Ngaba Ufuna i-Thyroidectomy iyonke? Kuthiwani Nge-Radioiodine (RAI)?
I-microcarcinoma ye-papillary yindlela yomhlaza womhlaza we-thyroid ophantsi kakhulu. Ezi ngqayi ezincinci - i-microcarcinomas - yenza malunga nesiqingatha sazo zonke i-cancer ye-thyroid efunyenwe e-United States naseYurophu kwiminyaka emithathu edlulileyo.
Indlela Encinci I-Microcarcinoma?
Kancinane kangakanani na? Izikhokelo zithi umhlaza wempuphu "yi-microcarcinoma" ukuba incinci kune .4 intshi (1 cm) ngobukhulu.
Isiganeko nokuThola
Isiganeko se-microcarcinoma sanda, ngokuyinhloko ngenxa yokufumanisa okungcono. Ezi zivumba ezincinci, ezingabonakaliyo zifumaneka kwixesha le-ultrasound kunye ne-X-rays yentloko nentamo.
Iingxabano zonyango
I-microcarcinoma ye-Papillary ithathwa njengengozi kakhulu yokufa. Nangona kunjalo, kuqhelekile ukuba ibuye iphinde, okanye iqhubeke, ukuze utyando luvame ukucetyiswa.
Abaphandi abakwi-10 yeYurophu Congress ye-Endocrinology (ECE) bachaze ngesifundo esilandelayo eside esilandelayo esakhangela iziphumo zezigulane zeMayo Clinic ezine-microcarcinoma ye-thyroid. Olu pho nonongo lufumene ukuba:
- Phakathi kwezigulane ezingaba ngu-900 ezazisuswe ngokugqithisileyo, akukho naluphi na ukusasazeka kweekhensi kwiminyaka engama-20 yokulandelelana
- Iminyaka engama-20 kunye neminyaka engama-40 yokuphindaphinda kwama-tumors e-thyroid yayingu-6% kunye ne-9%.
- Phakathi kwendawo yonke yokufunda, izigulane ezingaphantsi kwezi-3 (0.3%) zafa nge-styryroid microcarcinoma
- Inani lokusinda kunye nokufa kweqela lokufunda alizange lihluke kakhulu ukusuka kubantu abalawulayo
Abaphandi baphetha ukuba iziphumo zabo ziqinisekisa ezi zinto:
- I-papillary thyroid microcarcinoma inexela elihle kakhulu ukuba i-tumor yokuqala isuswe ngokupheleleyo ngexesha lotyando.
- Ngaphezu kwe-99% yezigulane ezine-carcarcinoma ye-thyroid ye-papillary ayikho ingozi yokusasazeka komhlaza okanye ukufa komdlavuza we-thyroid.
- I-postoperative yomsakazo we-radioiodine ukusasaza akuzange kuphuculwe umngcipheko wokuphindaphinda okanye ukufa kumdlavuza we-thyroid oneminyaka engama-40.
Izikhombandlela ze-American Thyroid Association zibonisa i-thyroidectomy yakho yonke i-microcarcinoma epilisi efunyenwe ngaphambi kokuhlinzwa, kwaye ngenxa yezicubu ezinomzimba okanye ezingavumelekanga, ukukunceda ukuqinisekisa ukuba i-tumor isuswe ngokupheleleyo.
I-European ye-Thyroid Association (i-ETA) kunye neBritish Thyroid Association (BTA), nangona kunjalo, nincoma i-thyroidectomy yakho kunye ne-lobectomy ngokulandelelana kwizigulane ezingekho phantsi kwengozi ezingenayo nayiphi na imbali yokuchasana kwemitha. Kwaye i-American Association ye-Clinical Endocrinologists ibonisa ukuba i-lobectomy (ukususwa kwesigxina se-thyroid gland) kunye ne-isthmectomy (ukususa isiqhelo esidibanisa i-lobes) sinconywa kwizigulane ezinobungozi obuncinane be-microcarcinoma.
