Chirwere cheropa

Chii chinonzi gomarara rechiropa?

Gomarara rechiropa kukura nekupararira kwemasero asina hutano muchiropa. Gomarara rinotangira muchiropa rinonzi primary liver cancer. Gomarara rinopararira kuchiropa richibva kune imwe nhengo rinonzi metastatic liver cancer. Hepatocellular carcinoma (HCC) ndiyo inonyanya kuzivikanwa mhando yekenza yechiropa.

Chiropa

Chiropa chinoumbwa nemasero anonzi hepatocytes. Iinewo mamwe marudzi emasero, anosanganisira masero anotevedza tsinga dzayo dzeropa uye masero anotevedza machubhu madiki muchiropa anonzi bile ducts. Iyo bile ducts inotakura bile kubva pachiropa kuenda kune gallbladder kana zvakananga kuura.

Chiropa inhengo hombe yegland mumuviri uye inoita akasiyana mabasa akakosha kuti muviri ugare usina chepfu nezvinhu zvinokuvadza. Iyo inowanikwa kurudyi yekumusoro quadrant yedumbu, pasi chaipo pembabvu. Chiropa chine basa rekugadzira bile, chinova chinhu chinokubatsira kugaya mafuta, mavhitaminzi, nezvimwe zvinovaka muviri. Nhengo yakakosha iyi inochengetawo zvinovaka muviri zvakadai seglucose, kuti ugare uchiguta panguva dzaunenge usiri kudya. Inoputsawo mishonga uye chepfu. Kana gomarara rikakura muchiropa, rinoparadza maseru echiropa uye rinokanganisa kugona kwechiropa kuti chishande zvakanaka.

Kenza yechiropa inowanzo kuverengerwa sepuraimari kana yechipiri. Kenza yechiropa yepakutanga inotangira mumasero echiropa. Yechipiri gomarara rechiropa rinoitika apo maseru ekenza kubva kune imwe nhengo inopararira kuchiropa. Kusiyana nemamwe maseru mumuviri, maseru egomarara anogona kubva panzvimbo yekutanga, kana kuti kenza payakatanga. Iwo maseru anoenda kune dzimwe nzvimbo dzemuviri kuburikidza neropa kana iyo lymphatic system. Cancer masero anozopedzisira aunganidzwa mune imwe nhengo yemuviri otanga kukura ipapo.

Iwe haugone kurarama pasina chiropa chako. Iyo ine akawanda akakosha mabasa:

• Inotsemuka uye inochengetera huzhinji hwezvinhu zvinovaka muviri zvinobva mumatumbo zvinoda kuti muviri wako ushande. Zvimwe zvinovaka muviri zvinofanirwa kuchinjwa (kugadziriswa) muchiropa zvisati zvashandiswa kune simba kana kuvaka uye kugadzirisa nyama dzemuviri.
• Inoita yakawanda yezvinhu zvinovhara zvino chengetedza kubva pakubuda ropa zvakanyanya kana watemwa kana kukuvara.
• Inoendesa bile mumatumbo kuti ibatsire kutora zvinovaka muviri (kunyanya mafuta).
• Inotyora doro, zvinodhaka, uye marara ane chepfu muropa, ayo anobva apfuura kubva mumuviri kuburikidza neweti uye chitsiko

Mhando dzakasiyana dzemasero ari muchiropa dzinogona kuumba mhando dzinoverengeka dzemaronda akaipa (ane gomarara) uye ane bundu (risina gomarara). Aya mamota ane zvikonzero zvakasiyana, anorapwa zvakasiyana, uye ane chirevo chakasiyana (maonero).

Ndezvipi zvinhu zvine njodzi nezvikonzero zvegomarara rechiropa?

