Khansa ya chithokomiro - papillary carcinoma

Papillary carcinoma ya chithokomiro ndiye khansa yofala kwambiri ya chithokomiro. Chithokomiro chimakhala mkati kutsogolo kwa khosi lakumunsi.

Pafupifupi 85% ya khansa yonse ya chithokomiro yomwe imapezeka ku United States ndi mtundu wa papillary carcinoma. Amakonda kwambiri akazi kuposa amuna. Zitha kuchitika ali mwana, koma nthawi zambiri zimawoneka mwa akulu azaka zapakati pa 20 ndi 60.

Zomwe zimayambitsa khansara sizikudziwika. Matenda obadwa nawo kapena mbiri yabanja yamatendawa imatha kukhala pachiwopsezo.

Kutentha kumawonjezera chiopsezo chokhala ndi khansa ya chithokomiro. Chiwonetsero chitha kuchitika kuchokera:

• Mankhwala opangira ma radiation kunja kwa khosi, makamaka ali mwana, amagwiritsidwa ntchito pochiza khansa yaubwana kapena zovuta zina zaubwana
• Kutulutsa kwa radiation kuchokera ku masoka achilengedwe a nyukiliya

Magetsi omwe amaperekedwa kudzera mumitsempha (kudzera mu IV) panthawi yamayeso azachipatala samathandizanso kuwonjezera chiopsezo chokhala ndi khansa ya chithokomiro.

Khansa ya chithokomiro nthawi zambiri imayamba ngati chotupa chaching'ono m'matenda a chithokomiro.

Ngakhale zotupa zing'onozing'ono zitha kukhala khansa, ambiri (90%) ma nodule a chithokomiro alibe vuto ndipo alibe khansa.

Nthawi zambiri, sipakhala zisonyezo zina.

Ngati muli ndi chotupa pa chithokomiro chanu, wothandizira zaumoyo wanu akhoza kuyitanitsa mayeso otsatirawa:

• Kuyesa magazi.
• Ultrasound cha chithokomiro ndi khosi.
• Kujambula kwa khosi kapena MRI kuti mudziwe kukula kwa chotupacho.
• Laryngoscopy kuti ayese kuyenda kwa mawu.
• Chida chabwino cha singano (FNAB) kuti mudziwe ngati chotupacho chili ndi khansa. FNAB itha kuchitidwa ngati ultrasound ikuwonetsa kuti chotupacho sichichepera 1 sentimita.

Kuyesedwa kwa majini kumatha kuchitidwa pachitsanzo cha biopsy kuti muwone zosintha zamasamba zomwe zingachitike. Kudziwa izi kungathandize kuwongolera othandizira.

Kuyesedwa kwa chithokomiro nthawi zambiri kumakhala koyenera mwa anthu omwe ali ndi khansa ya chithokomiro.

Chithandizo cha khansa ya chithokomiro chingaphatikizepo:

• Opaleshoni
• Mankhwala othandizira ayodini
• Chithandizo chothana ndi chithokomiro (chithokomiro m'malo mwake)
  
• Mankhwala othandizira ma radiation (EBRT)
  

Opaleshoni yachitika kuti athetse khansa yambiri momwe angathere. Kukula kwakukulu, chotupa cha chithokomiro chimayenera kuchotsedwa. Nthawi zambiri, gland yonse imachotsedwa.

Pambuyo pa opaleshoniyi, mutha kulandira mankhwala a radioiodine, omwe nthawi zambiri amatengedwa pakamwa. Izi zimapha minofu yonse ya chithokomiro. Zimathandizanso kujambula zithunzi zamankhwala, kotero madotolo amatha kuwona ngati pali khansa iliyonse yomwe yatsalira kapena ikadzabweranso pambuyo pake.

Kusamalira khansa yanu kumadalira pazinthu zambiri monga:

• Kukula kwa chotupa chilichonse chomwe chilipo
• Kumene kuli chotupacho
• Kukula kwa chotupa
• Zizindikiro zomwe mungakhale nazo
• Zokonda zanu

Ngati opaleshoni siyosankha, chithandizo chama radiation chakunja chingakhale chothandiza.

