Igama elithi "amangqamuzana okuqapha" lwethusa. Kubalulekile ukuqala ukukhuluma ngalawa maseli ngokusho ukuthi akuwona wonke amangqamuzana angenakuqapha aphenduka umdlavuza. Eqinisweni, iningi alikho.
Abantu abaningi baye bezwa ngamangqamuzana anesifo esibelethweni somlomo wesibeletho esitholakala ngesikhathi se- Pap smears , kodwa amangqamuzana angama-precancerous angenzeka cishe kunoma yisiphi isifunda somzimba: i-bronchi, isikhumba, amabele, ikholoni, nokuningi.
Ake siqale ngokuchaza ukuthi lawa maseli aphi nokuthi ahluke kanjani kumaseli "avamile" emizimbeni yethu.
Incazelo
Amaseli angaphambi kokucwaninga (okubizwa nangokuthi amangqamuzana angaphambi kokuqala) achazwa njengamaseli angavamile angaba amangqamuzana anomdlavuza kodwa wona ngokwawo awahambelani.
Umqondo wama cell precancerous udideka ngoba akuyona inkinga emnyama neyemhlophe. Ngokuvamile, amaseli awahambanga kusuka evamile ngelanga elilodwa, ukuba alungiselele ngosuku olubili, bese eqhubeka nomdlavuza ngosuku lwesithathu. Ngezinye izikhathi amangqamuzana angenaziqhumane aqhubekela emdlalweni, kepha kaningi akwenzi. Bangase bahlale okufanayo-okungukuthi, bahlale bengavamile kodwa bengabhubhisi-noma bangase bavele bajwayelekile.
Lokhu kuphawula okugcina kuyinto entsha kakhulu kubacwaningi bomdlavuza. Esikhathini esedlule, kwakucatshangwa ukuthi "umonakalo wenziwa" lapho iseli liguqulwa ukuze liqaphele ngamagciwane emvelo. Manje sifunda (ensimini ebizwa ngokuthi i-epigenetics) ukuthi amangqamuzana ethu aqinile kunalokho futhi izimo endaweni yethu (kungakhathaliseki ukuthi i-carcinogens, ama-hormone noma mhlawumbe nokucindezeleka) basebenza ndawonye ukuthola ukuthi iziphi izinguquko ezingavamile esitokisini zingahamba.
Kubalulekile ukugcizelela futhi ukuthi amangqamuzana anembayo awawona amangqamuzana omdlavuza . Lokhu kusho ukuthi ukushiywa yedwa, akusiyo imvelo-okungukuthi, ngeke isakaze kwezinye izifunda zomzimba. Amangqamuzana nje angavamile angakwazi, ngokuhamba kwesikhathi, aguqule izinguquko ezizoguqula zibe amangqamuzana omdlavuza.
Enye iphuzu lokudideka yilapho amaseli omdlavuza namaseli angenakuqedwa angabelana. Isibonelo, kwabanye abantu abathintekayo benomdlavuza wesifuba, kunezinye izifunda ezisebeleni ngisho nasendlini ngokwayo lapho amangqamuzana anqanda khona atholakele khona. Ezingxenyeni eziningi, kokubili amangqamuzana abulalayo futhi ahlelelekile atholakala.
Izigatshana zezinguquko zeDysplasia
Igama elithi dysplasia livame ukusetshenziselwa ngokufanayo ngemangqamuzana angenawo ama-precancerous, kodwa kukhona ukungafani okumbalwa. Lapho odokotela bekhuluma nge-dysplasia, bakhuluma ngamangqamuzana angavamile angaba nomdlavuza. Kodwa kwezinye izimo, amagama asetshenziselwa ukuchaza amaseli asebevele engumdlavuza kodwa aqukethe izicubu abaqala ngazo-into eyaziwa ngokuthi i- carcinoma-in-situ .
Izinguquko zangaphambili zivame ukuchazwa emazingeni noma amazinga okungajwayelekile. Kunezindlela ezimbili eziyinhloko ezichazwa ngazo: ukuqina nobude.
Ubunzima
- I-dysplasia eyomile: I- dysplasia elula ibhekisela kumaseli alungile kancane. Lawa maseli avame ukuqhubeka nomdlavuza.
- I-dysplasia esilinganiselwe: Lawa maseli ajwayelekile ngokweqile futhi abe nengozi ephezulu yokuba umdlavuza.