Ingxabano engakumbi kukuba ingaba i-iodine ye-radioactive (RAI) - eyaziwa ngokuba yonyango-yonyango ikwafuneka kwakhona emva kokutyunjwa ukubonelela ngesiphumo esihle kakhulu. Nangona uphando lweMayo alufumananga nzuzo, kuvunyelwene ukuba kuvunyelwe ukuba izigulane ze-microcarcinoma ezinobuncipheko obuphezulu, oko kukuthi, abo banokuphindaphinda, banama-tumors amaninzi, i- lymph nodes , kunye / okanye nawuphi na ubungqina bokusasazeka .
Uphononongo olwenziwe ngo-2009 kwiphepha leTyroid lalinemiphumo emangalisayo ephikisana nokufundiswa kweMayo Clinic. Uphononongo luka-2009 lufumene ukuba i-43% yezigulane ze-microcarcinoma ezifundwayo zifunyenwe zisasazeka ngomhlaza wazo kwi-lymph node zingama-3 kwiminyaka yokuhlinzwa kwaye ukuba iindlela ezingaphantsi kwamanyathelo ezingafaki i-iode ye-radioactive ayifanelekanga.
Ngomxholo we-2012 kwiNcwadi ye-Oncology , nangona kunjalo, yafumanisa ukuba unyango lwe-radioiodine alukho mfuneko kwaye aluphuculanga iziphumo / ukuhlaziywa kwe-microcarcinoma epilisi ngokubanzi-kwaye yayiyinzuzo kuphela kwizigulane ezinobungozi obuphezulu abanezondo ezinkulu, apho i-RAI yanciphisa izinga lokuphindaphinda.
Impembelelo yezigulane
Uninzi lwezigulane ezine-thyroidectomy ezincinane ziphela zifuna i-thyroid ye-hormone. Ngoko kuya kunengqiqo, ukuba uya kutyunjwa, kwaye ufune unyango emva koko, ukuxubusha inzuzo kunye neengxaki ze-thyroidectomy yakho kunye nogqirha wakho.
Kude ne-RAI, kufuneka uxoxe ngezibonelelo ezinokwenzeka ukuba unayo nayiphi na ingozi, kuquka imbali yentsapho, ukuvezwa kwemisebe, umhlaza wesifo se-thyroid okanye ezinye izinto ezixhalabisa. Yaye qiniseka ukuba ugqirha wakho uyazi izikhokelo zakutsha ukuze akwazi ukuvavanya imeko yakho yengozi, kwaye wenze isiluleko esilungileyo ngokubhekiselele kwi-RAI emva kokusebenza.
> Imithombo:
> Arora, N et. al. "I-Papillary thyroid carcinoma kunye ne-microcarcinoma: ngaba kukho isidingo sokuhlukanisa ezimbini? I- Thyroid 2009; 19: 473-77 PDF
> Carballo, Marilee et. al. "Ukunyanga okanye Ukungaphathwa: I-Adjuvant Radioiodine unyango kwi-Cancer Patients," Journal of Oncology . NgoSeptemba 2012, iWebhu
> Hay, Ian et. al. "I-thyroidectomy okanye i-radioiodine isaphulelo esele siphucukisiwe siphucule umphumo wexesha elide kwizigulane ezingama-900 ezine-microcarcinoma eziphathekayo nge-papillary ephathwayo ngo-1945 ukuya ku-2004," i- Endocrine Abstracts , (2008) 16 P685 Online
> Noguchi, S. et. al. "I-papillary microcarcinoma." Ingxelo Yehlabathi Yobuchopho , uMqulu 32, Isiqendu 5, iphepha 747-53. NgoMeyi 2008, Abstract
> Pearce, E. kunye neBraverman, L. "Iziphumo zePillyry Thyroid Microcarcinoma neziphumo zonyango," I- Journal ye-Clinical endocrinology kunye ne-Metabolism , ngoJulayi 2, 2013.
> Roti, uElio (2008) I-thyroid yamaphepha e-microcarcinoma epilisi: uphando oluchazayo kunye nokuhlaziya i-meta-analysis. I-European Journal ye-Endocrinology, (2008) 159 659-673