Isizathu esiqondile somdlavuza we- esophageal asiyazi, kodwa izakhi zofuzo zibonakala zidlala indima. Kunezici eziningi eziyingozi zokugula lesi sifo nazo zikhonjisiwe. Lezi zihluka kuye ngokuthi uhlobo lomdlavuza, nge-reflux ye-acid (GERD), isifo se-Barrett, nokukhuluphala okuxhunyaniswe ne-adenocarcinoma, kanye nokuhlanganiswa kokubhema nokudakwa ngokweqile okuhlobene neningi lama-squamous cell carcinomas.
Kukhona ukuhlukahluka okukhulu kwendawo lapho kwenzeka khona lezi zomshukela, futhi izici ezihlukahlukene zengozi zibonakala zibaluleke kakhulu ezindaweni ezihlukahlukene zomhlaba.
Njengoba lesi sifo sivame ukutholakala esikhathini esizayo, izigaba ezincane ezingaphathwa kahle, ngokuqaphela izici eziyingozi, kanye nokujwayela izimpawu zesifo somdlavuza wokuqeda , kubalulekile ukuthola lesi sifo ngokushesha ngangokunokwenzeka. Ngenxa yezizathu ezingaziwa, izigameko ze-adenocarcinoma yesifo sezanda nje kubonise ukwanda okukhulu emazweni athuthukile.
I-Genetics
Njengamanye amachiza, i-genetics ingase ibangele ekuthuthukiseni umdlavuza we-esophageal, futhi amaqoqo omdlavuza emindenini ahlonishwe kwezinye izindawo zomhlaba. I-Genetics cishe idlala indima ebaluleke kakhulu ku-squamous cell carcinoma kune-adenocarcinoma, ikakhulukazi ngokuqondene nokungafani okwegesi okuye kwahlanganiswa nesifo. Elinye i-genetic syndrome, i-tylosis, ihlotshaniswa nengozi ephezulu kakhulu ye-esophageal squamous cell carcinoma.
I-syndrome ibonakala ngokuqina kwesikhumba ezintendeni nasezintabeni ngenxa ye-vitamin A engalungile.
I-Genetics yedwa ayinayo isifo somdlavuza we-esophageal, kodwa inganezela engozini evezwa ezinye izici ezingozini zesifo.
Ukuqonda Ingozi
Isici esiyingozi yesifo sibhekisela ezintweni ezihlobene nethuba elikhulayo lokuthuthukisa lesi sifo kodwa akusho ukuthi kubangela lesi sifo.
Umdlavuza we-Esophageal uqala lapho ukulimala kwe-DNA (izakhi zofuzo) kuvela emangqamuzaneni avamile okwezinye izingqamuzana ukuze amangqamuzana akhule ngendlela engenakulawula. Ukuba nenkinga engozini akusho ukuthi uzokuthuthukisa umdlavuza we-inophageal, futhi abantu abangenazo izinkinga ezingabangela ingozi bangakwazi nokuthuthukisa lesi sifo ngezinye izikhathi.
Ezinye zezinto ezibeka ingozi ngenxa yomdlavuza we-esophageal yizinto ezibangela ukuthukuthela nokulimala emgodini wesifo, futhi sifunda ukuthi ukuvuvukala okungapheli kungaholela ekuguqulweni kwezicubu okugcina kuholela emdlalweni. Ezinye izici ezingozini, ezifana nogwayi, ziqukethe i- carcinogens (izinto ezibangelwa umdlavuza) ezingaphazamisa ngqo i-DNA.
I-Squamous Cell Carcinoma
Amagciwane e-squamous amangqamuzana aqala emangqamuzaneni aphezulu (amangqamuzana angama-squamous) aqondisa i - esophagus . Lezi zomshukela zivame kakhulu engxenyeni engenhla ye-esophagus futhi yilona uhlobo oluvame kakhulu emhlabeni jikelele.
Izici zengozi zalolu hlobo lomdlavuza we-esophageal zifaka:
Ubudala
Iningi le-squamous cell carcinomas livela kubantu abaphakathi kweminyaka engama-45 no-70, futhi lawa kancane angavamile kubantu abasha.
Ubulili
Ngenkathi umdlavuza wesifo sigxila kakhulu emadodeni kunabesifazane jikelele, ukuhlanekezela kuyiqiniso kwe-squamous cell carcinoma e-United States.
Umjaho
E-United States, i-squamous cell carcinomas zivame kakhulu kubantu abamnyama kunabamhlophe, kuyilapho okuphambene kuyiqiniso ku-adenocarcinomas.
