Asazi izimbangela eziqondile zesifo somdlavuza wesibindi, kodwa izici zokufaka ingozi zibandakanya ukusetshenziswa ngokweqile kotshwala, ukubhema, izifo zesibindi ezifana ne-hepatitis B ne-hepatitis C, ezinye izimo zezokwelapha nezifuzo, nezinye izinto ezikhathazayo. Njengoba kungekho ukuhlolwa kokuhlolwa kwesifo somdlavuza wesibindi ngalesi sikhathi, ukuqaphela izici zakho ezingozini futhi ukwazi izimpawu nezimpawu kuyindlela engcono kakhulu yokuthola umdlavuza wesibindi ezinyathelweni zangaphambili, ezingaphathwa kahle.
Umdlavuza wesibindi ungathinta kokubili izingane kanye nabantu abadala kodwa kwenzeka kaningi kubantu abadala. Kunezinhlobo eziningana zesifo somdlavuza wesibindi , kodwa izingozi ezingezansi zibhekisela kumdlavuza omdala oyinhloko wesibindi, okuthiwa i-hepatocellular carcinoma nomdlavuza we-bile duct (cholangiocarcinoma). Ucwaningo luye lwathola ukuthi umdlavuza wesibindi kanye nomdlavuza we-bile wokuhamba wanda emhlabeni wonke, futhi iyimbangela ehamba phambili yokufa komdlavuza kwezinye izindawo.
Izingozi Ezivamile Zengozi
I-Cancer iqala lapho uchungechunge lwezakhi zofuzo ludlulisa iseli ukuze likhule ngaphandle kokulawula. Lokhu kwenzeka kanjani emdlalweni wesibindi akuqinisekisiwe, kodwa izindlela eziningana zihanjisiwe. Yini eyaziwa ukuthi izici eziningana zandisa ingozi yomuntu yokuthuthukisa lesi sifo. Abanye babo benza lokho okukhulu, kanti abanye bangabangela ingozi kuphela imali encane. Kunezinye izici eziyingozi ezibhekwa, nakuba ochwepheshe abaqiniseki ukuthi bahlobene ngempela yini.
Kubalulekile ukuthi uqaphele ukuthi ukuba nesifo se-isifo somdlavuza wesibindi akusho ukuthi uzokuthuthukisa lesi sifo.
Ngokuvamile kubandakanya izinto ezisebenzisana ndawonye eziholela ekuthuthukiseni isisu. Ukuhlanganiswa kwezinkinga ezingabangela ingozi kungabangela ukwanda, kodwa kungabuye kube nokuphindaphindiwe, njengokwenyuka kokuphuza utshwala nokubhema noma ukushisa kwesibindi B nokubhema. Kodwa-ke, abantu bangase bahlakulele umdlavuza wesibindi uma bengenazo izifo ezikhona ezikhona zesifo.
Izici ezikhona eziyingozi zihlanganisa:
Umjaho kanye nocansi
Abase-Asia nabase-Pacific Islands bahlakulela umdlavuza wesibindi kaningi kunabantu bezinye izinhlanga, ikakhulukazi ngenxa yesifo se-hepatitis phakathi kwalezi zifunda. Abantu baseCaucasus bahlakulela kancane umdlavuza wesibindi, kodwa lesi sifo sibonakala sanda. Umdlavuza wesibindi uvame kakhulu emadodeni kunabesifazane, nakuba izizathu azicaci ngokuphelele.
I-Hepatitis B Infection
Ukutheleleka okungapheli kwe- hepatitis B kuyingozi enkulu ekuthuthukiseni umdlavuza wesibindi futhi iyimbangela ebangela umdlavuza wesibindi e-Afrika naseningizimu ye-Asia. Cishe amaphesenti angu-95 abantu ahlanza igciwane uma esenwe igciwane, kodwa cishe amaphesenti angu-5 abe yiziphathamandla ezingapheli zalesi sifo. Yilaba bantu abasengozini yokuthuthukiswa kwesifo somdlavuza wesibindi, nakuba abanye abantu abane-hepatitis B engapheli benengozini enkulu kunezinye.
Ukwelashwa kuyatholakala, kodwa abantu abaningi abaqapheli ukuthi baphatha igciwane noma bahlala endaweni lapho ukunakekelwa kwezokwelapha kungaphansi kwezinga eliphezulu. Ngokuvamile, abathwali be-hepatitis B banamathuba angaphezu kuka-100 okukhulisa umdlavuza wesibindi, kanti amaphesenti angu-2.5 abantu abane- cirrhosis ngenxa ye-hepatitis B (kanye no-0.5 kuya kwezingu-1 kubantu abangenayo i-cirrhosis) bazothuthukisa lesi sifo unyaka ngamunye.