- I-dysplasia ejulile: Lokhu kuyinto engavamile kakhulu eyabonakala ngaphambi kokuba iseli lichazwe njengomdlavuza. I-dysplasia ekhulu kakhulu ingcono kakhulu ukuqhubeka nomdlavuza.
Isibonelo esingase senze lokhu kucacise ukuthi i- dysplasia yomlomo etholakale kwezinye ama- Pap smears . Amaseli aphethwe ngomoya omncane akavamile ukuba nomdlavuza. Ngakolunye uhlangothi, uma kushiywe kungalashwa, i-dysplasia enamandla etholakalayo kwi-pap smear izoqhubeka nomdlavuza ngamaphesenti angu-30 kuya kuma-50 amaphesenti wesikhathi.
Kukhona ukudideka mayelana nokuthi yikuphi okuzokwakhiwa khona phakathi kwe-dysplasia ejulile ne-carcinoma in situ. I-carcinoma in situ igama elihunyushwe ngokoqobo ngokuthi "umdlavuza endaweni." Lawa amangqamuzana anomdlavuza angazange aphule kulokho okubizwa ngokuthi yi-embhedeni yangaphansi.
Amabanga
Enye indlela yokuchaza ubunzima bezinguquko ezinqamulelayo kumaseli kungamamaki.
Ngamaseli womlomo wesibeletho, lezi zigaba zivame ukusetshenziswa uma i-biopsy yenzeka ngemuva kokuthola i-dysplasia kwi-pap smear.
- I-dysplasia ebangeni eliphansi: Izinguquko eziphansi kwebanga azikwazi ukuqhubeka nomdlavuza.
- I-high-grade dysplasia: Amaseli ane-high-grade dysplasia cishe amathuba okuqhubeka nomdlavuza.
Isibonelo salokhu kungaba isibalo esincane se-dysplasia esibonakala ku-biopsy yomlomo wesibeletho. Ubuhle balezi zinguquko eziqhubekela phambili emdlavuza aphansi kakhulu. Ngokuphambene nalokho, i-high-grade colon dysplasia ehlobene nama- polyp polyps inengozi enkulu yokuqhubeka nokuba umdlavuza wekoloni .
Ukuxilongwa
Amaseli angaphambi kokucubungula atholakala ngokubukeka kwawo okungavamile ngaphansi kwe-microscope, ngokuvamile emva kokuba i-biopsy yenziwe.
Izimbangela
Kunezici eziningi ezingabangela ukuba amangqamuzana abe yisiqhumane, futhi lokhu kuyahluka kuye ngokuthi uhlobo oluthile lwamaseli abathintekayo.
Indlela elula yokuqonda izimbangela ukubuka izithonya emvelweni ezingalimaza amangqamuzana aphilile, okuholela ekushintsheni ku-DNA yeselula, okungase kuholele ekukhuleni okungavamile nentuthuko. Izinqubo ezimbalwa eziyinhloko ezingabangela ukungajwayelekile emangqamuzaneni (ngezibonelo ezimbalwa okufanele zifane) zifaka:
- Ukwelashwa: Nakuba amaphesenti angu-4 kuya kwangu-10 kuphela ekhansela e-US ahlobene nokutheleleka, izifo ezinamagciwane, amabhaktheriya, nama-parasite zithweswe cishe ingxenye yesine yamakhansela emhlabeni jikelele.
Ukutheleleka nge- papillomavirus yomuntu (HPV) kungabangela ukuvuvukala, okuholela emangqamuzaneni anqandekile emtholampilo. I-HPV nayo iyimbangela ebalulekile ye-dysplasia ehamba phambili emdlavuza wezinhloko nezintamo eziningi, njengomdlavuza wesilimi nomdlavuza womphimbo . Ukutheleleka okuningi nge-HPV kucacile ngaphambi kokuba kube nezinguquko ezingavamile zeseli ezenzekayo. Uma i-dysplasia iqala, ingase ixazululwe yodwa noma ngezokwelapha, noma iqhubekele emdlalweni wesibeletho ngaphandle komuthi.
