Umdlavuza we-Thyroid ngowona wesithathu oqhelekileyo uhlambalazo lwesifo seengxaki kubantwana. Lo mhlaza wesibeleko unabelana ngeziganeko ezininzi kunye nezigulane zomdlavuza we-thyroid eziquka i-subtypes eziqhelekileyo ezibandakanya i-papillary, follicular and medullary; kunye nomfazi wesilisa kumalunga malunga no-6: 1, phakathi kwabanye.
Nangona ixesha elide lokuphila lomhlaza we-thyroid lugqithiseleyo, kukho izifundo ezimbalwa ezibonisa iziphumo zecilisi zale ntsholongwane yabantwana.
Uninzi lwezifundo luye lwahlanganiswa nokuphononongwa kwamanye amaziko. Izifundo ezininzi zezikole zenzekile kodwa imizamo yokwenza idibanisa enkulu ingagqithwa ngamaziko okanye kwiindawo zokuhlala. Ukunciphisa ubungakanani besampula kulezi zifundo, kunye nesidingo sokulandela ixesha elide lwesifo ngesantya esicothayo sokubuyiselwa kwembuyekezo, kuye kwabangela ubunzima ekuhloleni iziphumo ezintle zengxelo zonyango.
Iintlobo ezimbini ze-otolaryngologist kunye neentamo zezintlu eziye zenziwa ukuba zichonge iziphumo ezinjalo ngokulandela izibalo ezininzi zezigulane kwixesha elide kufuneka zihlaziywe ezikhusela iindawo ezizimeleyo zeziko kunye neengingqi. Bavavanya i-database enkulu yesizwe kwiminyaka engama-12 ngomgudu wokuqonda kangcono iziphumo zekliniki zexesha elide, nangona zihlandlo zibulalayo, izifo kwizinga likazwelonke kwindawo yabantwana. Ubungakanani beli phofu lugweme ukuphazamiseka okukhoyo kulolu hlobo lophando.
Ababhali beZiphumo ezijoliswe kuLuntu kwi-Pediatric Thyroid Carcinoma, nguNina L. Shapiro MD, uLwahlulo lweNtloko kunye noKuPhepha kweNeck, iSikole seMpilo ye-UCLA, eLos Angeles, CA; kunye ne-Neil Bhattacharyya MD, kwiCandelo le-Otolaryngology, iBrgham kunye neSibhedlele sabamama, kunye neSebe le-Otology kunye neLaryngology, i-Harvard Medical School, iCambridge, MA.
Iziphumo zabo ziza kuboniswa kwi-19 ye-American American Society ye-Otolaryngology ye-Pediatric i-Otolaryngology http://www.aspo.us intlanganiso eqhutywa ngoMeyi 2-3, 2004, kwi-JW Marriott Desert Ridge Resort & Spa e-Phoenix, AZ.
Indlela yokujonga, i-Epidemiology, kunye ne-End Results (SEER) i-database (1988-2000) yahlaziywa, ikhutshwe zonke izigulana zezilwanyana nge-carcinoma ye-thyroid ngokwemiqathango elandelayo: (1) Ubudala ekuxilongweni ukususela ekuzalweni ukuya kwiminyaka eyi-18; (2) Ukongezwa kweprayimari yesifo se-thyroid esibi; (3) I-thyroid carcinoma ehlukileyo kakhulu (i-papillary okanye i-follicular) kunye (4) Unyaka wokuxilongwa phakathi kuka-1988 no-2000. Izigulane ezinezinye iintlobo zesisu ezifana ne-plastiki okanye i-medullary carcinoma zazingekho. Idatha yekliniki kunye ne-tumor echanekileyo esuka kwiziko leenkcukacha libandakanya ubudala ukuxilongwa, isini, i-hertology ye-tumor, ubukhulu be-tumor, ubungakanani besifo sesiseko esiyintloko, ubukhulu besifo se-nodal, unyango kunye nokuhlinzwa kunye / okanye iodode ye-radioactive kunye neenkcukacha zokuphila.
Idatha zafakwa kwaye zithengiswa kwi-SPSS version 10.0. Ukususela kwizifo eziguqukayo, ubukhulu besifo se-site esiyintloko sasigxina njengoko kwabikwa kwangaphambili. Isifo se-Nodal sabhalwa njengokuba khona okanye ukungabikho kwee-node zentsholongwane ngexesha loxilongo lokuqala.
Ubungakanani bonyango oluphambili lonyango lubekwa njenge-biopsy kuphela, i-lobectomy, i-thytectectomy subtotal, okanye i-thyroidectomy yakho yonke.