I-Hepatitis C Infection
I-Hepatitis C nayo iyingozi enkulu ekuthuthukiseni umdlavuza wesibindi futhi okwamanje iyimbangela ebangela umdlavuza wesibindi e-United States, eYurophu naseJapane. Ngokungafani nesifo se-hepatitis B, abantu abaningi abakususulu igciwane, futhi kuba yisifo esiqhubekayo. Amaphesenti angama-10 kuya ku-30 abantu abathintekayo baqhubeka nokuthuthukisa i-cirrhosis.
Ngokudabukisayo, abantu abaningi abazi ukuthi bane-HIV, futhi kunconywa ukuthi bonke abadala baseMelika abazalwa phakathi kuka-1945 no-1965 bahlolwe. Lapho i-hepatitis C etholakala futhi iphathwa ngemithi yokuvimbela i-anti-virus, ingozi ye-cirrhosis, futhi cishe umdlavuza wesibindi ingancishiswa kakhulu.
Izifo ezingezona ezidakayo ezinobuthi (isibindi se-NAFLD)
Isifo esingenalo utshwala esinamafutha aso yisimo esifana nesifo sesibindi sesibindi, kodwa kubangelwa ukuqoqwa kwamafutha esibindi (isibindi esinamafutha) ngendlela ehlukile. Kucatshangwa ukuthi yisifo esizimele (lapho umzimba wenza amasosha okulwa nawo ngokwawo) futhi ingaba nesakhi sezakhi zofuzo. Nge-NAFLD, ingozi yesifo somdlavuza wesibindi iphindwe izikhathi ezine kunabantu abaningi. Okuhlobene eduze, isifo se-metabolic syndrome singase sibe yingozi engozini yomdlavuza wesibindi.
I-Immunosuppression
Ukugonywa komzimba kukhulisa ingozi yesifo somdlavuza wesibindi, kanye nezinye umdlavuza. Ukuba nesandulela ngculazi nengculaza kuhlotshaniswa nengozi enkulu emihlanu yokukhula komdlavuza wesibindi. Abamukeli bezinto zokufakelwa komzimba kabili amathuba okuba nomdlavuza wesibindi njengabantu abaningi, futhi ingozi iphezulu nakakhulu kulabo abaye bathola ukufakelwa kwesibindi.
I-Lupus (i- Lupus Erythematosus yesistimu )
Isizathu asiqiniseki, kodwa abantu abane-lupus bangaphezu kokuphindwe kabili ukukhula komdlavuza wesibindi.
Isifo sikashukela
Abantu abanesifo sikashukela banengozi yesifo somdlavuza wesibindi kabili kuya kathathu ephakeme kunabantu abaningi. Ngesithakazelo, kubonakala sengathi imithi yesifo sikashukela i-Glucophage (metformin) inganciphisa le ngozi.
I-Chemical Exposures (ne-Occupational Risk)
Izimboni eziningi zamakhemikhali ziye zahlotshaniswa nokuthuthukiswa komdlavuza wesibindi futhi kungenzeka ukuthi izifo zomzimba zikhona.
Ukuvezwa okuvamile ukuthi umphakathi ungabhekana nakho yi-arsenic emanzini amanzi. Ukuchayeka komsebenzi nakho okukhathazayo, kufaka phakathi ukutholakala kwe-vinyl chloride (etholakala kuma-plastiki), i-acrylamide, i-PFOA noma i-perfluorooctanoic acid (etholakala ezindleleni zokuhlanza ezomile), ama-biphenyls amaningi (polyblorinated biphenyls) (PCBs), amakhemikhali aphefumulayo (PFCs), benzo (a) pyrene ( I-BaP), ne-trichlorethylene.
I-Sclerosing Cholangitis
I-cholangitis ye- sclerosing iyisifo esingapheli sesibindi esithinta isifo sofuba (njengesifo soCrohn esibandakanya ukolon kanye ne-ulcerative colitis). I-cholangitis ye-Sclerosing ibangela ukuvuvukala nokuqothula kwamadayipi enobhala njengokuthi ibhala liyabuyela esibindi esibangela ukubola lapho. Kucatshangwa ukuthi amaphesenti ayishumi kuya kwabangamaphesenti angu-15 abantu abanesifo bazoba ne-cholangiocarcinoma (umdlavuza we-bile duct).