Ukwelashwa nokuvuvukala okulandelayo nge-bacteria i- Helicobacter pylori (H. pylori) kungaholela ekutheni isifo se-atrophic gastritis esingapheli, ishintsho esivuthayo sokuvuvukala emgodini wesisu ongabangela umdlavuza wesisu . - Ukuvuvukala Okungapheli: Ukuvuvukala okungapheli kwezicubu kungaholela ekuguqulweni okungenakuqhathaniswa okungase kuthuthuke kumdlavuza. Isibonelo sabantu ababhekene nesifo se-reflux ye-gastroesophageal (GERD) isikhathi eside. Ukuvuvukala okungapheli kwesifo sesisu nge-acids kungaholela esimweni esaziwa ngokuthi yisifo sikaBarrett . Phakathi kwabantu abane-Barrett, cishe amaphesenti angama-1 ngonyaka azokwenzela umdlavuza we-esophageal . Indawo ebalulekile yokucwaninga iwukunquma noma ukukhipha izindawo ze-high-grade dysplasia izokwehlisa ingozi yokuthuthukisa umdlavuza we-esophageal.
Esinye isibonelo ukuvuvukala kolononi kubantu abane- inflammatory disease (IBD) . I-IBD ingaholela kuma-polyps nge-colon dysplasia, ekugcineni ingabangela umdlavuza wekoloni. - I-irritation engapheliyo: Ukucasuka okungapheli kwemimoya yomoya ovela kumusi kagwayi , ukungcola komoya nezinye amakhemikhali ezimboni kungabangela i-bronchial dysplasia (i-dysplasia ye- bronchi ). Uma lokhu kutholakala kusenesikhathi-ngesikhathi se- bronchoscopy kanye ne-biopsy, isibonelo-amangqamuzana angama-precancerous ngezinye izikhathi angaphathwa nge-cryosurgery ngaphambi kokuba abe nethuba lokuqhubekela emdlalweni wamaphaphu .
Izinhlobo Zemibuzo Yokuqala
Amakhansela aqala ngamaseli e-epithelial (cishe amaphesenti angama-85 ekhansela) angase abe nesimo esinqunyiwe. Lokhu kuhluke kumdlavuza oqala kumaseli we-mesothelial njengama-sarcomas. Amanye ama-precantcerous states ashiwo ngenhla, kodwa afaka:
- I-neoplasia ye-cervical intraepithelial (i-CIN) - Isimo esingenalutho somdlavuza wesibeletho
- Isisindo sikaBarrett (amangqamuzana angavamile okwemvelo angase aqhubeke abe umdlavuza we-esophageal)
- I-aperptic lobular hyperplasia (engase ikhule ibe ngumdlavuza webele)
- Ama-polyps adenomatous ekolon (okungase athuthuke ibe ngumdlavuza wekoloni)
- I-actinic keratoses (izinguquko ezingavamile esikhumbeni ezingase zibe isikhumba somdlavuza wesikhumba esincane)
- I-moles ye-Dysplastic (engase ikhule ibe yi-melanoma)
- I-bronchial epithelial dysplasia (engase ikhule ibe ngumdlavuza wamaphaphu)
- I-atrophic gastritis (izinguquko ezingezansi ezingeni lesisu ezingase zikhule zibe ngumdlavuza wesisu (esiswini)
Kubuye kubalulekile ukuqaphela ukuthi amangqamuzana angenaziqhumane angahle aqhubeke angaba amangqamuzana anomdlavuza noma cha.
Iyini Isikhathi Sokugcina?
Ukuxoxa ngezinguquko ezinqamulelayo kuyithuba elihle lokukhuluma ngomunye umqondo onzima ukuqonda ekuthuthukisweni komdlavuza: i-latency.
Isikhathi se- latency sichazwa ngokuthi yisikhathi sesikhathi phakathi kokuchazwa kwesifo somdlavuza (i-carcinogen) nokuthuthukiswa komdlavuza kamuva. Abantu bavame ukumangala lapho behlakulela umdlavuza eminyakeni eminingi emva kokuvezwa kwe-carcinogen; isibonelo, abanye abantu bayathinteka uma bekhula nomdlavuza wamaphaphu ngisho nalapho bekayeka ukubhema amashumi amathathu ngaphambili.
