Indlela Izitatimende Zangase Zithinte Ngayo Abantu abane-Cancer Lung?
Statin Izidakamizwa kanye Cancer Lung
Kungenzeka ukuthi uzwile ukuthi izidakamizwa ze-statin zingathuthukisa ukusinda komdlavuza wamaphaphu, ukusiza ukwelashwa, noma ingozi yomdlavuza wamaphaphu aphansi. Kuzo zonke lezi zici, izifundo zibonisa ngani? Ingabe bakhuluma ngokuvimbela umdlavuza wamaphaphu ngaphambi kokuba uqale, noma ukwelapha umdlavuza wamaphaphu ngemuva kokuba usuvele ukhona? Ingabe uhlobo lomdlavuza wamaphaphu luyinkinga futhi kunendaba yini ukuthi yiziphi ezinye zokwelashwa ozisebenzisayo?
Ngezinye izikhathi ososayensi bamangala lapho ukwelashwa kwesimo esisodwa kubonakala kusiza isimo esingavumelani. Izitatimende zesitatimende zingase zibe enye yalezi zonyango. Le mithi eyanciphisa i-cholesterol phakathi kweminye imisebenzi yilezi ezinye izidakamizwa ezivame kakhulu emhlabeni wonke. Abacwaningi baye bathatha isithakazelo kulezi zidakamizwa eminyakeni yamuva ngemuva kokubona ukuhlanganiswa phakathi kokusetshenziswa kwezidakamizwa kanye nokuphila komdlavuza.
Yiziphi izitatimende?
Izitatimende ziyisigaba semithi ebizwa ngokuthi i-HMG-CoA reductase inhibitors. Nakuba umphakathi uvame ukubuka lezi zidakamizwa ngokuthi "i-cholesterol izidakamizwa ezinciphisa" injongo yabo eyinhloko ukunciphisa ingozi yokuhlaselwa yinhliziyo. Ngaphandle kokunciphisa i-cholesterol, lezi zidakamizwa zizinzisa amapulati emithanjeni ye-coronary , ukunciphisa ubukhulu bepletiki emithanjeni ye-coronary, futhi kunciphise ukwakheka kwegazi kwimizimba ye -coronary. Ngenxa yalokho, izitembu zinganciphisa ingozi yenhliziyo ngisho ne-cholesterol evamile.
Ngakolunye uhlangothi lwe-equation, ukwelapha amazinga e-cholesterol aphakeme yedwa - ngaphandle uma enza umehluko empilweni nasekusindeni - akuyona umgomo we-statin therapy.
Kungenzeka kanjani ukuthi izitatimende zithinte ingozi yomdlavuza?
Izifundo zezilwane nezifundo zeseli (ebheka umdlavuza womdlavuza ovuthwe esidlweni) ziye zaphakamisa ukuthi izitembu zinempahla elwa nomdlavuza.
Kucatshangwa ukuthi bangavimbela ukukhula kwamangqamuzana e-tumor, ukuhlasela, kanye nokwenzeka kwamangqamuzana omdlavuza ukusabalalisa (ukuxuba umzimba).
Ngokusho kweqembu elilodwa labaphenyi, ama-statins ayenayo i-lipophilic (fat-love) ayosebenza kahle kakhulu. Amaphilisi amaningi e-lipophilic ahlanganisa i-Lipitor (atorvastatin), iZocor (simvastatin), ne-Mevacor (lovastatin). I-lipophilic engaphansi (i-hydrophilic noma i- "water-loving") i-statins ihlanganisa iPravachol (pravastatin), i-Crestor (i-rosuvastatin), ne-Lescol (i-fluvastatin).
Isitatimende Sokusinda Ngomdlavuza We-Cancer
Ucwaningo lwamuva lubonisa ukuthi abantu abathatha izidakamizwa ze-statin ngaphambi noma ngemuva kokuxilongwa komdlavuza wamaphaphu bangase babe nesilinganiso esengeziwe sokusinda.
Kulolu cwaningo labantu abangaba ngu-14 000 abanomdlavuza wamaphaphu e-UK phakathi kuka-1998 no-2009, abantu ababesebenzisa izidakamizwa ze-statin ngaphambi kokuba baxilongwe babenciphise ngokuphindaphindiwe kwamaphesenti angu-12 ekufeni okuhlobene nomdlavuza wamaphaphu.
Kulabo abasebenzisa izidakamizwa ze-statin ngemuva kokuxilongwa , futhi bahlala okungenani izinyanga ezingu-6, kwaba nokunciphisa okungabonakali okuphawulekayo emaphesenti angu-11 okubulawa komdlavuza wamaphaphu. Kulabo abaye bagcwalisa imiyalelo yabo okungenani izikhathi ezingu-12 (sebenzisa unyaka noma ngaphezulu,) kunciphise ngokuphawulekayo emaphesenti angu-19 okubulawa komdlavuza wamaphaphu .
