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Kansarka qanjirka 'prostate': Abstract

Kansarka qanjirka 'prostate' (PCa) ayaa weli ah sababta ugu weyn ee dhimashada ragga Mareykanka waxaana faafitaanka cudurka uu weli sii kordhayaa adduunka oo dhan gaar ahaan dalalka ay raggu ku cunaan cunnada nooca reer galbeedka ah. Epidemiologic, preclinical and clinical studies ayaa soo jeedinaya doorka suurtagalka ah ee qaadashada cuntada ee dhacdooyinka iyo horumarka PCa. Dib-u-eegis yar ayaa bixinaysa dulmar ku saabsan suugaan dhawaan la daabacay oo la xidhiidha nafaqooyinka, arrimaha cuntada, qaababka cuntada iyo dhacdooyinka PCa iyo horumarka. Qaadashada karbohaydraytyada hoose, borotiinka soy, omega-3 (w-3) dufan, shaaha cagaaran, yaanyada iyo tamaandhada iyo zyflamend waxay muujiyeen ballanqaad yaraynta khatarta PCa ama horumarka. Qaadashada dufanka buuxa iyo heerka ?-carotene ee sarreeya ayaa kordhin kara khatarta. Xiriirka qaabka ayaa laga yaabaa inuu ka dhexeeyo folate, fitamiin C, fitamiin D iyo kalsiyum oo leh khatarta PCa. In kasta oo natiijooyinka aan iswaafaqsanayn iyo natiijooyinka aan dhammaystirnayn, suurtagalnimada doorka qaadashada cuntada ee ka hortagga iyo daaweynta PCa waa rajo. Isku darka dhammaan qodobbada faa'iidada u leh hoos u dhigista khatarta PCa ee qaabka cunto caafimaad leh ayaa laga yaabaa inay tahay talada ugu wanaagsan ee cuntada. Habkani waxa ku jira miraha iyo khudaarta qani ah, karbohaydraytyada la safeeyey oo la dhimay, wadarta dufanka iyo dufanka buuxa, iyo hilibka la kariyey ee la yareeyey. Tijaabooyin dheeri ah oo taxadar leh ayaa la dammaanad qaaday.

Erayada furaha: Cunto, Kansarka qanjirka 'prostate', Nafaqooyinka, Habka cuntada, Hab-nololeedka, Ka-hortagga, Daaweynta, Nafaqada, Faragelinta Cuntada, Dib u eegista

Hordhac: Kansarka qanjirka 'prostate'

Kansarka qanjirka 'prostate' (PCa) waa kansarka labaad ee ugu badan ee ragga, iyadoo ku dhawaad hal milyan oo xaaladood oo cusub laga helay adduunka oo dhan sannadkii [1], iyada oo ku dhawaad lix laab ay ka badan tahay dhacdooyinka Galbeedka marka loo eego waddamada aan galbeedka ahayn. Cuntooyinka, qaab nololeedka, arrimaha deegaanka iyo hiddaha ayaa la qiyaasayaa inay door ku leeyihiin kala duwanaanshahan. Dib-u-eeggani wuxuu diiradda saarayaa caddayntii ugu dambeysay ee doorka suurtagalka ah ee arrimaha cuntada ee PCa waxaana ka mid ah cudurrada faafa iyo caddaynta tijaabada caafimaad ee saameynta borotiinka, baruurta, karbohaydraytyada, fiber, phytochemicals, qaybaha kale ee cuntada, cuntooyinka oo dhan iyo qaababka cuntada ee dhacdooyinka PCa, horumarka iyo/ama horumarka. Xogta laga helay falanqaynta-meta ama tijaabooyinka random-ka ee si wanaagsan loo qaabeeyey iyo daraasadaha la filayo ayaa lagu xoojiyay dib u eegistan. Waa in la ogaadaa in daraasadaha ku saabsan qaadashada cuntada ama nafaqada iyo kansarka ay inta badan ku xiran yihiin xaddidaadyo kala duwan oo sidaas darteed adkeynaya fasiraadda natiijooyinka. Tusaale ahaan, marka daraasad loo qorsheeyay in lagu baaro saamaynta qadarka qaadashada dufanka, beddelka qaadashada dufanka si lama filaan ah waxay bedeli doontaa qaadashada borotiinka iyo/ama karbohaydrayt, waxaana laga yaabaa inay beddesho qaadashada nafaqooyinka kale sidoo kale. Natiijo ahaan, way adagtahay in loo nisbeeyo saamaynta isbeddelka qaadashada dufanka oo keliya. Intaa waxaa dheer, saameynta nafaqeeyayaalka yar yar ee suurtogalka ah waxay ku lug leedahay dhinacyo tiro buuxda iyo nooca nafaqeeyayaalka yar yar ee la isticmaalo. Labada dhinacba waxa laga yaabaa inay saameeyaan bilawga kansarka iyo/ama horumarka si madaxbanaan, laakiin mar walba laguma kala saari karo naqshadaha cilmi-baarista. In kasta oo mawduucan dhawaan dib loo eegay [2], oo la siiyay suugaanta cusub ee mawduuca, dib u eegis la cusboonaysiiyay ayaa lagu soo bandhigay halkan waxaana la bixiyay shax kooban oo tixraac degdeg ah (Shaxda 1).

Nafaqeeyayaalka Carbohydrateska Marka la eego mala-awaalka ah in insulintu ay tahay qodobka koritaanka PCa, waxa la qiyaasay in yaraynta karbohaydraytyada sidaas awgeed hoos u dhigista insulinta serum ay hoos u dhigi karto kobaca PCa [3]. Runtii, moodooyinka xayawaanka, mid ka mid ah cuntooyinka ketogenic-ka ee aan-carbohydrate-ka lahayn (NCKD) [4,5] ama cunto karbohaydrayt yar-yar (20% kcal sida karbohaydrayt) waxay saameyn wanaagsan ku leedahay hoos u dhigista kobaca qanjirka 'prostate' [6,7]. Daraasadaha aadanaha, hal daraasad ayaa lagu ogaaday in qaadashada sare ee karbohaydraytyada la safeeyey ay la xiriirto khatarta sii kordheysa ee PCa [7]. Marka lagu daro qadarka karbohaydraytyada, nooca karbohaydraytyadu waxay saameyn ku yeelan karaan PCa laakiin cilmi-baaristu waxay ahayd mid aan natiijo lahayn. Awoodda lagu dhimi karo khatarta PCa iyo horumarka iyadoo la saameynayo dheef-shiid kiimikaadka karbohaydraytyada waxaa si firfircoon loogu baarayaa Metformin. Metformin waxay hoos u dhigtay kororka unugyada PCa iyo dib u dhaca horumarka gudaha vitro iyo in vivo, siday u kala horreeyaan [8-10] iyo hoos u dhaca khatarta shilalka iyo dhimashada bini'aadamka [11-13]. Labo tijaabo oo cudud ah oo cudud ah ayaa sidoo kale muujisay saameyn togan oo metformin ah oo saameynaysa calaamadaha fidinta PCa iyo horumarka [14,15]. Si kastaba ha noqotee, daraasadaha kooxeed ee kale ma aysan taageerin saameynta metformin ee soo noqoshada ama khatarta shilalka PCa [16-22]. Inkasta oo ay suurtogal tahay in la dhimo wadarta ama karbohaydraytyada fudud ee ka faa'iidaysiga kontoroolka PCa, caddaynta ayaa ka maqan tijaabooyinka la kantaroolay ee la kala soocay (RCT). Labo tijaabo oo aan kala sooc lahayn ayaa socda oo baaraya saameynta cunto karbohaydrayt yar-yar (qiyaastii 5% kcal) ee PSA oo labanlaabantay waqti ka mid ah bukaannada PCa ee ka dambeeya qanjirka 'prostatectomy' (NCT01763944) iyo jawaabta glycemic ee bukaannada bilaabaya daawaynta androgen deprivation (ADT) NCT00932672 ). Natiijooyinka ka soo baxa tijaabooyinkan ayaa iftiimin doona saamaynta qaadashada karbohaydrayt ee calaamadaha horumarka PCa iyo doorka qaadashada karbohaydrayt ee la dhimay ee waxyeelada ADT.