Lapho amangqamuzana eqala ukuvezwa ku-carcinogen, umonakalo wenziwa ku-DNA esitokisini. Ngokuvamile ukuqoqwa kwalomonakalo (ukuqoqwa kwezinguquko) ngokuhamba kwesikhathi okuholela esitokisini ukuba ibe yingozi. Ngemva kwalesi sikhathi, iseli lingathuthuka ngezigaba zobumnene ukuya ekulinganiseni-nase-severe-dysplasia ngaphambi kokugcina zibe yisifo somdlavuza. Ingqamuzana ingabuye ibekwe endaweni evimbela ukuqhubekela phambili kwayo emdlalweni, noma ibuye iphinde uyibuyisele esitokisini esivamile (kungani ukudla okunempilo nokuzivocavoca kubalulekile ngisho noma uke wahlushwa i-carcinogen).
Lena indlela elula yokuchaza inqubo, futhi sifunda ukuthi kuyinkimbinkimbi kakhulu kunalokho esake sicabanga. Kodwa ukuqonda inqubo eqondile kusiza ukuchaza isikhathi se-latency esiyibona ne-kansa eminingi.
Ngabe Amaseli Aqala Ukwelapha?
Impendulo yukuthi isikhathi esiningi, asazi ukuthi kuthatha isikhathi esingakanani ukuthi amangqamuzana angenakuqapha abe nomdlavuza. Ngaphezu kwalokho, impendulo ngokuqinisekile ihlukahluka kuye ngokuthi hlobo luni selufundwa.
Njengoba kuphawuliwe ngenhla, amaseli womlomo wesibeletho ane-dysplasia enamandla aqhubekela phambili emdlalweni we-30 kuya kwangu-50 wamaphesenti wesikhathi, kodwa isikhathi esasithatha ukuthi senzeke sasihluka. Esinye isifundo sibheke abantu abangu-115 abane-dysplasia yezintambo zomculo, 15 baqhubeka behlakulela umdlavuza omangalisa (omunye wayeno-dysplasia omnene, owodwa wayene-dysplasia elinganisiwe, eyisikhombisa yayine-dysplasia enamandla futhi engu-6 yayine-carcinoma in situ). Ezingamaphesenti angu-73 zalaba baguli, izilonda zabo eziqanjiwe zaba umdlavuza ongenangqondo wezintambo zomlomo phakathi nonyaka owodwa, kanti abanye abasakhulayo baba nomdlavuza kamuva.
Zikhona Izimpawu?
Amaseli angaphambi kokuqala ahlale ekhona ngaphandle kwezimpawu. Uma izimpawu zikhona, zizoxhomeka endaweni yezinguquko ezihamba phambili; isibonelo, izinguquko ezinqandekile esibelethweni somlomo wesibeletho zingabangela ukuthi amangqamuzana ahlume kalula, okwenza kube nokuphuma kwamagciwane okungavamile . Izinguquko zangaphambili emlonyeni zingabonwa njengamabala amhlophe (leukoplakia). Futhi ezindaweni ezingabonakali emehlweni, njengoba izicubu zihlanganisa imigwaqo yomoya, i-dysplasia ivame ukutholakala lapho ukuhlolwa kwe-biopsy kwenziwa enye isizathu.
Ukwelapha
Ukwelashwa kwamangqamuzana okuqapha kuzophinde kugxile kunendawo yamaseli.
Ngezinye izikhathi ukuqapha okusheshayo yilokho okunconywa ukubona ukuthi izinga le-dysplasia liqhubeka noma lixazulula ngaphandle kokwelashwa.
Ngokuvamile amangqamuzana angenakuqedwa azosuswa ngenqubo efana ne-cryotherapy (ekhanda amangqamuzana) noma ukuhlinzwa ukukhipha isifunda lapho amaseli angavamile khona. Ngisho noma amaseli angavamile asusiwe, kubalulekile ukukhumbula ukuthi noma yini eyenza amangqamuzana abe angavamile endaweni yokuqala angathinta amanye amaseli esikhathini esizayo.
Isibonelo, uma amangqamuzana angavamile wesibeletho aphathwa nge-cryotherapy, kuzobe kubalulekile ukubheka izinkinga eziphindaphindiwe nge-Pap smears esikhathini esizayo. Futhi uma isifo sikaBarrett siphathwa nge-cryotherapy, usazobe usadingeka ukuba uhlolwe isisindo sakho ngezikhathi esikhathini esizayo.
