Cholangiocarcinoma shine ciwon daji na bile ducts. Yana shafar epithelium na intra ko ƙarin bishiyar hanta, wato nama da aka haɗa da ƙwayoyin juma da ke haɗe da kafa tsarin tashoshin tattara bile. Bile ruwa ne mai ruwan hoda mai launin rawaya wanda hanta ke samarwa, saboda haka yuwuwar ci gaban ciki ko ƙarin cutar hanta.

Duk da ƙarancin cutar da har yanzu ba a san ta ba, cholangiocarcinoma yana da kusan kashi 3% na cututtukan daji na ciki da kusan 10 zuwa 15% na munanan cututtukan hepato-biliary. Akwai ɗan rinjaye na maza a cikin ci gaban wannan cutar. Bugu da ƙari, cutar tana tasowa a matsakaita tsakanin shekaru 50 zuwa 70.

Asalin ci gaban wannan ƙwayar har yanzu ba a sani ba. Duk da haka, zai zama kamar faruwar hakan ba zato ba tsammani, wato yana shafar wasu mutane ne kawai a cikin yawan jama'a ba tare da kasancewar "sarkar watsawa" da aka ayyana ba. (1)

Wannan kansar na iya haɓaka a:

- intrahepatic bile ducts. Waɗannan hanyoyin sun ƙunshi ƙananan bututu (canaliculi), Hanyoyin herring da bile ducts. Wannan saitin tashoshi sun haɗu don ƙirƙirar tashar hagu da dama ta kowa. Waɗannan suna barin hanta don bi da bi suna samar da bututu na gama gari. Wani nau'in tumor da ke shafar mahada tsakanin hanyoyin hanta na dama da hagu ana kiransa: Ciwon Klatskin;

- hanyoyin bile extrahepatic bile, waɗanda suka haɗa da babban bututun bile da ramin bile.

Alamomin da ke da alaƙa da irin wannan cutar kansa sun bambanta dangane da ciki ko ƙarin lalacewar hanta. Bugu da ƙari, bayyanar cututtuka na asibiti yawanci suna bayyana lokacin da cutar take a matakin ci gaba.

Cuta ce da ba kasafai ake samun ta ba a cikin mutane 1 cikin 100. (000)

Alamun cutar sun bayyana a wani mataki na ci gaba kuma sun bambanta dangane da wurin da ƙwayar take.

Lallai, a cikin yanayin inda ƙwayar cuta ta fi ƙarfin jiki, alamun alaƙa sune: (1)

- alamun cholestatic: bayyanannen kujeru, jaundice, fitsari mai duhu, pruritus, da sauransu;

- rashin jin daɗi;

- asarar nauyi;

- jin gajiya da rauni.

A cikin mahallin intrahepatic, an bayyana cutar ta hanyar rashin jin daɗi da takamaiman alamun ciki kamar:

- asarar nauyi;

- anorexia;

- ciwon ciki.

Wasu alamomin kuma ana iya danganta su da cutar: (2)

- zazzaɓi ;

- ciwon kai;

- zafi a saman dama na ciki.

An bayyana cutar a matakai da yawa: (3)

- mataki na 1a: ciwon kansa yana cikin gida a cikin bututun bile;

- mataki na 1b: ciwon daji ya fara yaduwa da yaduwa ta cikin tasoshin lymphatic;

- mataki na 2: ciwon daji ya fara yaduwa ta cikin kyallen takarda (galibi hanta) da tasoshin lymphatic;

- mataki na 3: ciwon kansa yana cikin sifar metastatic a mafi yawan jini da tasoshin lymphatic;

- mataki na 4: cutar kansa ta bazu zuwa dukkan gabobin jiki.

Ainihin dalilin ciwon sankarar hanji shine, har yau, har yanzu ba a sani ba. Koyaya, abubuwan haɗari don haɓaka cholangiocarcinoma an fi fahimtar su.

Ciwon daji yana tasowa daga maye gurbi a cikin jigilar jigilar bayanan kwayoyin halitta: DNA.

