Sakurabani muntazam ravishda ko'rib chiqish va men va Chikago Universitetining boshqa hisobotlaritahlil natijalari shuni ko'rsatadiki, surunkali jigar kasalligi bo'lgan bemorlarda kolorektal saraton (CRC) xavfi yuqori, hatto bu bemorlarga jigar transplantatsiyasi o'tkazilgan bo'lsa ham, bu xavf hali ham mavjud. (Oshqozon-ichak Endosc. Onlayn versiyasi 21 yil 2016 dekabr)
Sakurabaning ta'kidlashicha, jigar kasalligi sabablaridan qat'i nazar, surunkali jigar kasalligi bo'lgan bemorlarda KRK xavfi yuqori va bu xavf jigar transplantatsiyasidan keyin ham mavjud. Shuning uchun surunkali jigar kasalligi bilan og'rigan bemorlar skrining tekshiruvidan o'tishi yoki CRC xavfini kamaytirish uchun ko'proq intensivlik bilan kuzatilishi kerak.
Sakuraba va boshq. Jigar transplantatsiyasidan oldin va keyin surunkali jigar kasalligi bo'lgan bemorlarda CRC xavfini baholadi. Tadqiqotchilar elektron ma'lumotlar bazasi orqali surunkali jigar kasalliklari va KRS xavfi bo'yicha tadqiqotlarni izladilar va 55 ta tadqiqotda jami 991 50 bemorni tekshirdilar. According to Sakuraba, in studies that included patients with hepatitis and cirrhosis, the total standardized incidence rate (SIR) was 2.06 (95% CI 1.46 ~ 2.90, P <0.0001), and the heterogeneity was moderate (I2 = 49.2%) This is most likely due to differences in disease subgroups and research intensity.
Uchta tadqiqot shuni ko'rsatdiki, birlamchi sklerozli xolangit (PSC) bilan og'rigan bemorlarda CRC (SIR = 6.70, 95% CI 3.48-12.91; P <0.0001) va o'rtacha heterojenlik (I2 = 36.3%) xavfi ortadi, bu aniq. tadqiqot intensivligining farqiga. Jigar transplantatsiyasiga uchragan bemorlarni o'z ichiga olgan ushbu tadqiqotlarda SIR 2.16 (95% CI 1.59 dan 2.94, P <0.0001) va heterojenlik o'rtacha (I2 = 56.4%) edi.
Tahlil qilishda otoimmun bilan bog'liq jigar kasalliklarining ulushi CRC xavfi bilan bog'liq edi. Sakuraba shunday dedi: "Ilgari faqat PSC bilan og'rigan bemorlarda CRC xavfi ortadi deb o'ylar edi, ammo bizning tadqiqotlarimiz shuni ko'rsatdiki, boshqa surunkali jigar kasalliklari bo'lgan bemorlarda CRC xavfi ham ortadi. Xuddi shu o'sish juda muhimdir. "
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 yo'g'on ichak saratoni, 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.
Bolandning aytishicha, bu topilmalar yangi emas, chunki yallig'lanish va immunosupressiya yo'g'on ichak saratoni uchun xavf omillari hisoblanadi. Uning fikricha, kolonoskopiya, ayniqsa, PSC bilan og'rigan bemorlar uchun jigar metastazlarini jarrohlik tekshirishning bir qismi bo'lishi mumkin. U, shuningdek, yo'g'on ichakning turli qismlarida paydo bo'ladigan o'smalar katta biologik farqlarga ega bo'lganligi sababli, kasallikning xavfi asosan chap yoki o'ng yo'g'on ichak bilan bog'liqmi yoki yo'qligini yanada o'rganish qiziqarli bo'lishini ta'kidladi.