protein

Heerka ugu habboon ee qaadashada borotiinka ee ugu wanaagsan caafimaadka guud ama caafimaadka qanjirka 'prostate' ma cadda. Inkasta oo ay caan ku yihiin cuntooyinka karbohaydrayt-yar ee borotiinku ku badan yahay, cilmi-baadhisyadii ugu dambeeyay ee bini-aadmiga ayaa sheegay in qaadashada borotiinka hooseeya ay la xiriirto khatarta hoose ee kansarka iyo guud ahaan dhimashada ragga 65 iyo ka yar. Ragga ka weyn 65, qaadashada borotiinka hooseeya ayaa lala xiriiriyay khatarta sare ee kansarka iyo guud ahaan dhimashada [23]. Noocyada xayawaanka saamiga u dhexeeya borotiinka iyo karbohaydraytyadu waxay saameeyaan caafimaadka wadnaha, gabowga iyo cimri dhererka [24]. Doorka borotiinka cuntada iyo borotiinka iyo saamiga karbohaydrayt ee horumarinta PCa iyo horumarka waxay u baahan tahay daraasad dheeraad ah.

Borotiinno ku salaysan Xoolaha

Barashada qaadashada borotiinka, sida dhammaan dhinacyada sayniska nafaqeynta, waxay noqon kartaa caqabad. Tusaale ahaan, hilibka xoolaha, oo ah isha borotiinka ee cuntooyinka reer galbeedka, kama koobna borotiinka oo keliya, laakiin sidoo kale wuxuu ka kooban yahay dufan, kolestarool, macdan iyo nafaqooyin kale. Qadarka nafaqooyinkan oo ay ku jiraan asiidh dufanku way ku kala duwanaan kartaa hal hilib ilaa kan kale. Daraasadihii hore ee bini'aadamka ayaa muujiyay in isticmaalka digaaga aan maqaarka lahayn, kaas oo ka hooseeya kolestaroolka iyo dufanka buuxa marka loo eego hilib badan oo cas, aan la xiriirin soo noqoshada ama horumarka PCa [25]. Si kastaba ha ahaatee, isticmaalka digaaga la dubay ayaa si ka duwan loola xiriiriyay PCa horumarsan [26,27], halka hilibka cas ee la kariyey uu la xiriiriyay kororka khatarta PCa sare [26,27]. Markaa, sida cuntada loo diyaariyo waxa laga yaabaa inay wax ka beddesho saamaynta ay ku leedahay khatarta PCa iyo horumarka. Guud ahaan, cunista kalluunka waxa laga yaabaa in lala xidhiidhiyo hoos u dhaca dhimashada PCa, laakiin heerkulka sare ee kalluunka la kariyey ayaa laga yaabaa inuu gacan ka geysto kansarka PCa [28]. Sidaa darteed, waxaa lagula talinayaa in si joogto ah loo isticmaalo kalluunka laakiin heerkulka karinta waa in lagu hayaa dhexdhexaad.

Borotiin ku Salaysan Caanaha

Ilaha kale ee borotiinka caanka ah waa waxyaabaha caanaha laga sameeyo, sida caanaha, farmaajo iyo caano fadhi. Daraasado hore ayaa muujiyay in caanuhu ay kordhiyeen khatarta guud ee PCa laakiin maaha PCa dagaal ama dilaa ah [29,30]. Intaa waxaa dheer, caanaha buuxa iyo isticmaalka caanaha dufanku ku yar yahay labadaba ayaa la soo sheegay inay kor u qaadaan ama dib u dhigaan horumarka PCa [29,31]. Kooxda dabagalka caafimaadka Dhakhaatiirta oo ay la socdaan 21,660 rag ah, wadarta isticmaalka caanaha ayaa la ogaaday inay la xiriirto korodhka dhacdooyinka PCa [32]. Gaar ahaan, caanaha dufanku hooseeyo ama caanaha dufanku waxay kordhiyeen PCa-ga heerka hoose, halka caanaha buuxa ay kordhiyeen khatarta PCa-ga ee dilaaga ah. In kasta oo aan la garanayn qaybta saxda ah ee alaabta caanaha kaxaysa ururadan, xaddi badan oo dufan iyo kaalshiyam ah ayaa laga yaabaa inay ku lug yeeshaan. Daraasad isku-dhafan oo ragga 1798 ah ayaa muujisay in borotiinka caanaha uu si wanaagsan ula xiriiray serum IGF-1 [33] heerarka kaas oo kicin kara bilawga ama horumarka PCa. Haddaba, cilmi-baaris dheeraad ah ayaa loo baahan yahay si loo caddeeyo xiriirka ka dhexeeya qaadashada caanaha iyo PCa. Ma jirto xog ku filan oo lagu bixiyo talooyinka si gaar ah ula xiriira caanaha ama borotiinka caanaha iyo khatarta PCa ama horumarka.

Borotiinno ku-saleysan dhirta

Alaabta soy iyo soy-ku-salaysan waxay qani ku yihiin borotiinka iyo phytoestrogens kuwaas oo fududayn kara kahortaga PCa, laakiin doorkeeda PCa ma cadda. Daraasad lagu sameeyay jiirarka, qaadashada alaabada soyka ayaa lala xiriiriyay aromatase hepatic oo hoos u dhacay, 5?-reductase, muujinta soo-dhoweynta androgen iyo hiddo-wadaha la habeeyey, FOXA1, culeyska kaadi mareenka iyo horumarka buro PCa [34]. Tijaabo aan kala sooc lahayn oo dhowaan lagu sameeyay ragga 177 oo qaba cudur halis sare leh ka dib markii qanjirka 'prostatectomy' ee xagjirka ah uu ogaaday in borotiinka soy-ka ee laba sano ah uusan saameyn ku yeelan khatarta soo noqoshada PCa [35]. Inkasta oo cilmi-baarista cudurrada faafa iyo kuwa hore [36,37] ay taageeraan doorka suurtagalka ah ee soy / soy isoflavones ee hoos u dhigista khatarta PCa ama horumarka, falanqaynta-meta-naxdu ma helin saameyn weyn oo qaadashada soy ee heerarka PSA, hormoonka jinsiga ee ku xiran globulin, testosterone, testosterone free, estradiol ama dihydrotestosterone [38]. RCT kale ee bukaanada ka hor qanjirka 'prostatectomy' sidoo kale ma helin wax saameyn ah oo soy isoflavone supplements ilaa lix toddobaad PSA, testosterone wadarta serum, testosterone bilaash ah, wadarta estrogen, estradiol ama wadarta kolestaroolka [39]. Maadaama inta badan RCT-yada la sameeyay ay ahaayeen kuwo yar oo waqti gaaban, baaritaan dheeraad ah ayaa loo baahan yahay.