• Yenguva refu hepatitis B uye hepatitis C hutachiona hwakabatana nekenza yechiropa nekuti zvinowanzoendesa kuchirwere checirrhosis. Hepatitis B inogona kukonzera kenza yechiropa isina cirrhosis.
• Kunwisa doro.
• Kufutisa uye chirwere cheshuga zvakabatana zvakanyanya nerudzi rwechiropa chisina kujairika chinonzi nonalcoholic fatty chiropa chirwere (NAFLD) icho chinogona kuwedzera njodzi yekenza yechiropa, kunyanya kune avo vanonwa zvakanyanya kana vane hutachiona hepatitis.
• Humwe hutachiona hwehutachiona.
• Kuratidzirwa kwezvakatipoteredza kumaafatoxin.
• Zvimwe zvakawanda zvirwere zvechiropa, zvinosanganisira autoimmune zvirwere sePBC, uye zvimwe zvirwere zvisingawanzoita seTyrosinemia, Alpha1-antitrypsin kushomeka, Porphyria cutanea tarda, chirwere cheGlycogen chekuchengetedza, uye chirwere cheWilson chinogona kutungamira kuchiropa, izvo zvinowedzera mukana wekenza yechiropa.

Vanachiremba havana chokwadi nei vamwe vanhu vachiwana gomarara rechiropa asi vamwe vasina. Nekudaro, pane zvimwe zvinhu zvinozivikanwa kuwedzera njodzi yekuva nekenza yechiropa:

• Kenza yechiropa inowanzoitika kune vanhu vanopfuura makore makumi mashanu.
• Yenguva refu hepatitis B kana C hutachiona hunogona kukuvadza zvakanyanya chiropa chako. Hepatitis inopararira ichibva pamunhu-kuenda-kumunhu kuburikidza nekubata zvakananga nemvura yemumuviri yemunhu ane hutachiona, senge ropa ravo kana urume. Inogona zvakare kupfuudzwa kubva kuna amai kuenda kumwana panguva yekusununguka. Iwe unogona kudzikisa njodzi yako yehepatitis B uye C nekushandisa chengetedzo panguva yepabonde. Kune zvakare jekiseni rinokwanisa kukudzivirira kubva kuhepatitis B.
• Kuva nezvinwiwa zviviri kana kupfuura zvinodhakwa zuva rega rega pamusoro pemakore mazhinji zvinowedzera mukana wako wekenza yechiropa.
• Cirrhosis inzira yekukuvara kwechiropa umo hutano hwakanaka hunotsiviwa nemavara ane vanga. Chiropa chakatsvuka hachigone kushanda nemazvo uye chinogona kupedzisira chaunza matambudziko akawanda, kusanganisira gomarara rechiropa. Kunwa doro kwenguva refu uye hepatitis C ndizvo zvinonyanya kukonzera cirrhosis muUnited States. Ruzhinji rwevaAmerica vane gomarara rechiropa vane cirrhosis vasati vaita gomarara rechiropa.
• Kujekesa kune aflatoxin chinhu chinenjodzi. Aflatoxin chinhu chine chepfu chinogadzirwa nerudzi rweforoma inogona kukura nzungu, zviyo, uye chibage. MuUnited States, mitemo inobata chikafu inogumira kuratidzira kune aflatoxin. Kunze kwenyika, zvakadaro, aflatoxin kuratidzwa kunogona kuve kwakakwirira.
• Chirwere cheshuga uye kufutisa zvakare zvine njodzi. Vanhu vane chirwere cheshuga vanowanzo nyanyisa kana kufutisa, izvo zvinogona kukonzera matambudziko echiropa uye nekuwedzera njodzi yekenza yechiropa.

Referensi: Healthline

Nzira yekuderedza njodzi yekenza yechiropa?

