Cudurka caabuqa ee caabuqa , ama IBD, waxaa ka mid ah bakteeriyada maqaarka iyo cudurka Crohn. Labadaba waa cuduro aan la daweyn karin oo ah xuubka mindhicirka. Labadaba daaweyn ayaa yareyn kara qalliinka iyo isbitaalada.
Qaadashada IBD oo loola dhaqmo waxay la xiriirtaa khatarta kordhaysa ee lymfomada, khatartuna waxay ku xidhan tahay arrimo kale oo aan ahayn mid la daaweyn karo.
Cudurka Dhiigga Caabuqa
IBD waxay ka timaadaa infakshanka mindhicirka, taas oo keeni karta dhiigbax, qandho, kor u kaca tirada unugyada cad ee dhiigga , iyo sidoo kale shuban iyo casiraadda xanuunka caloosha. Xaaladaha aan caadi ahayn ee IBD ayaa badanaa ku jira barashada sawirada sida baaritaanka CT, ama baarista walamadka, tusaale ahaan.
Khatarta Lymphoma
Dadka qaba IBD waxay daaweeyeen daweyno gaar ah - sida wakiilada anti-TNF iyo isbeddelada difaaca - waxay halis dheeraad ah u yihiin kansarrada qaarkood oo ku lug leh unugyada dhiigga ee cadaanka ah , sida uu qabo baaritaano badan. Si kastaba ha ahaatee, waxaa jira waxoogaa hubaal ah oo ku saabsan inta ay le'eg tahay khatarta jirta.
Lymphoma waa kansar ka bilowda unugyada dhiigga ee cadaanka ah, kaas oo qayb ka ah habka difaaca jidhka. Labada qaybood ee ugu muhiimsan ee lymphoma waa Hodgkin iyo non-Hodgkin lymphoma (NHL) . Waxaa jira noocyo badan iyo noocyo badan . Waxaa la arkay in NHL uu ku dhaco heer ka sarreeya heerarka la filayo ee ku saabsan cudurrada kala duwan ee u baahan in laga hortago, sida IBD.
Halista lymphoma ma aha mid isku mid ah qof kasta oo leh IBD. Halista ayaa ku kala duwan sida waafaqsan sida da'da, jinsiga, iyo waxyaabaha kale ee shakhsi ahaaneed. Qiimeynta khatarta iyo faa'iidooyinka daaweynta IBD ee takhtarkaaga ayaa qayb muhiim ah ka ah go'aanka daaweynta. Inta badan, waxaa la go'aaminayaa in faa'iidada badan ee daaweyntu ay ka badan tahay khatarta yaryar ee soo gaarta.
Daaweyntii IBD
Isticmaalka daawada anti-inflammatory ee IBD si ay u soo jiidaan daaweyn ka dib marka lagu daro daaweynta dayactirka daawooyinka difaaca jirka ayaa weli ah habka ugu wanaagsan ee daaweynta. Thiopurines - sida azathioprine - ayaa si weyn loogu isticmaalaa daaweynta cudurka daacuunka ee firiiriciga ah ee joogtada ah.
Bukaannada qaba daawada IBD ee lagu daaweeyo thiopurines, waxaa jira khatar sare oo ah noocyada kansarka dhiigga, laakiin tirada kansarrada oo kobcaya daaweynta ayaa la rumeysan yahay inay aad u yar tahay. Dadka qaada xubinta xubnaha jirka, NHL ee la xidhiidha baqdinta difaaca waxaa loo yaqaan 'disorder' -continuous lymphoproliferative, iyo qaar ka mid ah waxa la yaqaan ee ku saabsan halista lenfoma waxay ka timaaddaa kooxdan bukaanka ah.
Noocyo gaar ah oo lymfoma ah ayaa lagu arkay walxaha difaaca jirka ee loo isticmaalo IBD. Lymphoma ka dib marka xubin ka mid ah xubin ka mid ah. Lymphoma ka dib marka la qaato mononucleosis, ama mono, waa macquul, iyo foomkani wuxuu u eg yahay inuu saameeyo ragga da'doodu ka yartahay 35 sano. Marar dhif ah, hepatosplenic lymphoma ayaa laga yaabaa inuu horumar sameeyo, waxayna u egtahay in uu kobcayo ugu yaraan 2 sanno oo daweyn ah oo lagu daweeyo iskubaaxyada iyo daweynta necrosis ee ka hortagga uur-jiifka, ama qaaxada oo keliya.