I-Geography
Isimo sezinhlobo zombili zomdlavuza we-esophageal sihlukahluka kakhulu emhlabeni jikelele. Isibalo esiphezulu se-squamous cell carcinoma sendawo esiyi-oop is in the "Asian Esophageal Cancer Belt". Lesi sifunda sihlanganisa izindawo ezifana neTurkey, i-Iran, i-Kazakhstan, nephakathi nenyakatho yeChina. Lesi sigameko siphakeme nakakhulu eningizimu-ntshonalanga ye-Afrika.
Ukubhema
I-squamous cell carcinomas ye-esophagus cishe izikhathi ezinhlanu ezivamile kubantu ababhema. Nokho, ukubhema akuyona into engozini yokuba nomdlavuza we-esophageal kuzo zonke izingxenye zomhlaba. Isibonelo, e-China, kubonakala sengathi ukubhema kudlala indima encane kuphela; Izinto zokudla zibonakala zibaluleke nakakhulu.
Ukusetshenziswa Kokudakwa Kakhulu
Njengokubhema, ukungenisa utshwala kuyingozi enkulu ebangelwa i-squamous cell carcinoma yezinye izingxenye zomhlaba kodwa hhayi ezinye. Ukudla ngokweqile kotshwala kuhlotshaniswa nokukhuphuka kwengozi ka-1.8 ukuya kwangu-7.4. Ngokunciphisa ukuthambisa utshwala, ngokusho kokucwaninga ngo-2018, empeleni kuhlotshaniswa nengozi ephansi yokuthuthukisa lesi sifo kunabo abalahla.
Ukubhema Ukusetshenziswa Kokudakwa Kakhulu
Inhlanganisela yokubhema nokuphuza yiyona nto ebaluleke kakhulu engozini ye-squamous cell carcinoma futhi kucatshangwa ukuba ilandise ngamaphesenti angaba ngu-90 emhlabeni jikelele. Ingozi iphezulu kunalokho okungalindelwe uma ungenezela ingozi yokubhema kanye nokuphuza ngokweqile yedwa (esikhundleni sokungeza, ingozi yanda).
Ukuvezwa Kwezemvelo
Ukuvezwa kwamakhemikhali athile-i-tetrachlorethylene esetshenziselwa ukuhlanza owomile, isibonelo-ingandisa ingozi yomdlavuza we-esophageal.
Ukuphuza i-Lye (i-Drain Cleaner)
I-Lye itholakala ekuhlanzeni izindlu zasendlini futhi i-agent esebenzayo. Unyaka ngamunye izingane eziningi zifaka ingozi ngemikhiqizo. Umdlavuza we-Esophageal ungase uvele eminyakeni eminingi ngemuva kokungenisa ngengozi.
I-Achalasia
I-Achalasia yisimo lapho i-muscular band engxenyeni engezansi yengxenyana engezansi (i-sphincter engezansi ephansi) ingaphumuli kahle ukuze ivumele ukudla ukushiya isisu bese ingena esiswini. Lokhu kubangela kokudla okusele futhi kunwetshe indawo ephansi. I-Achalasia ihlotshaniswa nengozi ephezulu yomdlavuza we-esophageal, umdlavuza uvame ukuvela eminyakeni engu-15 kuya kweyengu-20 ngemva kokuxilongwa.
Ukwelashwa kwezidakamizwa ku-Chest and Upper Abdomen
Ukwelashwa kwezidakamizwa esifubeni sezimpawu ezifana nomdlavuza wesifuba noma isifo sikaHodgkin kungandisa ingozi. Ngenkathi abesifazane abene-radiation ngemuva kwe-mastectomy benengozi ephakeme, lokhu akubonakali kube yinkomba yabesifazane abanemisebe yokugcina imisipha emva kwe-lumpectomy.
Umlando weNhloko neNeck noma i-Cancer Lung
Umlando womuntu womdlavuza uhlotshaniswa nengozi ephakeme yomdlavuza we-esophageal, ikakhulukazi i-squamous cell carcinomas ekhanda, entanyeni nasemaphaphu.
Ukuphuza Ukuphuza Okushisayo
Ukuphuza iziphuzo ezishisayo kakhulu (okufudumele kakhulu kunekhofi ejwayelekile) sekuye kwacatshangwa kucatshangelwa ukuba kuthwale ingozi ekhulayo. Ucwaningo lwe-2018 lwasekela le nkolelo, nakuba ukuphuza itiye emazingeni aphezulu okushisa kwakungengozi kuphela lapho kuhlangene nokuphuza utshwala ngokweqile noma ukubhema.
