelitz BI, uBrensinger C, Lewis JD. Ingozi eyengeziwe ye-lymphoma phakathi kweziguli zesifo sofuba esivuvukala esiphathwa nge-azathioprin no-6-mercaptopurine. Gut. 2005; 54 (8): 1121-1125.
Askling J, Brandt L, Lapidus A, et al. Ingozi yomdlavuza we-hematopoietic ezigulini ezinesifo sofuba esiswini. Gut. 2005; 54 (5): 617-622.
Bhandari BM, Kroser JA, Bloomfeld RS, Lynch SP. Izifo Ze-Bowel Inflammatory. I-American College of Gastroenterology. 2013.
Siegel CA. Ingozi ye-Lymphoma ekuguleni kwezifo ezivuthayo. I-Gastroenterol Hepatol. 2009; 5 (11): 784-790.