Pambuyo pa opareshoni kapena mankhwala a radioiodine, muyenera kumwa mankhwala otchedwa levothyroxine kwa moyo wanu wonse. Izi zimalowetsa mahomoni omwe chithokomiro chimapanga.

Wothandizira anu ayenera kuti mukayezetse magazi miyezi ingapo kuti muwone kuchuluka kwa mahomoni a chithokomiro. Mayesero ena omwe angachitike mukalandira chithandizo cha khansa ya chithokomiro ndi awa:

• Ultrasound cha chithokomiro
• Chiyeso chazithunzi chotchedwa radioactive iodine (I-131) chojambulidwa
• Bwerezani FNAB

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Kuchuluka kwa khansa ya chithokomiro papillary ndibwino kwambiri. Oposa 90% achikulire omwe ali ndi khansara amakhala zaka zosachepera 10 mpaka 20. Kulosera kwake ndikwabwino kwa anthu omwe ali ochepera zaka 40 komanso kwa iwo omwe ali ndi zotupa zing'onozing'ono.

Zinthu zotsatirazi zitha kuchepetsa kupulumuka:

• Okalamba kuposa zaka 55
• Khansa yomwe yafalikira kumadera akutali a thupi
• Khansa yomwe yafalikira kumatenda ofewa
• Chotupa chachikulu

Zovuta zimaphatikizapo:

• Kuchotsa mwangozi ma gland a parathyroid, omwe amathandiza kuwongolera calcium m'magazi
• Kuwonongeka kwa mitsempha yomwe imayendetsa zingwe zamawu
• Kufalikira kwa khansa ku ma lymph node (osowa)
• Kufalitsa khansa kumalo ena (metastasis)

Itanani omwe akukuthandizani ngati muli ndi chotupa m'khosi.

Papillary carcinoma ya chithokomiro; Khansa ya chithokomiro cha papillary; Chithokomiro cha papillary carcinoma

• Matenda a Endocrine
• Khansa ya chithokomiro - CT scan
• Khansa ya chithokomiro - CT scan
• Kukulitsa kwa chithokomiro - scintiscan
• Chithokomiro

Haddad RI, Nasr C, Bischoff L. NCCN Malangizo Kuzindikira: Chithokomiro Carcinoma, Mtundu 2.2018. J Natl Compr Khansa Netw. 2018; 16 (12): 1429-1440. PMID: 30545990 pubed.ncbi.nlm.nih.gov/30545990/.

Haugen BR, Alexander Erik K, Baibulo KC, et al. Maupangiri a 2015 Chithokomiro cha Association of Thyroid Association kwa Odwala Achikulire Okhala Ndi Mitundu Yachithokomiro ndi Khansa Yosiyanasiyana ya Chithokomiro: Gulu Loyang'anira Gulu la American Thyroid Association Gulu Lamagulu a Chithokomiro ndi Khansa Yosiyanasiyana ya Chithokomiro. Chithokomiro. 2016; 26 (1): 1-133. PMID: 26462967 pubed.ncbi.nlm.nih.gov/26462967/.

Kwon D, Lee S. Khansa yotupa ya chithokomiro. Mu: Myers EN, Snyderman CH, olemba. Opaleshoni ya Otolaryngology Mutu ndi Khosi Opaleshoni. Wachitatu ed. Philadelphia, PA: Elsevier; 2018: mutu 82.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya chithokomiro (wamkulu) (PDQ) - mtundu wazachipatala. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Idasinthidwa pa Januware 30, 2020. Idapezeka pa February 1, 2020.

Thompson LDR. Zotupa zotupa za chithokomiro. Mu: Thompson LDR, Bishop JA, eds. Mutu ndi Neck Pathology. Wachitatu ed. Philadelphia, PA: Elsevier; 2019: chap 25.

Tuttle RM ndi Alzahrani AS. Kukhazikitsa ziwopsezo mumtundu wosiyanitsa khansa ya chithokomiro: kuchokera pakuzindikira mpaka kutsata komaliza. J Clin Endocrinol Metab. 2019; 104 (9): 4087-4100. (Adasankhidwa) PMID: 30874735 pubed.ncbi.nlm.nih.gov/30874735/.