I-Aflatoxin Exposure
Yize kuyingozi engavamile e-United States, lokhu kubaluleke kakhulu emhlabeni wonke. I-Aflatoxin B1 iyi-toxin eyenziwa yi-fungi (ye-genus Aspergillus) ekhula ekudleni okunjengokolweni, amantongomane, amanye amantongomane, ama-soybean, kanye nommbila. I-toxin ibangela ukulimala egazini le- p53 emangqamuzaneni wesibindi-isisindo sokucindezela i- tumor esisiza ukulungisa i-DNA ewonakele nokuvimbela ukukhula kwamangqamuzana awonakele. Ucwaningo luqhubeka futhi izifundo zihlola ukuthi i-aflatoxin ibangelwa yini umdlavuza wesibindi yedwa noma njengento ehlangene uma ihlanganiswa nesifo sofuba
Imithethonqubo yokudla eqinile kanye nokuhlolwa kwenza lokhu kungabonakali okuvamile e-United States, ngokusebenzisa ukungcola kanye nokubulawa kwesifo kuvamile emhlabeni wonke. I-toxin ivame ukutholakala ekudleni okungakagcinwa kahle, ngokuvamile ezindaweni ezifudumele nezishisayo. Abahambi baseMelika beya ezindaweni ezinjalo cishe akufanele bakhathazeke, nakuba-kucatshangwa ukuthi ukuchayeka kwesikhathi eside kudingeka ukuba kubangele umdlavuza wesibindi.
I-Genetics
Umdlavuza wesibindi ungagijima emindenini (ngisho ngaphandle kwesifo sofuzo esaziwa), futhi ukuba nesihlobo nesifo (ngakwesinye icala) kwandisa ingozi yakho. Ingozi enkulu kakhulu uma isihlobo sokuqala se-degree njengomzali, umntakwethu, noma ingane.
Ezinye izifo zofuzo ezaziwayo nazo zithinta ingozi, kuhlanganise:
I-Hemochromatosis
I-herochromatosis e-Hereditary (isifo esingaphezu kwensimbi) yisimiso esikhonywe ukunyuswa komzimba nokugcinwa kwensimbi, ngokuvamile kwesibindi. Ngokuhamba kwesikhathi, lesi simo ngokuvamile siholela ekuhlulekeni kwesibindi (kanye nezinye izinkinga zezokwelapha).
Ingozi yesifo somdlavuza wesibindi kubantu abane-hemochromatosis izikhathi ezingu-20 eziphakeme kunaleyo yabantu abaningi. Ukwelapha (ukuhoxisa ngezikhathi ngegazi) kunganciphisa ingozi yezinkinga, kodwa abantu abaningi abazi ukuthi banesimo baze bahlakulele izinkinga. Kucatshangwa ukuthi abantu abayizigidi eziyi-1 e-United States bathinteka ngenye yezinhlobo ze-hemochromatosis.
I-Cirrhosis yeBiliary Primary
I-cirrhosis yebhiliyari eyinhloko yisimo esibonakala sinezakhi zofuzo, njengoba isebenza emindenini. Kuyinto isifo esiphuthumayo, esizimele lapho i-bile ekwakheni isibindi, emakhakheni enobungozi futhi eholela ekulimaleni kwesibindi kanye ne-cirrhosis. I-cirrhosis eyinhloko yebhiliyali ihlotshaniswa nobungozi obukhulu besifo somdlavuza wesibindi, okufana nalokho okutholakala kubantu abane-hepatitis C. engapheli.
Izifo zikaWilson
Isifo sikaWilson yisifo esiyingqayizivele se-genetic esibonakala ngokuqoqwa kophusi emzimbeni futhi kucatshangwa ukuthi iyingozi engozini yomdlavuza wesibindi.
Ezinye izifo ezithintekayo
Ezinye izifo ezithathelwanayo ezingase zande ingozi yesifo somdlavuza wesibindi kuhlanganisa i-alpha-1 antitrypsin ukuntuleka, i-tyrosinemia, i-porphyria cutanea tarda, nezifo zokugcina iglycogen.
Izindlela Zengozi Yokuphila
Izindlela zokuphila zibalulekile ekuthuthukiseni umdlavuza wesibindi. Ngenkathi ungeke ukwazi ukulawula eziningi zezinto ezivame ukubhekana nobungozi okukhulunywe ngenhla, unalo ikhono lokuthonya lokhu.