Daraasado badan ayaa sii waday inay baadhaan isoflavone aasaasiga ah ee soy, genistein, iyo saamaynta ay ku leedahay PCa. Kartida genistein si uu u xakameeyo goynta unugyada PCa, duulaanka iyo metastasis ayaa la soo sheegay [40]. Genistein waxaa laga yaabaa inuu wax ka beddelo cusboonaysiinta gulukooska iyo gulukoosta gaadiidka (GLUT) ee unugyada PCa [41]. Daraasadaha la isticmaalayo unugyada burooyinka iyo moodooyinka xayawaanka waxay soo jeedinayaan in genistein laga yaabo inuu la tartamo oo uu xannibo estrogens endogenous si ay ugu xidhaan receptor estrogen, taas oo ka hortagaysa kororka unugyada, korriinka, iyo soo saarista kala duwanaanshaha iyo, gaar ahaan, genistein wuxuu xakameyn karaa kala-baxa unugyada, soosaarka protease, duulaanka unugyada iyo sidaas awgeed. ka hortagga metastasis [42]. Si kastaba ha noqotee, midna plasma ama heerarka genistein-ka kaadi mareenka lama xiriirin khatarta PCa haddii daraasadaha xakamaynta kiisaska [36,40,43]. Marxaladda 44,45 ee placebo-control RCT oo leh ragga 2, kaabista 47 mg genistein saddex ilaa lix toddobaad ayaa si weyn hoos u dhigtay calaamadaha androgen-ka ee horumarka PCa [30]. Intaa waxaa dheer, genistein waxaa laga yaabaa inay faa'iido u leedahay hagaajinta kemotherabi cabazitaxel ee PCa-u adkaysta castration metastatic [46]. Daraasadaha kiliinikada ayaa loo dammaanad qaaday inay sii baadhaan doorka soy iyo soy isoflavones ee ka hortagga ama daaweynta PCa. Talo qeexan oo ku saabsan qaadashada borotiinka ee ka hortagga PCa ama daawaynta lama hayo weli.

Fat

Natiijooyinka cilmi-baarista ee lagu baarayo isticmaalka dufanka leh khatarta PCa ama horumarka ayaa iska hor imaanaya. Wadarta guud ee qaadashada [47] ee dufanka cuntada iyo ka kooban aashitada dufanka leh ayaa si madax-bannaan ula xiriiri kara bilawga PCa iyo/ama horumarka. Iyadoo daraasaadka xayawaanku ay si isdaba joog ah u muujinayaan in yaraynta qaadashada dufanka cuntada ay hoos u dhigto kobaca burada [48-50] iyo cuntooyinka dufanka badan, gaar ahaan dufanka xayawaanka iyo saliidda galleyda waxay kordhiyaan horumarka PCa [51], xogta bini'aadamku waa kuwo aan joogto ahayn. Daraasadaha xakamaynta kiis iyo daraasaadka kooxuhu waxay muujiyeen midkoodna wax xiriir ah oo ka dhexeeya wadarta isticmaalka dufanka iyo khatarta PCa [52-55] ama xiriirka ka soo horjeeda qaadashada baruurta iyo badbaadada PCa, gaar ahaan ragga leh PCa gudaha [47]. Intaa waxaa dheer, daraasad iskutallaab ah ayaa muujisay in qaadashada dufanka lagu muujiyay boqolkiiba wadarta guud ee kalooriyada si wanaagsan loola xiriiriyay heerarka PSA ee ragga 13,594 oo aan lahayn PCa [56]. Marka la eego xogtan is khilaafsan, waxaa suurtogal ah in nooca dufanka leh [56] halkii ay ka ahaan lahayd wadarta qaddarka laga yaabo inay door muhiim ah ka ciyaaraan horumarinta PCa iyo horumarka. Daraasad la sameeyay ayaa lagu ogaaday in asiidh dufan leh oo balaasma ah ay si togan ula xiriirto khatarta PCa ee koox la filayo oo ah 14,514 rag ah oo ka tirsan Daraasada Kooxda Iskaashatada Melbourne [57]. Intaa waxaa dheer, daraasad kale ayaa lagu ogaaday in cunista dufan badan oo ku salaysan dhirta ay la xiriirto hoos u dhaca khatarta PCa [58]. Daraasadahani waxay taageerayaan habraaca cuntada ee hadda jira ee cunista dufanka xoolaha ku salaysan iyo dufanka dhirta ku salaysan.

Xogta ku saabsan omega-6 (w-6) iyo omega-3 (w-3) isticmaalka dufanka badan ee polyunsaturated (PUFA) iyo khatarta PCa ayaa iyaguna is khilaafaya. In kasta oo ay jiraan xog lagu taageerayo xidhiidhka ka dhexeeya kordhinta w-6 PUFA qaadashada (badanaa laga soo qaatay saliid galley) iyo khatarta guud ahaan iyo heerka sare ee PCa [57,59], dhammaan xogta ma taageerto isku xirka [60]. Dhab ahaantii, qaadashada dufanka badan ee polyunsaturated ayaa lala xiriiriyay hoos u dhaca dhammaan sababaha dhimashada ee ragga aan lahayn PCa-ga ee daraasadda Dabagalka Xirfadlayaasha Caafimaadka [58]. Habka la dhajiyay ee isku xira w-6 PUFAs iyo khatarta PCa waa beddelka arachidonic acid (w-6 PUFA) ee eicosanoids (prostaglandin E-2, hydroxyeicosatetraenoic acids iyo epoxyeicosatrienoic acids) taasoo horseedaysa caabuqa iyo koritaanka unugyada [61]. Taa beddelkeeda, w-3 PUFAs, kuwaas oo ugu horrayn laga helo kalluunka saliidda leh ee biyaha qabow, waxay hoos u dhigi karaan koritaanka PCa iyada oo loo marayo tiro habab ah [61-63]. Daraasad lagu sameeyay ragga 48 ee leh khatarta yar ee PCa ee hoos yimaada ilaalinta firfircoon, ku celi biopsy lix bilood gudahood waxay muujisay in unugyada qanjirka 'prostate w-3 fatty acids, gaar ahaan eicosapentaenoic acid (EPA), ay ka ilaalin karto horumarka PCa [64]. In vitro iyo daraasaadka xayawaanka waxay soo jeedinayaan in w-3 PUFAs ay keenaan anti-bararka, pro-apoptotic, antiproliferative iyo anti-angiogenic paths [65,66]. Waxaa intaa dheer, daraasad jiirka ah oo la barbardhigay noocyada kala duwan ee dufanka ayaa lagu ogaaday in kaliya cuntada saliidda kalluunka (taas oo ah, omega-3 ku salaysan cuntada) ay hoos u dhigtay korriinka PCa marka loo eego dufanka kale ee cuntada [67]. Marka la eego xogta bini'aadamka, tijaabada wajiga II ee la kala soocay ayaa muujisay in cunto dufan yar leh oo leh w-3 kabitaan afar ilaa lix toddobaad ka hor prostatectomy xagjirka ah ayaa hoos u dhigtay korodhka PCa iyo horumarka wareegga unugyada (CCP) dhibcaha [62,68]. Cunnada saliidda kalluunka ee dufanku ku yar tahay waxay keentay hoos u dhaca 15 (S) - heerarka hydroxyeicosatetraenoic acid waxayna hoos u dhigtay dhibcaha CCP marka loo eego cuntada reer galbeedka [69]. Faa'iidooyinka suurtagalka ah ee omega-3 fatty acids ee kalluunka waxaa taageera suugaanta cudurrada faafa ee muujinaya in qaadashada w-3 dufanka dufanka leh ay la xiriirto khatarta PCa ee dilaaga ah [70,71]. Inkasta oo ay jirto ballan-qaadka omega-3 fatty acids, dhammaan daraasaduhu kuma raacsana. Kaabista 2 g alfa-linolenic acid (ALA) maalintii muddo 40 bilood ah 1,622 rag ah oo qaba PSA <4 ng/ml waxba kama beddelin PSA-gooda [72]. Si kastaba ha noqotee, daraasad kale ayaa lagu ogaaday in serum dhiig oo sarreeya n-3 PUFA iyo docosapentaenoic acid (DPA) ay la xiriirto hoos u dhaca wadarta khatarta PCa halka serum EPA iyo docosahexaenoic acid (DHA) ay suurtogal tahay inay la xiriiraan kororka khatarta PCa-ga sare [73] . Cilmi baaris dheeraad ah ayaa loo baahan yahay si loo fahmo doorka omega-3 PUFAs ee ka hortagga ama daaweynta PCa.