Wadannan maye gurbi na kwayoyin halitta a cikin sel suna haifar da karuwar ci gaba da ci gaban sel wanda ba a sarrafa shi wanda ke haifar da samuwar kwayar halitta da ake kira tumor.

Idan ba a gano cutar kansa ba a cikin lokaci kuma / ko ba a yi maganin ta da sauri ba, to ƙwayar na iya girma da yaduwa kai tsaye zuwa wasu sassan jiki ko by kwararar jini. (3)

Cholangiocarcinoma yana da alaƙa da ƙari wanda ke shafar duwatsu bile. Wannan yawanci yana tasowa sannu a hankali kuma juyin halittarsa ​​zuwa yanayin metastatic shima a hankali.

Bugu da ƙari, ana yin gwajin cutar sau da yawa a matakin ci gaba.

Ciwon na iya girma a kowane matakin tare da bile kuma ya toshe kwararar bile.

Kodayake ainihin asalin cutar ita ce, har zuwa yau, har yanzu ba a san ta ba, da yawa abubuwan haɗari da ke da alaƙa da cutar a bayyane suke. Wannan shine lamarin musamman tare da: (2)

• kasancewar cysts a cikin bile ducts;
• kumburi na hanjin bile ko hanta;
• sclerosing cholangitis na farko da na sakandare (kumburin kumburin hanjin bile wanda ke haifar da gajarta da rushewar kwararar bile na al'ada);
• ulcerative colitis (cututtukan kumburi na babban hanji);
• karusar ciwon typhoid na yau da kullun (ci gaban zazzabin typhoid wanda asalinsa ya fito ne daga wakili mai kamuwa da cuta kuma ana iya yada shi daga mutum zuwa wani);
• parasitic cututtuka ta Opisthochis viverrini wata biyu Clonorchis sinensis;
• fallasawa ga thorotrast (wakili mai bambanci wanda aka yi amfani da shi a hoton rediyo na x-ray).

 Wasu dalilai na sirri suma suna shigowa cikin ci gaban irin wannan ƙari: (3)

• shekaru; mutane sama da 65 suna da haɗarin kamuwa da cutar;
• daukan hotuna zuwa wasu sinadarai. Bayyanawa ga thorotrast shine mafi kyawun misalin. Tabbas, an tabbatar da cewa fallasawa ga wannan wakilin sinadarai da aka yi amfani da shi sosai a cikin rediyo, kafin haramcin sa a cikin 1960s, yana ƙara haɗarin haɓaka cholangiocarcinoma. Sauran sunadarai kuma suna da hannu wajen haɓaka haɗarin kamuwa da cutar, kamar asbestos ko PCBs (polychlorinated biphenyls). Na farko an yi amfani da shi na dogon lokaci azaman kayan hana wuta a cikin gine -gine, gini da masana'antu. PCBs kuma galibi ana amfani da su a masana'antu da gini. Wadannan sinadarai yanzu suna karkashin tsauraran dokoki;
• kasancewar hepatitis B ko C;
• kasancewar cirrhosis;
• kamuwa da cutar kanjamau (Virus na rashin lafiyar ɗan adam);
• nau'in I da nau'in ciwon sukari na II;
• kiba;
• taba.

Dole ne a yi gwaje -gwaje daban -daban na gwajin cutar kansa na duwatsun bile don yin gwajin cutar. (3)