Lesi sifundo sibheke kubantu abanomdlavuza wesifo samangqamuzana omncane ongasona omncane kanye nomdlavuza omncane wamangqamuzana wamaphaphu futhi uhumusha iziguli ezingama-3 638 zomdlavuza wamaphaphu. Uma lezi zinombolo zizosebenza kubantu abaningi abanomdlavuza wamaphaphu, lokhu ngeke kube inombolo encane, ngoba kulindeleke ukuba abantu abayi-158.040 bafe ngomdlavuza wamaphaphu ngo-2015 e-United States kuphela. Njengoba kuqhathaniswa okusheshayo, abantu abangaba ngu-3 000 bafa emlilweni ohlobene nomuzi e-United States unyaka ngamunye.
Kubaluleke kakhulu ukuphawula ukuthi lolu cwaningo lusheshe , futhi asikwazi ukuthi izidakamizwa ze-statin ngokwayo zenza ukunciphisa ekufeni .
Isibonelo, kungaba khona esinye isici (esinye isichazamazwi) kubantu abasebenzisa izidakamizwa ze-statin esikhundleni sokuthi baxhunywe nokusinda okuthuthukisiwe.
Izitatimende Zokufa Kwe-Cancer kanye ne-Lung
Ukubuyekezwa kwezifundo ezanyatheliswa ngo-Ephreli 2015 (izifundo ezingu-41) zibuka umphumela wama-statins kuwo wonke umdlavuza wokufa komdlavuza, kubonakala sengathi zisekela umbono wokuthi izitembu zingathinta isifo somdlavuza. Lezi zifundo, ezibandakanya abantu abangaba yizigidi eziyisikhombisa, ziphakamisa ukuthi ukusetshenziswa kwama-statins ngemuva kokuxilongwa komdlavuza kuhlanganiswe nokunciphisa amaphesenti angu-19 kuzo zonke izimbangela zokufa kanye nokuncipha kwamaphesenti angu-23 ekufeni kwabantu abathile. Isiphetho sabacwaningi ababheke kulezi zifundo ukuthi "ukusetshenziswa kwesimiso kokubili ngaphambi nangemva kokuxilongwa kuyinzuzo yokuphila okuphelele nokuphila komdlavuza othize." Kodwa kubalulekile ukuthi uqaphele ukuthi umane nje umdlavuza wamaphaphu usele ngemuva kwezinye zezifundo, ngezifundo eziningi bebukele umdlavuza webele, umdlavuza wombala, nomdlavuza wesifo sofuba.
Umphumela Wezitatimende Ngokwelashwa Kwembele Yengculazi
Akuyona into eyaziwa ngokuthi ama-statins asithinta kanjani ukwelashwa ngabanye ngomdlavuza, kodwa isifundo esisodwa esincane sathola ukuthi ukufaka isithunzi esimweni semithi efana ne-Tarceva kubangele ukuthuthukiswa okuphawulekayo ekusindeni okungenasiphelo kubantu abangenawo omncane wesifo somdlavuza wamaphaphu ukuze ushintsho lwe-KRAS. Lesi sihloko sibheka ukuhlolwa kwezakhi zofuzo kubantu abane nomdlavuza wamaphaphu .
Ngokwesiko, abantu abavivinya ukuguquguquka kwe-KRAS abaphenduli nemithi ebizwa ngokuthi i-epidermal growth factor receptor tyrosine kinase inhibitors ( EGFR-TKIs ). Imithi kulesi sigaba (imithi ehlosiwe) esetshenziswa emdlavuza wamaphaphu ihlanganisa iTarceva (erlotinib) no-Iressa (gefitinib). Kubantu abanesigaba 3B nesigaba 4 somdlavuza wesifo samangqamuzana ongasona omncane okwenziwe ukuguquguquka kwe-KRAS, ukungezwa kwesimiso sekuphindwe kabili ubude bokusinda-mahhala.
Ucwaningo lwangaphambili emangqamuzaneni omdlavuza wamaphaphu wabantu bathola ukuthi ukwengeza amangqamuzana omdlavuza wesifo wamaphaphu. Ngokweqile, kucatshangwa ukuthi i-statin iholela ekunciphiseni kwe-isoprenoids enethonya ku-RAS - ngenxa yalokho kuyimpumelelo emangqamuzaneni omdlavuza wamaphaphu onguquko lwe-KRAS.