Cholesterol

Daraasado badan oo hore oo caafimaad ayaa muujiyay in ururinta kolestaroolku ay gacan ka geysato horumarka PCa [74-76]. Waxaa la soo jeediyay in kolestaroolka sare ee Lin et al. Daawada BMC (2015) 13:3 Bogga 5 ee 15 wareegga wareegga waxay noqon kartaa arrin halis u ah burooyinka adag, ugu horrayn iyada oo loo marayo hagaajinta isku-dhafka kolestaroolka, waddooyinka bararka [77] iyo steroidogenesis intratumoral [78]. Marka loo eego daraasad dhowaan lagu sameeyay ragga 2,408 ee loo qorsheeyay biopsy, kolestaroolka serum wuxuu si madaxbanaan ula xiriiriyay saadaasha khatarta PCa [79]. Iyadoo la raacayo natiijooyinka kolestaroolka, isticmaalka kolestaroolka hoos u dhigaya daawada statin post radical prostatectomy (RP) ayaa si weyn loola xiriiriyay hoos u dhigista khatarta soo noqoshada biochemical ee 1,146 bukaannada qanjirka 'prostatectomy radical [80]. Daraasad kale ayaa sidoo kale muujisay in statins ay yareyn karto khatarta PCa iyagoo hoos u dhigaya horumarka [81]. Inkasta oo habka aan la dhisin, cilmi-baarisyo dhawaanahan ayaa sidoo kale muujiyay in heerka lipoprotein-cufnaanta sare (HDL) ee kolestaroolka uu la xiriiro khatarta sare ee PCa iyo, sidaas darteed, HDL sare ayaa ilaalinaya [81-84]. Natiijooyinkani waxay taageerayaan fikradda ah in faragelin cunto caafimaad leh oo wadnaha ah oo hoos u dhigta kolestaroolka ay sidoo kale faa'iido u leedahay caafimaadka qanjirka 'prostate'.

Fiitamiinnada & Macdanta

Halkan waxaan dib u eegi doonaa xogta dhawaan ee fiitamiinada A, B complex, C, D, E, iyo K iyo selenium. Labada tijaabo ee caafimaad ee waaweyn: Carotene iyo Retinol Trial Trial (CARET; PCa waxay ahayd natiijo labaad) iyo Machadka Qaranka ee Caafimaadka-Maraykanka Ururka Dadka Hawlgabka ah (NIH-AARP) oo lala xiriirinayo khatar sare oo ah inuu yeesho PCa dagaal badan, gaar ahaan kuwa qaata kaabista-carotene-ka-shaqsiyeedka [85,86]. Si la mid ah, heerka serum-ka-carotene ee sarreeya ayaa lala xiriiriyay khatar sare oo PCa ah oo ka mid ah ragga 997 ee Finnishka ah ee ku jira kooxda Xubinta Khatarta Cudurka Wadnaha ee Kuopio Ischemic [87]. Si kastaba ha ahaatee, ?-carotene supplement lama helin in ay saamayso khatarta PCa-ga dilaaga ah inta lagu jiro daawaynta [88], ama daraasadda mustaqbalka ee Danish ee 26,856 ragga [89]. Wareega retinol sidoo kale lama xiriirin khatarta PCa ee kiis weyn oo daraasad xakameyn ah [90]. Markaa, xidhiidhka ka dhexeeya fitamiin A iyo PCa wali ma cadda.

Caddaynta hore waxay soo jeedinaysaa in folate-ku yaraada ay hoos u dhigi karto kobaca burada, halka kabitaanku aanu wax saameyn ah ku yeelan korriinka ama horumarka, laakiin waxay si toos ah u horseedi kartaa isbeddellada epigenetic iyada oo la kordhinayo methylation DNA [91]. Laba falanqeyn-meta ayaa sidoo kale muujiyay in wareegga wareegga heerarka folate-ku ay si togan ula xiriiraan khatarta sii kordheysa ee PCa [92,93], halka cuntada ama folate-ka dheeriga ah aysan saameyn ku yeelan khatarta PCa [94] ee daraasad kooxeed oo lala yeeshay ragga 58,279 ee Nederland. 95] iyo daraasad xakamaynta kiis ee Talyaaniga iyo Switzerland [96]. Dhab ahaantii, hal daraasad oo ku saabsan koox rag ah oo ku jira qanjidhada xagjirka ah ee prostatectomy ee dhowr xarumood oo Maamulka Veterans ee Maraykanka oo dhan ayaa xitaa muujiyay in heerarka folate-ka sare ee serum ay la xiriiraan PSA hoose iyo, sidaas darteed, khatarta hoose ee fashilka biochemical [97]. Daraasad kale oo la adeegsanayo xogta 2007 ilaa 2010 Caafimaadka Qaranka iyo Nafaqada Sahanka Imtixaanku wuxuu muujiyay in heerka folate-ka sarreeya laga yaabo inuu ka ilaaliyo heerarka PSA ee sarreeya ee ragga 3,293, 40-sano jir iyo ka weyn, iyada oo aan la aqoonsan PCa [98]. Waxaa la soo jeediyay in folate laga yaabo inay door labanlaab ah ka ciyaarto kansarka qanjirka 'prostate', sidaas darteed, xiriirka adag ee ka dhexeeya folate iyo PCa wuxuu sugayaa baaritaan dheeri ah [99].

In kasta oo doorka suurtagalka ah ee fitamiin C (ascorbic acid) uu yahay antioxidant-ka daaweynta kansarka ka hortagga, tijaabooyinka lagu baarayo qaadashada cuntada ama kabidda fitamiin C waa yar yihiin. A RCT ma muujin wax saameyn ah qaadashada fitamiin C ee khatarta PCa [89]. Intaa waxaa dheer, fitamiin C ee qiyaasta sare waxay u dhaqmi kartaa wax ka badan pro-oxidant marka loo eego antioxidant, adkeynaya naqshadeynta cilmi-baarista iyo fasiraadda.

Nooca asaasiga ah ee firfircoon ee fitamiin D, 1,25 dihydroxyvitamin D3 (calcitriol) waxay caawisaa samaynta lafaha saxda ah, waxay keentaa kala soocida unugyada difaaca qaarkood, waxayna joojisaa dariiqyada ka hortagga burooyinka, sida fidinta iyo angiogenesis, waxaana la soo jeediyay inay ka faa'iideysato khatarta PCa [100]; si kastaba ha ahaatee, natiijadu waxay sii ahaanaysaa kuwo aan la isku raacsanayn. Daraasado dhowaan la sameeyay ayaa lagu ogaaday in korodhka heerka fitamiin D ee serum ay la xiriirto hoos u dhaca khatarta PCa [101,102]. Intaa waxaa dheer, kaabidda fitamiin D waxay hoos u dhigi kartaa horumarka PCa ama waxay keeni kartaa apoptosis unugyada PCa [103-105]. Daraasado kale, si kastaba ha ahaatee, ayaa sheegay in aysan saameyn ku yeelanin fitamiin D-ga PSA [106] ama wax saameyn ah kuma yeelan xaaladda fitamiin D ee khatarta PCa [107,108]. Daraasadaha qaarkood ayaa si liddi ku ah u sheegay in heerka fitamiin D-ga hoose uu la xiriiro khatarta hoose ee PCa ee ragga da'da ah [109], ama fitamiin D-ga sare ee serum ayaa lala xiriiriyay khatar sare oo PCa ah [110,111]. Daraasad ayaa xitaa soo jeedisay in xiriir qaabaysan uu ka dhex jiri karo heerka fitamiin D-ga iyo PCa iyo heerka ugu wanaagsan ee fiitamiin D-wareejinta ee ka-hortagga PCa uu noqon karo mid ciriiri ah [112]. Tani waxay la socotaa natiijooyinka laga helay nafaqooyinka kale ee ah in qaadashada badan ee nafaqo wanaagsan laga yaabo inaysan mar walba ka fiicnaan.