Matanho ekuderedza njodzi yekenza yechiropa anosanganisira:

• Kugara uchiona chiremba anoongorora chirwere chechiropa
• Taura nachiremba wako nezve hutachiona hwehutachiona hwehutachiona, kusanganisira hepatitis A uye kubatira hepatitis B
• Tora matanho ekudzivirira kusangana ne hepatitis B uye hepatitis C. Unogona kuwana zvakawanda nezve kudzivirira hutachiona B pano, uye maitiro ekudzivirira hepatitis C pano.
• Kana iwe uine cirrhosis kana chirwere chisingaperi chechiropa, tevera zvawakarayirwa nachiremba wako kuti urapwe uye uongororwe gomarara rechiropa
• Kana iwe uri kufutisa kana kufutisa, chirwere cheshuga, kana kunwa zvakanyanya, taura nachiremba wako

Kenza yechiropa inoonekwa sei?

Iko kuongororwa kwekenza yechiropa kunotanga nenhoroondo yezvokurapa uye kuongororwa kwemuviri. Ive neshuwa yekuudza chiremba wako kana iwe uine nhoroondo yekureba-kwenguva refu kunwisa doro kana chisingaperi hepatitis B kana C hutachiona.

Kuongororwa kuongororwa uye maitiro ekenza yechiropa anosanganisira anotevera:

• Chiropa chinoshanda bvunzo dzinobatsira chiremba wako kuona hutano hwechiropa chako nekuyera huwandu hwemapuroteni, enzyme enzyme, uye bilirubin muropa rako.
• Kuvapo kweAlpha-fetoprotein (AFP) muropa kunogona kuva chiratidzo chegomarara rechiropa. Iyi protein inowanzo gadzirwa muchiropa uye yolk sac yevana vasati vazvarwa. Kugadzirwa kweAFP kunowanzo mira mushure mekuzvarwa.
• Abdominal CT kana MRI scans inogadzira yakadzama mifananidzo yechiropa uye dzimwe nhengo mudumbu. Vanogona kubvumira chiremba wako kuti ataure apo bundu riri kukura, kuona kukura kwaro, uye kuongorora kana rapararira kune dzimwe nhengo.

Chiropa Chirwere

Imwe bvunzo yekuongorora inowanikwa chiropa biopsy. Chiropa chiropa chinosanganisira kubvisa chidimbu chiduku chechiropa. Izvo zvinowanzoitwa uchishandisa anesthesia kudzivirira iwe kubva kunzwa chero kurwadziwa panguva yekuita.

Muzviitiko zvakawanda, tsono biopsy inoitwa. Munguva iyi maitiro, chiremba wako anozoisa tsono yakatetepa kuburikidza nedumbu rako uye muchiropa chako kuti uwane sampuro yeshuga. Muenzaniso unobva waongororwa pasi pe microscope yezviratidzo zvegomarara.

Chiropa chiropa chinogona kuitwawo uchishandisa laparoscope, inova mutete, inoshanduka chubhu ine kamera yakasungirirwa. Iyo kamera inobvumira chiremba wako kuti aone kuti chiropa chinotaridzika sei uye kuti aite yakanyatsojeka biopsy. Iyo laparoscope inoiswa kuburikidza nekacheka kucheka mudumbu. Kana zvimisikidzo zvinyama kubva kune dzimwe nhengo zvichidikanwa, chiremba wako achaita yakakura incision. Izvi zvinonzi laparotomy.

Kana gomarara rechiropa rikawanikwa, chiremba wako anoona danho rekenza. Staging inotsanangura kuomarara kana kukura kwecancer. Inogona kubatsira chiremba wako kuona nzira dzako dzekurapa uye maonero ako. Chikamu chechina chikamu chepamusoro chekenza yechiropa.

Mhando dzekenza yechiropa

Chirwere chechiropa chekutanga

Kenza inotangira muchiropa inonzi primary cancer cancer. Kune anopfuura anopfuura imwe mhando yekenza yechiropa yekutanga.

Hepatocellular carcinoma (HCC)

Iyi ndiyo inowanzozivikanwa kenza yechiropa muvanhu vakuru.