Ukudlulela ngokweqile, Ukusetshenziswa Kokudakwa Kosuku Olude
Ukusebenzisa ngokweqile, ukusetshenziswa kwesikhathi eside kotshwala kungabangela izifo eziningi zesibindi, kuhlanganise nesifo sofuba esibangelwa yizidakamizwa kanye nesifo sobudlova. Ngokuhamba kwesikhathi, i-cirrhosis iqala ukunqunywa kwesibindi, futhi ngokuvamile, ukwehluleka kwesibindi. Umdlavuza wesibindi ngokuyinhloko uhlotshaniswa nokuphuza ngokweqile, noma ukuphuza iziphuzo ezingaphezu kwezintathu nsuku zonke, nakuba izilinganiso ezincane zingase zidale izifo zesibindi eziphawulekayo nezingenakugwema.
Ukuphuza utshwala, nakuba kungahlanganiswa nomdlavuza wesibindi phezu kwesikhathi esifushane, kungandisa ingozi yokuziphatha okuhlobene nokuthola isifo sofuba B noma C.
Ukubhema
Ukubhema kuyinkinga engozini yokudla kaningi , futhi umdlavuza wesibindi awunjalo. Ucwaningo oluthile lubonisa ukuxhumana phakathi kokubhema nesifo somdlavuza wesibindi, futhi labo bobabili ababhema futhi baphuze kakhulu banengozi enkulu yesifo.
Izingane ezizalelwa abazali ababhema ngaphambi noma ngesikhathi sokukhulelwa zengozini enkulu yomshukela ongaqabulanga wesifo sofuba okuthiwa i-hepatoblastoma.
Ukukhuluphala
Indima yokukhuluphala komdlavuza wesibindi ayiqinisekisiwe ngokwayo, kepha ukukhuluphala kwandisa ingozi yokuthuthukisa isifo sobungozi obungelona utshwala, isimo esisitshengisa ingozi yesifo somdlavuza wesibindi, kanye nesifo sikashukela, esithinta ingozi kathathu.
Ukusetshenziswa kwe-Anabolic Steroid
Ama-steroids anabolic, afana nalawo asetshenziswa yi-weightlifters, ayinengozi yesifo sesibindi nesifo somdlavuza wesibindi.
Ukufuna i-Betel Quid
Okuvamile e-United States, ukuhlafuna i-betel quid kuyinhloko engozini yesifo somdlavuza wesibindi ezindaweni lapho ngokuvamile kuqhutshwa khona.
Izingozi ezingenzeka zengozi
Kunobunye ubufakazi bokuthi ukususwa kwe-gallbladder (cholecystectomy) kwandisa ingozi, nakuba abacwaningi abaqiniseki ngokuxhumana.
Ijaji libuye libheke ukuthi ngabe kukhona ingozi ekhulayo ehlobene nokusetshenziswa kwamaphilisi okulawula ukubeletha kwamanje.
Kucatshangwa ukuthi kunengozi ethile ehlobene nemisebe yezokwelapha (njenge-CT izicathulo zesisu), kodwa lokhu kubungozi cishe kuncane kakhulu kunezinzuzo ezikhona zokwelapha.
I-parasite ebangela i- schistosomiasis ifundwe ngendima yayo engenzeka emdlalweni wesibindi. Esikhundleni sokuba yinto engozini, kucatshangwa ukuthi kuyisici esibambisene nesifo somdlavuza wesibindi esihlobene nokutheleleka kwesifo se-hepatitis B no-C.
> Imithombo:
> I-American Cancer Society. Ingabe Siyazi ukuthi Yini Ebangelwa I-Cancer Cancer? Kubuyekezwe 04/28/16. https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/what-causes.html
> Erkekoglu, P., Oral, D., Chao, M., no B. Kocer-Gumusel. I-Hepatocellular Carcinoma Nezizathu Ezenzekayo Zezici Neziphilayo: Ukubuyekeza. I-Journal of Environmental Pathology, Toxicology, ne-Oncology . 2017. 36 (2): 171-190.
> Jiang, K., noBel Centeno. Amakhansela Okuqala Eyesibindi, Ingxenye 2: Izindlela Zokuqhubeka Ne-Carcinogenesis. I-Cancer Control . 2018. 2191): 10732748177444658.
> National Cancer Institute. I-Primary Liver Cancer Treatment (PDQ) -Health Professional Version. Kubuyekeziwe -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 ne-Viral Hepatitis Exposures e-Guatemala: Ama-Biometricers we-Molecular aveza umbono oyingqayizivele wezingozi zengozi esifundeni se-High High Cancer Incidence. PLoS One . 2017. 12 (12): e0189255.