Daraasad dhowaan la sameeyay ayaa muujisay in xidhiidhka ka dhexeeya fitamiin D iyo PCa ay wax ka beddeleen borotiinka D-ku-xidhan [113] kaas oo laga yaabo inuu qayb ahaan sharraxay natiijooyinkii hore ee aan iswaafaqsanayn. Dheeraad ah, falanqaynta-meta-baadhista ee baadhista xidhiidhka ka dhexeeya soo-dhoweeyaha Vitamin D (VDR) polymorphisms (BsmI iyo FokI) iyo khatarta PCa ayaa sheegay in aanay xidhiidh la lahayn khatarta PCa [114]. Haddaba, doorka fitamiin D ee PCa weli ma cadda.

Tijaabo kala duwan oo la kala soocay oo wadartoodu ahayd 14,641 dhakhaatiir rag ah oo Maraykan ah?50 jir ah, ka qaybgalayaashu waxay si aan kala sooc lahayn u heleen 400 IU oo fitamiin E ah maalin kasta celceliska guud ee 10.3 (13.8) sano. Kaabista fitamiin E ma lahayn saameyn degdeg ah ama mid fog oo ku saabsan halista wadarta kansarrada ama PCa [115]. Si kastaba ha ahaatee, qiyaas dhexdhexaad ah oo dheeri ah oo fitamiin E ah (50 mg ama qiyaastii 75 IU) waxay keentay khatarta PCa-ga hoose ee 29,133 ragga Finnishka ah ee sigaarka cabba [116]. Daraasado dhowr ah oo sax ah ayaa soo jeedinaya fitamiin E wuxuu hoos u dhigayaa korriinka burada, qayb ahaan sababtoo ah joojinta isku-darka DNA-da iyo kicinta waddooyinka apoptotic [117]. Nasiib darro, daraasadaha bini'aadamka ayaa ka yaraa taageerada. Laba daraasadood oo indho-indhayn ah (Daraasadda Ka-hortagga Kansarka II Kooxda Nafaqada iyo NIH-AARP Cunnada iyo Daraasadda Caafimaadka) labaduba ma muujin wax xiriir ah oo ka dhexeeya dheellitirka fitamiin E iyo khatarta PCa [118,119]. Si kastaba ha ahaatee, serum sare ?-tocopherol laakiin aan ahayn heerka ?-tocopherol ayaa lala xiriiriyay hoos u dhaca khatarta PCa [120,121] iyo ururka waxaa laga yaabaa in lagu beddelo kala duwanaanshaha hidde-sideyaasha fiitamiin E ee la xiriira hiddo-wadaha [122]. Taas beddelkeeda, tijaabo la kala soocay oo la filayo, Selenium iyo Vitamin E Tijaabada Ka Hortagga Kansarka (SELECT), ayaa muujisay kabitaanka fitamiin E si weyn u kordhay khatarta PCa [123] iyo in heerka plasma-tocopherol-ka sare uu la falgalo supplements selenium si loo kordhiyo heerka sare. Khatarta PCa [124]. Natiijooyinkani waxay la jaan qaadayaan daraasad-kooxeed kiis 1,739 xaaladood iyo 3,117 kontaroolo kuwaas oo muujiyay fitamiin E oo kordhay khatarta PCa ee kuwa leh heerka selenium hooseeya laakiin aan ahayn kuwa leh heerka sare ee selenium [125]. Sidaa darteed, cilmi baaris dheeraad ah ayaa loo baahan yahay si loo baaro xiriirka ka dhexeeya fitamiin E iyo PCa iyo saameynta qiyaasta iyo isdhexgalka nafaqooyinka kale waa in la tixgeliyaa.

Faytamiin K ayaa la mala awaalay si uu uga caawiyo ka hortagga PCa iyadoo la dhimayo kaalshiyamka noolaha. Daraasadaha hore waxay muujinayaan isku-darka fiitamiinnada C iyo K ay leeyihiin firfircoonida antitumor awood leh oo ku jirta vitro waxayna u dhaqmaan sidii kiimiko-iyo radiosensitizers in vivo [126]. Ilaa hadda, daraasado yar ayaa baadhay tan, inkastoo hal daraasad oo la adeegsanayo Baaritaanka Mustaqbalka ee Yurub ee Kansarka iyo Nafaqada (EPIC) -Kooxda Heidelberg waxay heleen xiriir aan leexleexad lahayn oo u dhexeeya fitamiin K (sida menaquinones) qaadashada iyo dhacdooyinka PCa [127]. Wax yar ama daraasad hore looma samayn si loo baaro doorka calcium ee PCa. Falanqaynta dib-u-eegista iyo falanqaynta-meta waxay soo jeedinayaan khatarta PCa oo kordhay ama la dhimay qaadashada kalsiyumka oo kordhay, halka kuwa kale ay soo jeedinayaan urur la'aan [128,129]. Daraasad kale ayaa soo jeedinaysa ururka U-qaabeeya, halkaas oo heerarka calcium ee aad u hooseeya ama kaabista labadaba ay la xiriiraan PCa [130].

Selenium, dhanka kale, ayaa la mala awaalay si looga hortago PCa. Inkasta oo daraasadaha vitro ay soo jeediyeen in selenium ay joojiso angiogenesis iyo bararka marka ay keenayso apoptosis [131], natiijooyinka ka soo baxa SELECT ma muujin wax faa'iido leh oo selenium oo keliya ama marka lagu daro fitamiin E ee PCa chemoprevention [123]. Dheeraad ah, kabka selenium kama faa'iidaysan ragga leh heerka selenium hooseeya laakiin waxay kordhisay khatarta PCa-ga sare ee ragga leh heerka selenium ee koox si aan kala sooc lahayn loo doortay oo ah 1,739 xaaladood oo leh heer sare (Gleason 7�10) PCa iyo 3,117 kontaroolada [ 125]. Daraasad kooxeed Nederlaan ah oo la filayo, oo ay ku jiraan 58,279 rag ah, 55- ilaa 69-sano jir, ayaa sidoo kale muujisay in selenium ciddiyaha lugaha ay la xiriirto hoos u dhaca khatarta PCa sare [132]. Cilmi-baaris dheeraad ah ayaa loo baahan yahay si loo caddeeyo doorka selenium ee PCa.

Kiimikooyinka dabiiciga ah

Marka ay la socdaan fiitamiinnada iyo macdanta [2], dhirtu waxay ka kooban tahay phytochemicals oo leh saameyn liddi ku ah kansarka. Caadi ahaan aan loo tixgelin xeryahooda muhiimka ah, phytochemicals waxay leeyihiin sifooyinka antioxidant iyo anti-bararka.

Silibinin waa flavonoid polyphenolic ah oo laga helo miraha yamaaruggii caanaha. Waxaa lagu muujiyay in vitro iyo in vivo si loo xakameeyo kobaca PCa iyada oo la beegsanayo soo-dhoweynta koritaanka epidermal (EGFR), IGF-1 reseptor (IGF-1R), iyo nukliyeerka-kappa B (NF-kB) waddooyinka [133,134]. Daraasad dhowaan la sameeyay ayaa muujisay in silibinin laga yaabo inay faa'iido u leedahay ka-hortagga PCa iyadoo la joojinayo muujinta TGF?2 iyo kansarka la xidhiidha fibroblast (CAF) - sida biomarkers ee unugyada qanjirka 'prostate' ee bini'aadamka [135]. Markaa, silibinin waa musharrax rajo leh oo ah wakiilka kiimikaad ee PCa kaasoo sugaya cilmi-baaris dheeraad ah.