• Ana amfani da gwajin jini a cikin ganewar cholangiocarcinoma. A zahiri, a cikin mahallin inda ƙwayar cuta ke tasowa a cikin bile biyun, ƙwayoyin cutar kansa suna sakin wasu sunadarai masu siffa waɗanda za a iya gano su ta hanyar gwajin jini. Koyaya, waɗannan alamun kuma ana iya sakin su a ƙarƙashin wasu yanayi. Kasancewar waɗannan abubuwan ba a haɗa su da tsari ba tare da haɓaka ciwon daji na duwatsun bile;
• na'urar binciken hanyoyin bile ta sa ya yiwu a sami hoton ciki na wannan sashin jiki don gano duk wani rashin lafiya;
• tomography, ta hanyar jerin X-ray na hanta, yana ba da damar ƙarin cikakkun bayanai game da wannan sashin ta hanyar hotuna masu girma 3;
• MRI (Hoto na Magnetic Resonance), ta amfani da tsarin filayen maganadisu da raƙuman rediyo don samun hoton cikin hanta;
• retrograde cholangiopancreatography endoscopy wata hanya ce ta haskaka ƙarin cikakkun abubuwan da ba daidai ba na hanyoyin bile;
• ana kuma amfani da cholangiography na transhepatic percutaneous don samun cikakken bayyani na gallbladder;
• biopsy yana ba da damar tabbatar da ganewar asali.

Yawancin lokuta na ciwon daji na bile ba za a iya warkewa ba. Koyaya, jiyya don cutar galibi alama ce ta musamman.

Ana aiwatar da bin diddigin na godiya ga ƙungiya mai ɗimbin yawa wanda ya ƙunshi ƙungiyar kwararru (likitocin tiyata, likitan oncologist, likitan rediyo, ma'aikatan jinya, likitan gastroenterologist, da sauransu). (3)

Magungunan da aka bayar sun dogara ne da alamun cutar da kuma ci gaban cutar kansa.

A mataki na 1 da na 2, ana iya tiyata don sabunta sashin gallbladder, bile ducts ko hanta.

A mataki na 3, damar samun nasarar maganin ya dogara da matakin lalacewar tasoshin lymphatic.

A ƙarshe, a mataki na 4, nasarar nasarar jiyya yana da ƙarancin inganci.

Jiyya da cutar na iya haifar da ayyukan tiyata da ke ba da damar sabunta kyallen kyallen takarda: wani ɓangaren bile wanda ke ɗauke da ƙwayoyin cutar kansa, mafitsara, wasu tasoshin lymphatic da abin ya shafa ko ma ɓangaren hanta.

Yawanci, tsakanin 20% zuwa 40% na mutanen da ake yi wa aikin tiyata suna rayuwa shekaru 5 ko fiye bayan aikin.

Dangane da asalin ciwon ciki, jaundice, da dai sauransu, buɗaɗɗen hanyoyin bile wani lokaci ya zama dole. Ana aiwatar da wannan sakin ta amfani da bututun bakin ciki da aka ratsa ta cikin bile.

Magungunan radiation ba magani bane na yau da kullun don cholangiocarcinoma, duk da haka yana iya zama mai tasiri wajen rage alamun cutar tare da iyakance yaduwar metastases. Akwai nau’o’in jiyya iri biyu: farcewar farfaɗo da waje da farmaki na ciki.

Bugu da ƙari, aikin rediyo na iya haifar da illa kamar tashin zuciya, amai ko ma gajiya mai tsanani.

Hakanan ana amfani da Chemotherapy don dalilai masu kama da maganin radiation. Ko don rage alamun, don iyakance yaduwar ƙwayar cuta da haɓaka tsawon rayuwar abin da abin ya shafa. Chemotherapy sau da yawa ana haɗa shi da radiotherapy. Illolin da ke da alaƙa da chemotherapy suma suna da alaƙa da aikin rediyo da asarar gashi.

Wasu bincike sun nuna fa'idodin da ke tattare da haɗuwar magunguna biyu da ake amfani da su a cikin ilimin jiyya (Cisplatin da Gemcitabine).

Har zuwa yau, jiyya da ke da alaƙa da ciwon daji na duwatsu bile ba su da tasiri kamar waɗanda ke da alaƙa da sauran nau'in cutar kansa. Don haka, karatu da yawa suna mai da hankali kan wannan nau'in cutar kansa don nemo ingantattun hanyoyin magance cutar.

Bugu da ƙari, bincike kan haɓaka hanyoyin kwantar da hankali da aka yi niyya ma na yanzu. Waɗannan magunguna ne waɗanda ke yin niyya ga wani mataki na ci gaban cutar kansa.