Uma ukhuluma ngeziphuzo, kungenzeka ukuthi uzwile ukuthi i-soda ingabangela umdlavuza we-esophageal ngendlela yokukhwabanisa okuhlobene. Lokhu kuxhumana okungenzeka kwakunqunywe yisifundo esivela ku-National Cancer Institute kanye nezifundo ezalandela ukuthi azitholanga kuphela ingozi enkulu ye-squamous cell carcinoma noma i-adenocarcinoma kodwa okungeyona into ehlukile.
Ukudla
Ukudla-ikakhulukazi ukudla okuncane ezitshalweni nemifino, futhi inyama ebomvu kanye / noma eqhutshiwe-kuhlotshaniswa nengozi ephakeme yezo zinhlobo zomdlavuza we-esophageal, kodwa isixhumanisi sinamandla kakhulu nge-squamous cell carcinoma. Ngokudla, indlela yokupheka ibonakala ibalulekile, futhi ukupheka noma ukugcoba emazingeni okushisa aphezulu kuhlobene nengozi enkulu. I-Betel nama-nati ama-nati abuye ahlotshaniswa nokuthuthukiswa komdlavuza we-esophageal.
E-China, ukudla okuphezulu ku-nitrate kungase kube kabili ingozi. Ingozi iphinde ibe yilabo ababenokukhubazeka kwamagithamini namaminerali (ikakhulukazi i-folate, i-vitamin C, ne-molybdenum) emazweni asathuthuka.
I-Human Papillomavirus Infection (HPV)
I-papillomavirus yabantu (i-HPV), igciwane elidala umlomo wesibeletho kanye namanye amanyevuza, kungenzeka ukuthi lihlobene nokuthuthukiswa kwe-squamous cell carcinoma. Ngesikhathi abacwaningi bengenakuqiniseka ukuthi ngabe igciwane liyabangela, litholakala ku-third of cancer esophageal e-Asia nasezingxenyeni zase-Afrika. Kuze kube manje, i-HPV ayibonakali ixhunyaniswa nomdlavuza we-esophageal e-United States.
Adenocarcinoma
I-Adenocarcinomas yenzeke kaningi kakhulu engxenyeni yesithathu engezansi ye-esopha bese iqala emangqamuzaneni amancane. Ngokujwayelekile, ingxenye yesithathu engezansi ye-esophagus ifakwe amangqamuzana angama-squamous, kodwa umonakalo ongapheli (njenge-chronic acid reflux) imiphumela ekuguqulweni kwala maseli ukuze kubonakale kufana namaseli afaka isisu namathumbu. Ngokuhamba kwesikhathi, la maseli angase abe amangqamuzana angenangqondo futhi amangqamuzana omdlavuza. I-Adenocarcinomas manje idlula ama-squamous cell carcinomas e-United States, e-United Kingdom, e-Australia nase-Western Europe.
Izici zengozi zalolu hlobo lomdlavuza we-esophageal zifaka:
Ubudala
Njenge-squamous cell cancers, i-adenocarcinomas ivame kakhulu kubantu abaphakathi kweminyaka engu-50 no-70.
Ubulili
E-United States, i-adenocarcinomas izikhathi eziyisishiyagalombili zivame kakhulu emadodeni kunabesifazane.
Umjaho
Ngokungafani ne-squamous cell cancers, i-adenocarcinomas ye-esophagus ivame kakhulu (nge-factor of 5) kumhlophe kunabamnyama.
I-Geography
Isigameko se-adenocarcinoma se-esophagus siphezulu eNtshonalanga Yurophu, eNyakatho Melika (ikakhulukazi e-United States) nase-Australia.
Izifo ze-Reflux ze-Gastroesophageal (GERD)
I-reflux yama-acid, noma isifo se-reflux ye-gastroesophageal ( GERD ), iyisici esibalulekile se-adenocarcinoma esinezinkinga, cishe cishe amaphesenti angu-30 alawa makhansela acatshangwa ukuthi ahlotshaniswa nesimo. Kucatshangwa ukuthi phakathi kwamaphesenti angu-0.5 kanye namaphesenti angu-1 abantu abane-GERD bayoba nomdlavuza we-esophageal.