Curcumin waxaa loo isticmaalaa cunto lagu daro Aasiya iyo daawo dhireed oo bararka [136]. In vitro, curcumin waxay joojisaa borotiinka pro-inflammatory NF-?B halka ay keenayso apoptosis iyada oo la kordhinayo muujinta hiddo-wadaha proapoptotic [137]. In vivo, curcumin waxay hoos u dhigtaa korriinka PCa ee jiirarka iyada oo la dareensiinayo burooyinka chemo- iyo radiotherapy [136]; si kastaba ha ahaatee, ma jiro wax tijaabo ah oo biniaadmi ah oo baadhay saamaynta ay ku leedahay PCa.

rummaanka

Diirka iyo miraha rummaanka iyo walnuts waxay qani ku yihiin ellagitannins (punicalagins). Kiimikooyinkan phytochemicals ayaa si sahal ah loogu metaboolay qaabka firfircoon ee ellagic acid by flora mindhicirka [138]. Tijaabooyin hore oo daaweyn ah ayaa muujinaya ellagitannins waxay joojinayaan kororka PCa iyo angiogenesis ee xaaladaha hypoxic waxayna keenaan apoptosis [137,138]. Tijaabooyin mustaqbalka ah ee ragga leh PSA kor u kaca ka dib daaweynta aasaasiga ah, casiirka rummaanka ama POMx, oo laga soo saaro rummaanka ganacsiga ee laga heli karo, waxay kordhisay PSA waqti labanlaab ah marka loo eego gundhigga [139,140], inkasta oo aan wax tijaabo ah lagu darin koox placebo. Natiijooyinka waxay ka sugayaan placebo RCT oo la filayo iyadoo la isticmaalayo laga soosaaray rummaanka ragga leh PSA kor u kaca. Si kastaba ha noqotee, tijaabada kontoroolka placebo, laba kiniin oo POMx ah maalin kasta ilaa afar toddobaad ka hor intaan la qaadin qanjirka 'prostatectomy radical' wax saameyn ah kuma yeelan cudurka kansarka ama cadaadiska oksaydhka ama cabirrada kale ee burooyinka [141].

Shaah cagaaran

Shaaha cagaaran wuxuu ka kooban yahay tiro polyphenols antioxidant ah oo ay ku jiraan catechins, sida epigallocatechin gallate (EGCG), epigallocatechin (EGC), (?) -epicatechin-3-gallate (ECG) iyo (?) -epicatechin. Daraasadaha hore waxay soo jeedinayaan EGCG waxay joojisaa korriinka PCa, waxay keentaa dariiqyada apoptotic-ga gudaha iyo dibedda waxayna hoos u dhigtaa caabuqa iyadoo la xakameynayo NFkB [137]. Intaa waxaa dheer, sifooyinka antioxidant ee EGCG waa 25 ilaa 100 jeer ka awood badan fiitamiinada C iyo E [131]. Tijaabada preprostatectomy la kala soocay ee la filayo, nimanka cunaya shaaha cagaaran ee la dubay ee Lin et al. Daawada BMC (2015) 13:3 Bogga 7 ee 15 qalliinka ka hor waxay kordhiyeen heerarka polyphenols shaaha cagaaran ee unugyada qanjirka 'prostate' [142]. Tijaabo caddayn yar oo mabda'a ah oo leh ragga 60, maalin kasta oo kabitaan ah oo ah 600 mg shaaha cagaaran ee catechin soosaaray ayaa hoos u dhigtay dhacdooyinka PCa 90% (3% marka loo eego 30% ee kooxda placebo) [143]. Tijaabo kale oo yar ayaa sidoo kale muujisay in kabitaannada EGCG ay keentay hoos u dhac weyn oo ku yimid PSA, kobaca cagaarshowga cagaarshowga iyo korriinka kobaca endothelial ee ragga ee PCa [144]. Daraasadahaani waxay soo jeedinayaan polyphenols shaaha cagaaran inay hoos u dhigi karaan dhacdooyinka PCa waxayna yareeyaan horumarka PCa laakiin cilmi baaris dheeraad ah ayaa loo baahan yahay si loo xaqiijiyo loona caddeeyo qaabkeeda [137,143,145].

Resveratrol

In kasta oo inta badan daraasadaha vitro ay soo jeedinayaan in resveratrol ay joojiso kobaca PCa [146-148], resveratrol waxay xakameysaa korriinka burooyinka qaar [137] laakiin maaha dhammaan noocyada xayawaanka [149], oo ay suurtogal tahay inay sababto xaddidan bioavailability [150,151]. Ilaa hadda, ma jiraan tijaabooyin caafimaad oo baaraya ka hortagga ama saameynta daweynta ee resveratrol ee PCa.

Zyflamend

Zyflamend waa isku-darka ka-hortagga bararka ee geedo yaryar oo la muujiyay si loo yareeyo horumarka PCa iyadoo hoos loo dhigayo muujinta calaamadaha oo ay ku jiraan pAKT, PSA, histone deacetylases iyo daaweeyaha androgen ee moodooyinka xayawaanka iyo khadka unugyada PCa [152-154]. Inkasta oo ay suurtogal tahay ka hortagga kansarka [155], daraasado aad u yar ayaa lagu sameeyay bini'aadamka [156,157]. Marka lagu jiro sumadda furan ee tijaabada Wajiga I ee bukaanada 23 ee qaba qanjirka 'prostate intraepithelial neoplasia', Zyflamend kaligiis ama iyada oo lala kaashanayo kaabisyada kale ee cuntada ee bilaha 18 ayaa hoos u dhigtay halista horumarinta PCa [156]. RCTs badan oo bini'aadamka ah ayaa loo baahan yahay si loo xaqiijiyo waxtarka iyo codsiga caafimaad ee kabka dhirta.

Cuntooyinka Kale oo Dhan Miraha & Khudaarta

Miraha iyo khudaarta waa ilo qani ah oo laga helo fiitamiino, macdan iyo phytochemicals. Daraasado dhowr ah oo cudurrada faafa ayaa laga helay xiriirro aan kala go 'lahayn oo u dhexeeya wadarta qaadashada khudradda iyo khudradda [158], iyo qaadashada khudradda cruciferous iyo khatarta PCa [159,160]. Khudaarta allium, sida toonta, caleenta, chives, iyo basasha, waxay ka kooban yihiin phytochemicals sulfurous oo badan kuwaas oo la soo jeediyay si kor loogu qaado habka difaaca jirka, la joojiyo koritaanka unugyada, wax ka beddela muujinta hiddo-wadaha androgen-ka jawaaba oo keena apoptosis [161]. Inkasta oo tirada daraasadaha la daabacay ay xaddidan tahay, labadaba xogta bukaan-socodka iyo cudurrada faafa waxay soo jeedinayaan qaadashada khudradda allium-ka ayaa laga yaabaa inay ka ilaaliso PCa, gaar ahaan cudurrada gudaha [162]. Tijaabo aan kala sooc lahayn oo lala yeeshay ragga 199 ayaa sidoo kale lagu ogaaday in isku dhafka rummaanka, shaaha cagaaran, broccoli iyo turmeric ay si weyn u yareeyeen heerka kororka PSA ee ragga PCa [163].

Tamaandhada & Alaabta Yaanyada

Tiro daraasado ah ayaa baadhay xidhiidhka ka dhexeeya yaanyada iyo alaabta yaanyada ee PCa laakiin natiijadu waa mid aan natiijo lahayn. Lycopene-ka antioxidant-ka, oo qani ku ah yaanyada, ayaa sidoo kale si gaar ah loo darsay saameynta ay ku leedahay PCa. In vitro, lycopene waxay joojisaa wareegga gacanta ee dhowr xariiqo unug oo PCa ah waxayna hoos u dhigtaa calaamadaynta IGF-1 iyada oo soo jiidanaysa IGF-1 borotiinada isku xidha [131]. Inkasta oo cilmi-baarisyada xayawaanka qaarkood laga helay lycopene ay si gaar ah u gaabinayso kobaca PCa [164] ama waxay yaraynaysaa unugyada epithelial PCa marxaladaha bilawga, horumarinta iyo horumarka [165], laba daraasadood ayaa helay natiijooyin isku khilaafsan oo u dhexeeya koollada yaanyo iyo lycopene [166,167]. Daraasadaha mustaqbalka ee bini'aadamka waxay heleen isticmaalka lycopene sare [168,169] ama heerarka serum ka sarreeya ayaa lala xiriiriyay khatarta hoose ee PCa [170], laakiin kuwa kale ma laha [171,172]. Xoojinta lycopene-ka qanjirka 'prostatic lycopene' ee ka hooseeya heerka 1 ng/mg ayaa lala xiriiriyay PCa lix bilood ka dib biopsy (P = 0.003) [173]. Labo tijaabo oo preprostatectomy-gaaban ah oo la adeegsanayo suugo yaanyo ama kabitaan lycopene ah ayaa muujisay qaadashada lycopene ee nudaha qanjirka 'prostate' iyo antioxidant iyo saamaynta ka hortagga kansarka ee suurtagalka ah [174,175]. Iyadoo dhowr tijaabo oo bukaan-socod ah ay soo jeediyeen xiriirka ka soo horjeeda kabista lycopene, heerarka PSA iyo hoos u dhaca calaamadaha kansarka [171,176], ma jiraan tijaabooyin ballaaran oo la kala soocay oo tijaabiyay doorka lycopene ama alaabta yaanyada ee ka hortagga ama daaweynta PCa.