Cancer yeHepatocellular inogona kuve nemhando dzakasiyana dzekukura:

• Vamwe vanotanga sebundu rimwe rinokura. Kunze chete muchirwere ndipo panopararira kune dzimwe nzvimbo dzechiropa.
• Rudzi rwechipiri runoratidzika kunge rwunotanga sevazhinji madiki emukenza madiki mukati mechiropa, kwete chete bundu rimwe chete. Izvi zvinoonekwa kazhinji muvanhu vane cirrhosis (chisingaperi chiropa kukuvara) uye ndiyo yakajairika maitiro anoonekwa muUnited States.

Vanachiremba vanogona kupatsanura akati wandei madiki eHCC. Kazhinji kazhinji aya madiki haatapure kurapwa kana kufungidzira (maonero). Asi imwe yeaya madiki, fibrolamellar, zvakakosha kuziva. Kashoma, inoumba isingasviki 1% yeHCCs uye inowanzoonekwa kune vakadzi vadiki pane makore makumi matatu nemashanu. Kazhinji chiropa chisara hachina chirwere. Iyi subtype inowanzo kuve nemaonero ari nani pane mamwe mafomu eHCC.

Intrahepatic cholangiocarcinoma (bile duct kenza)

Inenge gumi kubva muzana kusvika makumi maviri muzana yekenza inotanga muchiropa ndeye intrahepatic cholangiocarcinomas. Iyi kanzira inotanga mumasero anoteedzera madiki bile bile (machubhu anotakura bile kuenda kune nduru) mukati mechiropa. Mazhinji cholangiocarcinomas, zvisinei, anotanga mumaburi bile kunze kwechiropa.

Kunyangwe rumwe ruzivo urwu rwuri kunyanya nezvehepatocellular cancers, cholangiocarcinomas inowanzobatwa nenzira imwechete. Kuti uwane rumwe ruzivo nezve rudzi urwu rwegomarara, ona Bile Duct Cancer.

Angiosarcoma uye hemangiosarcoma

Idzi ndidzo kenza dzisingawanzo dzinotanga mumasero akadzika midzi yeropa rechiropa. Vanhu vakaoneswa vinyl chloride kana kuti thorium dioxide (Thorotrast) vane mukana wekuvandudza aya kanzura. Zvimwe zviitiko zvinofungidzirwa kuti zvinokonzerwa nekuratidzwa kune arsenic kana radium, kana kune iyo nhaka nhaka inozivikanwa seyakagara hemochromatosis. Mune inenge hafu yezviitiko zvese, hapana chikonzero chinokonzeresa chinogona kuzivikanwa.

Mamota aya anokura nekukurumidza uye anowanzo kupararira zvakanyanya kuti abviswe pakuvhiya panguva yaanowanikwa. Chemotherapy uye radiation therapy inogona kubatsira kuderedza chirwere, asi magomarara aya anowanzo kunetsa kurapa. Magomarara aya anorapwa semamwe masarcomas. Kuti uwane rumwe ruzivo, ona Soft Tissue Sarcoma.

Hepatoblastoma

Urwu rudzi rwegomarara risingawanzo wanzoitika muvana, kazhinji kune avo vari pasi pemakore mana. Masero ehepatoblastoma akafanana nemasero echiropa che "fetus". Vanenge vana vaviri pavatatu vane mapundu aya vanorapwa zvinobudirira nekuvhiyiwa uye chemotherapy, kunyange zvazvo mapundu acho akaoma kurapa kana akapararira kunze kwechiropa.

Sekenza yechiropa kenza (metastatic kenza yechiropa)

Nguva zhinji kana gomarara richiwanikwa muchiropa harina kutangira ipapo asi kuti rapararira (metastasized) richibva kune imwe nzvimbo mumuviri, serwatata, muura, dumbu, zamu, kana mapapu. Nekuda kwekuti gomarara iri rakapararira kubva panzvimbo yaro yepakutanga (yekutanga), rinonzi gomarara rechipiri rechiropa. Aya mamota anopihwa mazita uye anorapwa zvichibva pane yavo yekutanga saiti (kwaakatanga). Semuenzaniso, gomarara rakatanga mumapapu rikapararira kuchiropa rinonzi kenza yemapapu richipararira kuchiropa, kwete kenza yechiropa. Inobatwawo segomarara remapapu.