Iziphumo: Abaphandi bachonge i-thy6 carcinomas yabantwana abangama-566 kwiminyaka eyi-12. Ixesha elidlulileyo kwi-presentation yayineminyaka eyi-16.0, kunye neepesenti ezingama-84 zezigulane zabesifazane. Iintlobo ze-tumor zazingama-378 (iipesenti ezingama-66.8) i-carcinomas yamaphepha, 137 (iipesenti ezingama-24.2) i-carcinomas yamaphepha kunye ne-follicular variant, kunye nama-51 (i-9.0 ekhulwini) i-follicular carcinomas. Ngokubanzi, ubukhulu bomzimba wesikhomba kwintetho yayingu-2.6 centimeters. Ngokubhekiselele kwisayithi esiyintloko yezifo, uninzi lwezigulana (iipesenti ezingama-74.2) zinezifo ezingenayo i-intrathyroidal kuphela.
Iqela elincinci lancinci elincinane (12.5 ekhulwini), kwaye bambalwa banesandiso esikhulu okanye esicacileyo (5.4 pesenti). Izifo ezithandekayo ezintanyeni entanyeni zazikho kwiiphesenti ezingama-37.1 zezigulane ekuxilongweni kokuqala. Ininzi yezigulane zaphathwa nge-thyroidectomy ngokupheleleyo (iipesenti ezingama-72.8) zilandelwa yi-thytectal thyroidectomy (i-13,4 ekhulwini) elandelwa yi-lobectomy elula (iipesenti ezi-7.2). Unyango lwe-iodine ye-radioactive lwalulawulwa kwi-51.4 pesenti yezigulane.
Ukuphila ngokubanzi kwiqela lonke bekuyiinyanga ezili-153.8, zincinci kwiinyanga ezili-155 zokulandelelwaniswa. I-papillary carcinomas (ukusinda kwintsholongwane, iinyanga ezili-155.3) zibhetele kangcono kunokuba i-follicular age, iminyaka yobudala, ubuchule kunye nokusetyenziswa kweyeza-i-iodine zonyango azizange zithintele kakhulu ukusinda. Ubulili besilisa, i-histology yezobuhlanga, kunye nokuqala kokuhlasela kwezifo zendawo zaye zaba nemiphumo ebalulekileyo ekunciphiseni ukusinda kwexesha elide.
Iziphumo ziyavumelana neziphumo ezivela kwezinye iingcali ezibonisa ukuba umdlavuza we-thyroid unomdla ngokubanzi kwiminyaka yeshumi elivisayo, kwaye ngokukodwa kubasetyhini. Uhlobo oluqhelekileyo lweengcambu zakhe luyi-papillary, njengoko kubonakala kubantu abadala. Ukusabalaliswa kwezifo ze-nodal (iipesenti ezingama-37.1) kwafana nokuye kwafunyanwa kwizifundo zangaphambili. Olu phando luye lwabonisa ukuba ngoxa unyango lwe-tumor yokuqala luvela kwi-lobectomy elula ukuya kwi-thyroidectomy yakho, ubungakanani bokungenelela kokungaphazamanga abukhompembelelo kwiziphumo zokusinda. Oku kufunyaniswayo kwahluke kwiingxelo eziliqela eziphambili ezichaza iziphumo eziphezulu kwizigulane ezithatha ukuthengiswa ngokugqithiseleyo okunjenge-sub-total or totalroid thyroidectomy. Ubudala kwi-diagnostic, isimo se-nodal, kunye nokongezwa kweyeza-i-iodine zonyango azizange zibe neempembelelo ezibalulekileyo ekusindeni. Ubulili besilisa, isandiso sesayithi esiyintloko sesifo, kunye ne-follicular subtype bonke babenempembelelo engafanelekanga yokusinda xa kuthelekiswa nezinye izifo zesifo. Izigqibo: I-thyroid carcinoma ibonisa iziphumo eziphambili zexesha lokuphila. Izigulane ngeendlela ezilandelelanayo zibonisa iziphumo ezinobuthathaka kunezinye ezinokutshintsha kwamaphepha. Nangona esi sifo sixhaphake ngakumbi kubafazi kunabesilisa, abesilisa abane-carcinoma ye-thyroid baneziphumo ezimbi kunabesifazane. Ukukhula kwendawo yesifo seprayimari esisekuhlaleni kusenokuba nesifo esincinci sichasene nesifo se-intrathyroidal sodwa. Nangona usebenze-uphando kunye nokulawula kufuneka kugxilwe kwisigulane ngasinye, ukubalwa kweengxaki ezinokuthi zincinci kunye nexesha elide, uphando olutsha lunikeza ulwazi oluqhubekayo lokusasazela izigulana nge-thyroid carcinoma malunga neengxaki malunga nokuphila kunye nezinto ezinokliniki ezichaphazela umphumo.