Coffee

Qaxwaha waxaa ku jira kafeyn iyo dhowr xeryood oo phenolic ah oo aan la aqoonsan oo laga yaabo inay u adeegaan sida antioxidants. Cilmi-baarisyada cudurrada faafa waxay soo jeedinayaan xiriirka ka soo horjeeda isticmaalka kafeega iyo khatarta PCa, inta badan cudurka marxaladda sare ama khatarta ah, natiijadu waxay ka madax bannaan tahay maadada caffeine [177,178]. Inkasta oo dhowr daraasadood oo cudurrada faafa ah [179-182] aysan helin wax xiriir ah oo ka dhexeeya isticmaalka kafeega iyo khatarta PCa, falanqaynta falanqaynta ee dhowaan ee daraasadaha mustaqbalka ayaa soo gabagabeeyey in isticmaalka qaxwada uu yarayn karo khatarta PCa [183]. Habka suurtagalka ah (yada) iyo dariiqyada ku lug leh lama garanayo laakiin waxaa ku jiri kara antioxidant, saameynta anti-bararka, gulukooska iyo dheef-shiid kiimikaadka insulin, iyo saameynta suurtagalka ah ee IGF-I iyo wareegga wareegga hormoonnada galmada.

Qaababka Cuntada

Inkasta oo qaar badan oo ka mid ah nafaqeeyayaalka ama cunnada la baaray saameyntooda ama xiriirka ay la leeyihiin khatarta PCa ama horumarka, natiijadu waxay ahaayeen kuwo aan la soo koobin. Sababta suurtogalka ah ee iswaafaq la'aanta ayaa ah xaqiiqda ah in saameynta hal nafaqeeyayaal ama cuntadu ay aad u yar tahay oo aan la ogaan karin. Intaa waxaa dheer, nafaqeeyayaalka dabiiciga ah ee cuntooyinka ku jira inta badan aad ayay isugu xidhan yihiin waxaana laga yaabaa inay is dhexgalaan oo, sidaas awgeed, ay saameeyaan saamaynta PCa. Markaa, falanqaynta qaabka cuntada ayaa heshay Lin et al. BMC Medicine (2015) 13:3 Bogga 8 ee 15 xiisaha, laakiin cilmi-baadhistu way xaddidan tahay, natiijooyinkii jirayna waxay noqdeen kuwo aan natiijo lahayn. Koox ka kooban 293,464 rag ah, cunto tayo sare leh, sida ku cad dhibcaha tusmada Cunitaanka Caafimaadka leh (HEI), ayaa lala xiriiriyay khatar hoose oo wadarta khatarta PCa-ga [70]. Cuntada Mediterranean-ka, oo ay ku badan tahay khudaarta, saliidda saytuunka, karbohaydraytyada adag, hilibka caatada ah iyo antioxidants, ayaa si joogto ah lagula talinayaa bukaanada si looga hortago cudurka wadnaha iyo buurnaanta [184], waxaana laga yaabaa inay muujiyaan ballan ka hortagga PCa [185]. Isticmaalka kalluunka iyo omega-3 fatty acid ee qaabka badda Mediterranean-ka ayaa si weyn ula xiriiriyay khatarta PCa ee dilaaga ah. Intaa waxaa dheer, u hoggaansanaanta cuntada Mediterranean ka dib markii la ogaaday PCa-ga aan metastatic ahayn ayaa lala xiriiriyay dhimashada guud ee hoose [186]. Halka, qaabka reer galbeedka ee leh qaadashada sare ee hilibka cas, hilibka la warshadeeyey, kalluunka shiilan, jajabka, caanaha dufanka badan iyo rootiga cad, ayaa lala xiriiriyay khatar sare oo PCa ah [187].

Intaa waxaa dheer, wadamada Aasiya ee leh isticmaalka sare ee omega-3 PUFAs, soy iyo phytochemicals phytochemicals ku salaysan shaaha cagaaran, waxay leeyihiin dhacdooyinka PCa hoose marka loo eego waddammada cuna cunnada 'style-style' ee galbeedka [188]. Si kastaba ha ahaatee, dhammaan daraasadaha [189-191] ma taageereen xiriirka ka dhexeeya qaabka cuntada qaarkood iyo khatarta PCa. Waxaa suurtogal ah in habka loo isticmaalo lagu aqoonsanayo hababka cuntada laga yaabo in aanay qaban dhammaan arrimaha cuntada ee la xidhiidha khatarta PCa. Taas beddelkeeda, nidaam kasta oo cunto ah ayaa laga yaabaa inuu ka koobnaado qaybo faa'iido leh iyo kuwo waxyeello leh labadaba taas oo keenta urur guud oo aan waxba ka jirin. Cilmi baaris dheeraad ah ayaa loo baahan yahay si loo sii wado raadinta qaababka cuntada ee isku dara inta badan nafaqooyinka/cuntooyinka faa'iidada leh ee PCa oo xaddidaya badi nafaqooyinka/ cunnada taban.

Tilmaamaha Mustaqbalka ee Tijaabooyin Caafimaad

Iyada oo lagu saleynayo tirada badan ee cudurrada faafa, daaweynta hore iyo kiliinikada ee lagu sharraxay dib u eegista, waxqabadyada cuntada ee ka hortagga iyo daaweynta PCa waxay leeyihiin ballanqaad weyn. Intaa waxaa dheer, dhowr arrimood oo cunto ah iyo fiitamiino/kaabooyin ayaa laga yaabaa inay la xiriiraan khatarta PCa iyo/ama horumarka cudurka. Tijaabooyin aan kala sooc lahayn ayaa si cad loo tilmaamay si loo aqoonsado nafaqooyin gaar ah ama daawaynta isku dhafan ee ka hortagga iyo daaweynta PCa.