MuUnited States neEurope, yechipiri (metastatic) chiropa tumarara zvinowanzoitika kupfuura gomarara rekutanga rechiropa. Izvo zvinopesana ndezvechokwadi kumatunhu mazhinji eAsia neAfrica.

Kuti uwane rumwe ruzivo nezvechiropa metastases kubva pamhando dzakasiyana dzekenza, ona chaiwo cancer mhando, pamwe neepamberi Cancer.

Benign chiropa tumota

Mamota eBenign dzimwe nguva anokura zvakakura zvakakwana kuti akonzere matambudziko, asi haakure kuita matishu ari pedyo kana kupararira kunzvimbo dziri kure dzomuviri. Kana vachida kurapwa, murwere anokwanisa kurapwa pamwe nekuvhiyiwa.

hemangioma

Rudzi rwakajairika rwechironda checancer chironda, hemangiomas, kutanga mumidziyo yeropa. Mazhinji hemangiomas echiropa haaite zviratidzo uye haadi kurapwa. Asi vamwe vanogona kubuda ropa uye vanoda kubviswa pamwe nekuvhiyiwa.

Hepatic adenoma

Hepatic adenoma ibundu rinotapira rinotanga kubva ku hepatocytes (rudzi rukuru rwechiropa). Zvakawanda zvinokonzeresa kusava nezviratidzo uye hazvidi kurapwa. Asi zvimwe zvinopedzisira zvichikonzera zviratidzo, sekurwadziwa kana bundu mudumbu (mudumbu nzvimbo) kana kurasikirwa neropa. Nekuti pane njodzi yekuti bundu rinogona kuputika (zvichikonzera kurasikirwa kwakanyanya kweropa) uye nenjodzi diki yekuti inogona kupedzisira yaita gomarara rechiropa, nyanzvi zhinji dzinowanzo kuraira kuvhiyiwa kubvisa bundu kana zvichibvira.

Kushandisa mimwe mishonga kunogona kuwedzera njodzi yekuwana aya mapundu. Vakadzi vane mukana wakakura wekuve nerimwe remamota aya kana vakatora mapiritsi ekudzivirira kubereka, kunyangwe izvi zvisingawanzoitika. Varume vanoshandisa vanabolic steroid vanogona zvakare kugadzira aya mamota. Adenomas inogona kudzikira kana mishonga iyi yamiswa.

Focal nodular hyperplasia

Focal nodular hyperplasia (FNH) kukura-kunge kukura kunoumbwa nemhando dzinoverengeka dzemaseru (hepatocytes, bile duct maseru, uye maseru ehunobatanidza). Kunyangwe hosha dzeFNH dziri benign, dzinogona kukonzera zviratidzo. Zvinogona kuva zvakaoma kuvaudza ivo kure kwechokwadi gomarara rechiropa uye vanachiremba dzimwe nguva vanozvibvisa kana kuongororwa kusiri kujeka.

Ose hepatic adenomas uye FNH tumarara zvinowanzoitika kune vakadzi kupfuura varume.

Kenza yechiropa inorapwa sei?

Kurapa kwekenza yechiropa kunosiyana. Zvinoenderana ne:

• huwandu, hukuru, uye nzvimbo yemamota ari muchiropa
• chiropa chiri kushanda sei
• kana cirrhosis iripo
• kuti bundu rapararira kune dzimwe nhengo here

Yako chaiyo yekurapa chirongwa ichave inoenderana nezve izvi zvinhu. Zvirwere zvekenza yechiropa zvinogona kusanganisira zvinotevera:

Kurapa kweproton

Proton therapy yakaratidza kuve sarudzo yakanaka yekurapa kune isiri metastatic chiropa cancer. Muzvizhinji zvezviitiko zvinoonekwa kuti bundu rinopera zvachose mushure mekurapa kweproton.