Ngezinye izinto ezingavamile, udokotela wakho angancoma ukuthi i-chemoprevention. Lona ukusetshenziswa kwemithi eyanciphisa ingozi yamangqamuzana ukuba abe engavamile esikhathini esizayo. Isibonelo salokhu ukuphatha isifo nge-H. pylori bacteria esiswini. Ukugibela umzimba wamabhaktheriya kubonakala kunciphisa amangqamuzana angenakuqhathaniswa nokuthuthukiswa komdlavuza wesisu. Abacwaningi babheka ukusetshenziswa kwezidakamizwa eziningana namavithamini ukuze babone ukuthi ukusetshenziswa kwabo kwabokubhema bangaphambili nabangamanje kuzokwehlisa ingozi yabo yokuthuthukisa umdlavuza wamaphaphu esikhathini esizayo.
Iphuzu lokugcina nelibalulekile lokwenzayo yisikhumbuzo sokuthi, kwezinye izimo, ukuqhutshwa kwezinguquko ezinqandekile kungashintshwa yendawo yethu: ukudla esikudlayo, ukuzivocavoca esikutholayo, kanye nokukhetha kokuphila esikwenzayo. Ukudla okucebile ekudleni okunamavithamini athile, isibonelo, kungasiza umzimba ukucacise ngokushesha igciwane le-HPV.
Imigomo Yokuthuthukiswa Kwengqayizivele
Kunemigomo eminingi echaza amangqamuzana enza ukuqonda lesi sihloko kunzima, ngakho isibonelo singasiza ukwenza lokhu kuqondwe kancane.
Ngomdlavuza we-squamous cell wamaphaphu , kubonakala sengathi amangqamuzana aqhubeka nokuqhubeka okuthile ngaphambi kokuba umdlavuza uqale. Iqala ngamaseli avamile wamaphaphu. Ukuguqulwa kokuqala yi-hyperplasia, echazwe njengamaseli akhule kakhulu noma asheshe kunalindelekile. Isibonelo, i-hyperplasia yenhliziyo yayiyoba igama elisetshenziselwa ukuchaza inhliziyo ekhulisiwe.
Isinyathelo sesibili yi-metaplasia lapho amangqamuzana eguqukela ohlobo lweselula olungavamile ukuvela. I-Metaplasia engxenyeni (okungaba isandulela somdlavuza we-esophageal), isibonelo, lapho ama-cell abukeka njengalawo avame ukutholakala emathunjini amancane atholakale esiteshini. Isinyathelo sesithathu yi-dysplasia, elandelwa yi-carcinoma in situ futhi, ekugcineni, i-squamous cell carcinoma.
Ukunciphisa Ingozi Yakho
Akukaze kube sekwephuzile ukuthatha imikhuba yokuvimbela-ngisho noma uthola ukuthi unomdlavuza. Ngokusho kwe-American Institute for Cancer Research, abantu abanomdlavuza nabo bangazuza ngokufunda ngokunciphisa ingozi yomdlavuza noma ukuncipha kokuphindaphindiwe ngokudla nokuzivocavoca.
Thatha isikhashana ukuhlola amathiphu ekunciphiseni ingozi yomdlavuza , engasiza ekunciphiseni umdlavuza wamapayipi kanye nezinye umdlavuza, kanye nama- superfoods ezokudla ezingasiza ukunciphisa ingozi yomdlavuza noma ukuphindaphinda umdlavuza.
> Imithombo:
> Chen, L., Shen, R., Ye, Y. et al. Amaseli ase-Sten Precancerous ayenokwenzeka kokubili ukuhlukanisa Benign and Malignant. PLosOne . 2007. doi.org/10.1371/journal.pone.0000293
> UKeith, i-R. Lung chemoprevention yomdlavuza. Izinqubo ze-American Thoracic Society . 2012. 9 (2): 52-6.
> Rohde, M. et al. Ukuqeda ukuhlukumezeka kwezilonda ezinqabile zezintambo zokukhuluma ukuze ugweme ingozi yomdlavuza. I-Danish Medical Journal . 2012. 59 (5): A4399.
> Seo, J. et al. Ukuqedwa kwe-Helicobacter pylori Kunciphisa I-Metachronous Cancer Gastric emva kokusinda kwe-Endoscopic ye-Cancer Early Gastric. I-Hepatogastroenterology . 2012. 60 (125).
> Toll, A. et al. Ukubaluleka kokubikezelwa kwe-high-grade dysplasia ku-adenomas e-colorectal. Izifo Eziphilayo . 2011. 14 (4): 370-3.