Dhawaan, ilaalinta firfircoon (AS) ayaa u soo baxday sidii ikhtiyaar macquul ah oo loogu talagalay ragga khatarta yar ee PCa. Ragga AS ayaa ku dhiirigeliyay inay u hoggaansamaan isbeddellada cuntada iyo hab-nololeedka [192], taasoo ka dhigaysa qaybtan bartilmaameed wanaagsan oo loogu talagalay faragelinta cuntada iyo tayada tijaabooyinka nolosha [193]. Badbaadayaasha PCa ee firfircoon oo ka warbixiya caadooyinka cunnada caafimaadka leh (taas oo ah, cunista cuntooyinka dufanku ku yar yahay, cuntooyinka karbohaydrayt-yar ee la safeeyey ee hodanka ku ah miraha iyo khudaarta) waxay leeyihiin tayada guud ee nolosha marka loo eego kuwa aan firfircoonayn, caafimaadka la'aanta ah [194]. Markaa, tijaabooyin badan oo kala sooc lahayn ayaa loo dammaanad qaaday si loo go'aamiyo guud ahaan saamaynta muddada dheer ee faragelinta cuntada ee dadkan. Gaar ahaan, su'aalaha muhiimka ah ee wax looga qabanayo tijaabooyinka mustaqbalka waa: 1) Waxqabadyada cuntada ma dib u dhigi karaan baahida daaweynta ragga ee AS; 2) Waxqabadyada cuntada ma ka hortagi karaan soo noqoshada ragga daweynta ka dib; 3) Waxqabadyada cuntada ayaa dib u dhigi kara horumarka ragga qaba cudurrada soo noqnoqda iyo, sidaas darteed, dib u dhigista baahida daaweynta hoormoonka; 4) Waxqabadyada cuntada ma yarayn karaan waxyeelada daawaynta PCa oo ay ku jiraan daawaynta hoormoonka iyo daawaynta cusub ee la beegsanayo; iyo 5) Ma jiraan wax door ah oo loogu talagalay faragelinta cuntada oo keliya ama lagu daro daawaynta la beegsanayo ee ragga ee daaweynta hoormoonka si looga hortago iska-caabbinta ama ka dib marka uu soo baxo cudurka iska caabbinta qashinka? Sababtoo ah caddaynta sii kordheysa waxay muujineysaa in cilladaha dheef-shiid kiimikaadka ay kordhiyaan khatarta PCa, faragelinta qaab nololeedka ee hagaajinaysa astaanta dheef-shiid kiimikaadka waa ikhtiyaar guul-guul ah oo ka hortagga iyo daaweynta PCa [195,196].

Gabagabo: Kansarka qanjirka 'prostate'

Cilmi-baarista mustaqbalka ayaa loo baahan yahay si loo go'aamiyo cuntada ugu habboon ee ka hortagga PCa ama daaweynta. Si kastaba ha ahaatee, dhowr arrimood oo cunto ah iyo qaar ka mid ah hababka cuntada ayaa ballan qaadaya dhimista khatarta PCa ama horumarka waxayna la socdaan tilmaamaha cuntada ee hadda jira ee Maraykanka [197]. La-talinta bukaannada cuntada ee ka-hortagga PCa-ga aasaasiga ah iyo kuwa sare, qaar badan ayaa aaminsan in Wadnaha caafimaadka qaba uu la mid yahay caafimaadka qanjirka 'prostate' karbohaydraytyada miraha oo dhan, yaraynta wadarta iyo dufanka buuxa, yaraynta hilibka aadka loo kariyay iyo isticmaalka qadar dhexdhexaad ah oo kalooriyo ah ama yaraynta karbohaydraytyada iyada oo ujeedadu tahay helitaanka iyo ilaalinta miisaanka jidhka oo caafimaad qaba.

Danaha iska soo horjeeda Qorayaashu waxay caddeeyeen inaysan lahayn dano iska soo horjeeda.

Wax ku biirinta qorayaasha P-HL iyo SF ayaa sameeyay dib u eegis, P-HL waxay diyaarisay qoraal-gacmeedka iyo SF iyo WA oo tafatiray oo bixiyay fikrado muhiim ah. Dhammaan qorayaashu way akhriyeen oo oggolaadeen qoraal-gacmeedka ugu dambeeya.

Maalgelinta Mahadnaq waxaa bixiyay deeqaha 1K24CA160653 (Freedland), NIH P50CA92131 (W. Aronson). Qoraal-gacmeedkan ayaa ah natiijada shaqada lagu taageeray agabka iyo adeegsiga tas-hiilaadka Xarunta Caafimaadka Maamulka Ciidanka Militariga, Galbeedka Los Angeles (W. Aronson).

Faahfaahinta qoraaga 1 Waaxda Daawada, Qaybta Nephrology, Xarunta Caafimaadka ee Jaamacadda Duke, Box 3487, Durham, NC 27710, USA. 2 Qaybta Urology, Waaxda Qalliinka, Arrimaha Ruug-caddaaga Nidaamka Daryeelka Caafimaadka ee Weyn ee Los Angeles, Los Angeles, CA, USA. 3 Department of Urology, UCLA School of Medicine, Los Angeles, CA, USA. 4 Qaybta Urology, Waaxda Qalliinka, Durham Arrimaha Veterans Center Medical Center, Qaybta Urology, Durham, NC, USA. 5 Duke Prostate Center, Waaxyaha Qalliinka iyo Cilmi-nafsiga, Xarunta Caafimaadka ee Jaamacadda Duke, Durham, NC, USA.

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Xir Accordion

Baaxadda Xirfadda Tababarka *

Macluumaadka halkan ku qoran "Kansarka qanjirka 'prostate', Nafaqada iyo Faragelinta Cuntada"looma talagelin in lagu beddelo xiriirka qof-ka-qof ah ee leh xirfadle daryeel caafimaad oo u qalma ama takhtar shati haysta mana aha talo caafimaad. Waxaan kugu dhiirigelineynaa inaad sameyso go'aamo daryeel caafimaad oo ku saleysan cilmi-baaristaada iyo iskaashigaaga xirfadle daryeel caafimaad oo u qalma.

Macluumaadka Blog-ga & Wada-hadallada Xadka

Baaxadda macluumaadka waxay ku kooban tahay Chiropractic, murqaha, dawooyinka jireed, fayoobida, gacan ka geysata etiological khalkhalka viscerosomatic gudaha bandhigyada kiliinikada, dhaqdhaqaaqa kiliinikada ee somatovisceral reflex ee la xidhiidha, dhismooyinka subluxation, arrimaha caafimaadka xasaasiga ah, iyo/ama maqaallada daawada shaqaynta, mowduucyada, iyo doodaha.

Waanu bixina oo soo bandhignaa iskaashiga bukaan-socodka oo leh takhasusyo ka kala socda qaybo kala duwan. Khabiir kastaa waxa lagu maamulaa baaxadda ku-dhaqankooda xirfadeed iyo awooddooda shatiga. Waxaan isticmaalnaa borotokoolka caafimaadka iyo fayo-qabka shaqada si aan u daaweyno oo u taageerno daryeelka dhaawacyada ama cilladaha habka muruqyada.

Fiidiyowyadayada, qoraaladayada, mawduucyada, mawduucyada, iyo aragtiyadayadu waxay daboolayaan arrimaha kiliinikada, arrimaha, iyo mawduucyada la xidhiidha oo si toos ah ama si dadban u taageera baaxadda hawlqabadkayaga caafimaad.*

Xafiiskayagu waxa uu si macquul ah isku dayay in uu bixiyo tixraacyo taageero ah waxana uu aqoonsaday daraasadda cilmi-baadhiseed ee la xidhiidha ama daraasadaha taageeraya qoraaladayada. Waxaan siinaa nuqulo ka mid ah daraasadaha cilmi-baarista ee taageeraya ee loo heli karo golayaasha sharciyeynta iyo dadweynaha marka la codsado.

Waxaan fahamsanahay inaan daboolno arrimaha u baahan sharaxaad dheeri ah oo ku saabsan sida ay gacan uga geysan karto qorshe daryeel gaar ah ama hab maamuuska daaweynta; haddaba, si aad uga sii wada hadasho mowduuca kor ku xusan, fadlan si xor ah u weydiiso Dr. Alex Jimenez, DC, ama nagala soo xiriir 915-850-0900.

Waxaan halkan u nimid inaan kaa caawinno adiga iyo qoyskaaga.

Barako

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: Tababaraha@elpasofunctionalmedicine.com

Ruqsad u haysta sidii Dhakhtar Chiropractic (DC) gudaha Texas & New Mexico*
Shatiga Texas DC # TX5807, Shatiga New Mexico DC # NM-DC2182

Ruqsad u haysta Kalkaaliso Diiwaangashan (RN*) in Florida
Shatiga Florida ee RN # RN9617241 (Maamulka No. 3558029)
Xaaladda is haysta: Shatiga Dawlad-goboleed badan: Loo oggolaaday inuu ku tababarto Gobollada 40*

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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Kansarka qanjirka 'prostate', Nafaqada iyo Faragelinta Cuntada