Kuongorora kwakarongeka uye neni kwaSakuraba uye mimwe mishumo kubva kuYunivhesiti yeChicagota ongororo mhedzisiro inoratidza kuti varwere vane chirwere chisingaperi chechiropa vane njodzi yakanyanya yegomarara remukati (CRC), kunyangwe varwere ava vakagamuchira chiropa, njodzi iyi ichiripo. (Gastrointestinal Endosc. Online version musi waDecember 21, 2016)
Sakuraba akataura kuti zvisinei nechikonzero chechirwere chechiropa, varwere vane chirwere chisingaperi chechiropa vane njodzi yakanyanya yeCCR, uye njodzi iyi ichiripo mushure mekuisirwa chiropa. Naizvozvo, varwere vane chirwere chisingaperi chechiropa vanofanirwa kuongororwa kana kuongororwa nehukuru hwakanyanya kudzikisa njodzi yeCRC.
Sakuraba et al. Wakaongorora njodzi yeCCR muvarwere vane chirwere chisingaperi chechiropa pamberi uye mushure mekuisirwa chiropa. Vatsvakurudzi vakatsvaga zvidzidzo pamusoro penjodzi yechirwere chisingaperi chechiropa uye CRC kuburikidza nedhatabhesi yemagetsi uye vakaongorora huwandu hwevarwere 55 991 muzvidzidzo makumi mashanu. Sekureva kwaSakuraba, mune zvidzidzo zvaisanganisira varwere vane hepatitis uye cirrhosis, iyo yakazara yakajairwa chiitiko chiitiko (SIR) yaive 2.06 (95% CI 1.46 ~ 2.90, P <0.0001), uye iyo heterogeneity yaive pakati nepakati (I2 = 49.2%) Izvi ndizvo. zvinowanzoitika nekuda kwekusiyana kwemapoka ezvirwere uye kusimba kwekutsvagisa.
Zvidzidzo zvitatu zvakaratidza kuti varwere vane primary sclerosing cholangitis (PSC) vane njodzi yakawandisa yeCRC (SIR = 6.70, 95% CI 3.48-12.91; P <0.0001), uye zvine mwero heterogeneity (I2 = 36.3%), Zviripachena kuti izvi zvakakodzera kumusiyano mukutsvaga kwekutsvaga. Mune izvo zvidzidzo zvaisanganisira varwere vakaiswa chiropa chekuisirwa, iyo SIR yaive 2.16 (95% CI 1.59 kusvika 2.94, P <0.0001), uye huterogeneity yaive pakati nepakati (I2 = 56.4%).
In meIn the ta ongororo, chikamu chezvirwere zvechiropa zvine chekuita ne autoimmune chaive chine chekuita nenjodzi yeCRC. Sakuraba akati, "Kare zvaifungidzirwa kuti varwere vePSC chete ndivo vangave nenjodzi yakawedzera yeCRC, asi tsvakiridzo yedu yakaratidza kuti njodzi yeCRC pakati pevarwere vane zvimwe zvirwere zvechiropa zvisingaperi ichawedzerawo. Kuwedzera kumwe chete kunokosha zvikuru. “
Patrick Boland from the Roswell Park Cancer Institute in New York is not a member of the study. He pointed out that most of the patients in the study have cirrhosis, PSC or have received liver transplantation. The risk of CRC in PSC patients is particularly obvious. PSC is associated with inflammatory bowel disease, which is a known risk factor for kenza yemaroni, which is also the strongest evidence. However, those who have undergone liver transplantation, especially those with underlying autoimmune diseases, have an increased risk of CRC. Organ transplantation requires the use of immunosuppressive agents, which puts the patient at risk of secondary malignancy for a long time. They have evidence that kidney transplant patients have an increased risk of colon cancer. The data from this study showed that the risk of colon cancer in patients who underwent liver transplantation would be doubled.
Boland akati izvi zvakawanikwa hazvisi zvitsva, nekuti kuzvimba uye kudzvinyirira immune zvinokonzeresa kenza yekoloni. Iye anotenda kuti colonoscopy inogona kuve chikamu chekuvhenekwa kuongororwa kwechiropa metastases, kunyanya kune varwere vane PSC. Akataura zvakare kuti nekuda kwekuti mamota anowanikwa munzvimbo dzakasiyana dzematumbo akakura ane misiyano mikuru yehupenyu, zvichave zvinonakidza kuenderera mberi nekudzidza kana njodzi yechirwere ichi ichinyanya kuenderana neyekuruboshwe kana kurudyi colon.