Izitatimende Zama-Statins kanye nama-Lung Cancer Prevention
Ngenkathi isifundo esincane esidala singatholi isixhumanisi phakathi kokuvinjwa komdlavuza wesifo nesifo samaphaphu, isifundo samanje eTaiwan sabonisa indima engenzeka, okungenani kwabesifazane, ikakhulukazi labo abanezinye izimo zokuphefumula ezifana ne-COPD nesifo sofuba sofuba . Abacwaningi baqhathanisa abesifazane abangaphezu kuka-17 000 abangenalo umdlavuza wamaphaphu nabesifazane abangaphezu kuka-17 000 abatholakala benomdlavuza wamaphaphu phakathi kuka-2005 no-2010. Ukusetshenziswa kwesikhathi eside kweZocor (simvastatin) kwakuhambisana nengozi engaphansi kuka-20 yomdlavuza wamaphaphu uma kuqhathaniswa nabesifazane ababengazange basebenzise imithi. Ukusetshenziswa kwesikhathi eside kweMevacor (lovastatin) kwakungekho, kodwa, okuhlobene nengozi ephansi yalesi sifo.
Funda ngempikiswano yamuva mayelana nokusetshenziswa kwezitho zomzimba kubesifazane .
Yini Okufanele Uyenze Ngalolu Lwazi?
Njengoba kuphawuliwe ngenhla, lolu cwaningo lusasencane, futhi izincomo eziphathelene nokusetshenziswa komthetho ngokuqondile ngomdlavuza azange zenziwe. Kulabo abaye basebenzisa imithi ye-statin ye-cholesterol ephakeme ngesikhathi sokwelapha umdlavuza wamaphaphu, lezi zifundo zingase zibe umthombo wesikhuthazo. Ungase ufise ukuxoxa ngesimo sakho esithile kufaka phakathi iphrofayela yakho ye-lipid ne-oncologist yakho bese umbuza ukuthi ucabangani ngalolu lwazi.
Lolu lwazi lufika ngesikhathi lapho imihlahlandlela yangaphambilini ye-cholesterol ibuzwa khona. Ngenyanga kaDisemba ka-2014, idokhumende ehlongozwayo yeKomiti Yezokuqondisa Iziqondiso Zezokudla yathi i-cholesterol yokudla ayisabhekwa njengokondla yokukhathazeka ngokweqile. Lokhu kuyisihloko esizodinga ukuxoxwa futhi sibe nomuntu phakathi kwakho ne-oncologist yakho.
Izinyathelo Ezilandelayo
Kunezinto ezithile ezilula abantu abangenza ngokwabo ukuthuthukisa ukusinda nomdlavuza wamaphaphu. Hlola lezizinto ezingu-10 ezingahle zithuthukise ukusinda kwakho emdlalweni wamaphaphu .
Imithombo
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Chen, J. et al. I-Atorvastatin inqoba ukumelana kwe-gefitinib ku-KRAS amangqamuzana angewona amancane amangqamuzana e-cell lung carcinoma. I-Cell Death & Izifo . 2013 Sep 26: 4: e814.
Cheng, M., Chiu, H., Ho. S., no-C. Yang. Ukusetshenziswa kwe-Statin kanye nobungozi bomdlavuza wamaphaphu wesifazane: isifundo sokulawulwa kwamacala asezindaweni. I-Cancer Lung . 2012. 75 (3): 275-9.
Fiala, O., Pesek, M., Finek, J., Minarik, M., Benesova, L., Bortlicek, Z., no-O. Topolcan. Izitatimende zithuthukisa ukuphumelela kwe-EGFR-TKIs kuziguli ezine-advanced stage esingekho encane yomdlavuza wesifo samaphaphu ephethe ukuguquguquka kwe-KRAS. Biology ye-Tumor . 2015 Feb 22. (i-Epub ngaphambi kokuphrinta)
Park, I., Kim., J., Jumg, J., noJan Han. I-Lovastatin inqoba ukumelana kwe-gefitinib kumaseli omdlavuza wesifo samangqamuzana angewona amancane anezinguquko ze-K-Ras. Izidakamizwa Ezintsha Zokuhlola . 2010. 28 (6): 791-9.
Yang, T., Lin, W., Lin, C., Sung, F., noCao. Ukulingana phakathi kokusetshenziswa kwe-simvastatin ne-lovastatin nengozi yomdlavuza wesifazane wamaphaphu: isifundo socwaningo lonke jikelele. I-International Journal of Clinical Practice . 2015. 69 (5): 571-6.
Zhong, S., Zhang, X., Chen., L., Ma, T., Tang, J., noJ. Zhao. Ukusetshenziswa kwe-statin nokufa kwabantu ezigulini zomdlavuza: Ukubuyekezwa kwesistimu nokuhlaziywa kwe-meta-analysis yezifundo zokuhlola. Ukubuyekezwa kweCanscer Treatment . 2015 Apr 11. (Epub ngaphambi kokuphrinta)