- Azathioprine wuxuu la xiriiray 2.40 x oo ah halista lenfoma ee daraasaddan lagu daabacay "Journal of American Epidemism".
- Isku-darka Azathioprine iyo 6-mercaptopurine wuxuu leeyahay 4.92-laab khatarta sare u ah horumarinta lymphoma ee dadka qaba IBD, sida lagu sheegay daraasad lagu daabacay "Gastroenterology iyo Hepatology."
Wax yar ayaa laga ogaadaa halista methotrexate iyo halista lenfoma ee IBD. Iyadoo wakiilada anti-TNF, daraasaddan 2009 ayaa lagu ogaaday in halista lymfoma ay la socoto anti-TNF + immunomodulator isaga oo ka badan kan immunomodulatorka oo keliya.
Khadka hoose
Waxaa jira su'aalo badan oo aan la aqbali karin oo ku saabsan halista lenfoma marka la eego daaweynta IBD. Haddii aad leedahay IBD oo aad u baahan tahay daaweyn, waxaa fiican inaad ka wada hadashid wixii walwal ah ee aad ka qabi karto khatarta dhakhtarkaaga, oo kaa caawin kara inaad wax ku soo bandhigto oo aad ka caawiso in aad xaqiiqdaada iyo tirooyinkaaga ku dartid xaalad gaar ah.
Iyadoo aan lahayn daaweyn haboon, bukaanka qaba cudurka Crohn iyo colitis bacdamaa waxay yeelan kartaa tayada nolosha oo aad u yar. Dhakhaatiirta qaarkood waxay muujinayaan xaqiiqda ah in laga yaabo in aan ka shaqeyno tiro yar oo kiisaska dheeraadka ah ee lymphoma ka mid ah kumanaan bukaan ah, iyo sannado badan oo nagu hoggaamiya in ay ka soo baxaan natiijooyin khatar ah.
Hal shay ayaa hubaal ah: walwalka xad dhaafka ah iyo cadaadiska daba-dheeraaday waxay la xiriiraan dhammaan noocyada dhibaatooyinka caafimaadka, markaa adiga iyo dhakhtarkaagu go'aamin inaad u baahan tahay daaweyn, ma fiicna inaad walwal qabto.
Ilaha:
Pasternak B, Svanstrom H, Schmiegelow K, iyo al. Isticmaalka Azathioprine iyo Khatarta Kansarka ee Cudurka Caabuqa Caabuqa. Am. J. Epidemiol . 2013; 177 (11): 1296-1305.
Kotlyar DS, Lewis JD, Beaugerie L, et al. Khatarta Lymphoma ee bukaanka qaba Cudurka Dhiigga Caabuqa Daawada Azathioprine iyo 6-Mercaptopurine: Falanqaynta Meta. Clin Gastroenterol Hepatol. 2015; 13 (5) 847-858.e4.
Bär F, Sina C, Fellermann K. Thiopurines oo ku jira cudurka mindhicirka ee dib-u-kicinta. World J Gastroenterol. 2013; 19 (11): 1699-1706.
Sokol H, Beaugerie L. Cudurka caabuqa ee infalmatory iyo jirrooyinka lenfoproliferative: Boodhku wuxuu bilaabayaa inuu dego. Gut . 2009 Oktoobar; 58 (10): 1427-36.
Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Khatarta sii kordhaysa ee lymphoma ka mid ah bukaanka caabuqa caabuqa caabuqa ee lagu daweeyo azathioprine iyo 6-mercaptopurine. Gut. 2005; 54 (8): 1121-1125.
Askling J, Brandt L, Lapidus A, et al. Khatarta kansarka hematopoietic ee bukaanka qaba cudurka calool-bararka. Gut. 2005; 54 (5): 617-622.
Bhandari BM, Kroser JA, Bloomfeld RS, Lynch SP. Cudurka Dhiigga Caabuqa. Kuliyada American Gastroenterology. 2013.
Siegel CA. Khatarta Lymphoma ee Cudurka Dhiigga Caabuqa. Gastroenterol Hepatol. 2009; 5 (11): 784-790.