I-Esophagus kaBarrett
Isisindo sikaBarrett yisimo lapho amangqamuzana avamile we-esophagus (amangqamuzana angama-squamous) ashintshwa ngamangqamuzana angenangqondo afana nalabo abakhona esiswini nasemathunjini. Kuvame ukutholakala kubantu abane-reflux ehlala njalo engaba njalo futhi kwenzeka kumaphesenti angu-6 kuya kumaphesenti angu-14 abantu abane-GERD engapheli. Nakuba izilinganiso zihluka, cishe 1 ku-100 kuya ku-1 kubantu abangu-200 abanesifo se-Barrett bazokwakha umdlavuza wokuqeda unyaka ngamunye. Njenga-adenocarcinoma, isisindo sikaBarrett sanda e-United States.
Ezinye izifundo (kodwa hhayi zonke) zibonise ukunciphisa ingozi ye-adenocarcinoma esophahleni kubantu abanesisindo sikaBarrett abasithathile izidakamizwa ezingezona ukuvuvukala (njenge-Advil, ibuprofen, proton pump inhibitors (njenge-Prilosec, omeprazole) , noma izidakamizwa ze-statin (njenge-Lipitor, atorvastatin).
I-Hernia yamaHiatal
I- hernia yokubeletha yinto ebuthakathaka yomswakama ovumela isisu ukuba sande ngaphakathi esifubeni kusukela esiswini futhi ngokuvamile kubangele izimpawu zokuphefumula. Ukuba nomtholampilo wokubeletha kungakwandisa ingozi ngesilinganiso sesi-2 ukuya ku-6.
Ukwedlula ngokweqile / ukukhuluphala
Ukweqisa ngokweqile noma okweqile kunandisa ingozi ye-adenocarcinoma yesifo. Ngokusho kokubuyekezwa kuka-2015, abantu abakhuluphele ngokweqile (index mass body of 25 kuya ku-29) bangamaphesenti angaba ngu-50 amathuba okuba nomdlavuza, kanti labo abakhuluphele (inqwaba yezinhlamvu zomzimba ezingama-30 noma ngaphezulu) cishe cishe kabili ukuthuthukisa umdlavuza we-esophageal. Ukuba nomhlobo wesifo sikashukela 2 kungabuye kwandise ingozi, kodwa akuqiniseki ukuthi lokhu kuhlobene nesifo sikashukela ngokwayo noma okuhambisana nokukhuluphala.
Ukubhema
Ukubhema kuhlotshaniswa nokuthuthukiswa kwe-adenocarcinoma ye-esophagus, kodwa kuncane kakhulu kune-squamous cell cancers. Ukubhema kuphakamisa ingozi ye-adenocarcinoma yi-factor of 2.7.
Imithi
Eminye imithi ihlotshaniswa nengozi ekhuphukile noma eyancipha ye-adenocarcinoma yesifo. Ukusetshenziswa kwe-bisphosphonates (esetshenziselwa i-osteoporosis) kungandisa ingozi, njengoba kungase kusetshenziswe ukwelashwa kwesifo se-hormone kuphela. Ngokuphambene nalokho, ukusebenzisa i-aspirin kuhlotshaniswa nokunciphisa ingozi.
> Imithombo:
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> Bast, uRobert C., et al. Holland-Frei Cancer Medicine. UWiley Blackwell, ngo-2017.
> Castro, C., Peleteiro, B., noN. Lunet. Izici eziguqulwayo kanye ne-Canophageal Cancer: Ukubuyekezwa Okuhlelekile Kwama-Meta-Analyzes Okushicilelwe. I-Journal ye-Gastroenterology . 2018; 53 (1): 37-51.
> Mayne, uSusan T., et. al. Ukusetshenziswa kwe-Carbonated Soft Drink kanye neNengozi Yokulinganisa I-Adenocarcinoma. Journal of the National Cancer Institute. 2006; 98 (1) 72-75.
> Sardana, R., Chhikara, N., Tanwar, B, .and A. Panghal. Impikiswano Yokudla Emdlalweni We-Cancer Esophageal kubantu: Ukubuyekeza. Ukudla nokusebenza . 2018 Apr 4. (Epub ngaphambi kokuphrinta).
> Yu, C., Tang, H., Guo, Y. et al. Ukusetshenziswa Kwamaholide Okushisayo Nokusebenzisana Kwalo Ngotshwala Nokusetshenziswa Kogwayi Ngengozi YeCanceral Cancer. Ama-Annal of Medicine yangaphakathi . 2015; 168 (7): 489.