Hepatectomy

Hepatectomy inoitwa kubvisa chero chikamu chechiropa kana chese chiropa. Kuvhiya uku kunowanzoitwa kana gomarara rakangovharirwa muchiropa. Nekufamba kwenguva, zvinyama zvasara zvine hutano zvinodzoka uye kutsiva chikamu chisipo.

Liver Transplant

Kuisa chiropa kunosanganisira kutsiva chiropa chose chine chirwere nechiropa chine hutano kubva kune anopa akakodzera. Kuisa kunogona kuitwa chete kana gomarara risina kupararira kune dzimwe nhengo. Mishonga yekudzivirira kurambwa inopihwa mushure mekuiswazve.

Kubvisa

Kubvisa kunosanganisira kushandiswa kwekupisa kana ethanol majekiseni kuparadza gomarara maseru. Inoitwa uchishandisa anesthesia yemuno. Izvi zvinopinza nzvimbo yacho kudzivirira kuti usanzwa chero kurwadziwa. Ablation inogona kubatsira vanhu vasina kukwikwidza kuvhiyiwa kana kuisirwa.

Kurapwa

Chemotherapy inzira ine hukasha yekurapa kwezvinodhaka iyo inoparadza cancer maseru. Mishonga inorowa mukati, kana kuburikidza nemutsinga. Muzviitiko zvakawanda, chemotherapy inogona kupihwa sekunze kurapwa. Chemotherapy inogona kushanda pakurapa kenza yechiropa, asi vanhu vazhinji vanowana mhedzisiro panguva yekurapa, kusanganisira kurutsa, kuderera kwechido, uye kutonhora. Chemotherapy inogona zvakare kuwedzera njodzi yako yehutachiona.

Radiation Therapy

Radiation kurapa kunosanganisira kushandiswa kwepamusoro-simba radiation matanda kuuraya cancer maseru. Inogona kununurwa neyekunze beam radiation kana nemukati radiation. Mune ekunze beam radiation, iyo radiation inotarisana nedumbu uye chipfuva. Radiation yemukati inosanganisira kushandiswa kwekateti kuisa jekiseni reredhiyo mukati meiyo arter hepatic. Iyo radiation inozoparadza iyo hepatic artery, iro reropa reropa rinopa ropa kuchiropa. Izvi zvinoderedza huwandu hweropa kuyerera kune bundu. Kana iyo hepatic artery ikavharwa, iyo portal vein inoramba ichisimbisa chiropa.

Targeted Therapy

Kurapa kwakanangwa kunosanganisira kushandiswa kwemishonga yakagadzirirwa kurova cancer maseru kwavanotambura. Ivo vanoderedza bundu kukura uye vanobatsira kuvhara pasi reropa kune iro bundu. Sorafenib (Nexavar) yakagamuchirwa seyakananga kurapwa kune vanhu vane gomarara rechiropa. Kurapa kwakanangwa kunogona kubatsira kune vanhu vasina kukwikwidza hepatectomy kana kuwedzerwa kwechiropa. Nekudaro, kurapwa kwakanangwa kunogona kuve nemhedzisiro.

Kubatanidza uye Chemoembolization

Embolization uye chemoembolization maitiro ekuvhiya. Ivo vapedza kuvhara iyo hepatic artery. Chiremba wako anoshandisa madiki masiponji kana zvimwe zvidimbu kuita izvi. Izvi zvinoderedza huwandu hweropa kuyerera kune bundu. Mune chemoembolization, chiremba wako anopinza chemotherapy mishonga mune yehepatic arteri zvisati zvaiswa majekiseni. Iko kuvharirwa kwakagadzirwa kunochengeta chemotherapy mishonga muchiropa kwenguva yakareba.