Umdlavuza wegilo - papillary carcinoma

I-papillary carcinoma ye-thyroid ingumdlavuza ovame kakhulu wegciwane le-thyroid. Indlala yegilo itholakala ngaphakathi ngaphambili kwentamo engezansi.

Cishe ama-85% awo wonke umdlavuza wegilo otholakala e-United States wuhlobo lwe-papillary carcinoma. Kuvame kakhulu kwabesifazane kunabesilisa. Kungenzeka kungenzeka ebuntwaneni, kepha kuvame ukubonwa kubantu abadala abaphakathi kweminyaka engama-20 nengama-60.

Ayaziwa imbangela yalo mdlavuza. Ukukhubazeka kofuzo noma umlando womndeni wesifo kungaba yingozi.

Imisebe inyusa ingozi yokuba nomdlavuza wegilo. Ukuvezwa kungenzeka kusuka ku:

• Izindlela zokwelapha ngemisebe zangaphandle ezinomthamo omkhulu entanyeni, ikakhulukazi ngesikhathi sobuntwana, zisetshenziselwa ukwelapha umdlavuza wezingane noma ezinye izimo zezingane ezinganomdlavuza
• Ukuchayeka ngemisebe evela ezinhlekeleleni zezitshalo zenuzi

Imisebe enikezwa ngomthambo (ngokusebenzisa i-IV) ngesikhathi sokuhlolwa nokwelashwa ayikhuphuli ingozi yokuba nomdlavuza wegilo.

Umdlavuza we-thyroid uvame ukuqala njengesigaxa esincane endlebeni yegilo.

Yize ezinye izigaxa ezincane zingaba ngumdlavuza, iningi (90%) lamaqhubu endlala yegilo awanabungozi futhi awunomdlavuza.

Isikhathi esiningi, azikho ezinye izimpawu.

Uma unesigaxa ku-thyroid yakho, umhlinzeki wakho wezokunakekelwa kwempilo anga-oda izivivinyo ezilandelayo:

• Ukuhlolwa kwegazi.
• I-Ultrasound yengxenye yegilo yegilo nentamo.
• Ukuhlolwa kwe-CT kwentamo noma i-MRI ukuthola ubukhulu besimila.
• I-Laryngoscopy yokuhlola ukuhamba kwentambo yezwi.
• I-biopsy aspiration biopsy (FNAB) enhle ukuthola ukuthi isigaxa sinomdlavuza yini. I-FNAB ingenziwa uma i-ultrasound ikhombisa ukuthi isigaxa singaphansi kwesentimitha elilodwa.

Ukuhlolwa kofuzo kungenziwa kusampula ye-biopsy ukubona ukuthi yiziphi izinguquko zofuzo (ukuguquka) okungaba khona. Ukwazi lokhu kungasiza ekuqondiseni izincomo zokwelashwa.

Ukuhlolwa kokusebenza kwe-thyroid kuvame ukujwayelekile kubantu abanomdlavuza we-thyroid.

Ukwelashwa komdlavuza wegilo kungabandakanya:

• Ukuhlinzwa
• Ukwelashwa kwe-iodine enemisebe
• Ukwelashwa kokucindezela i-thyroid (i-thyroid hormone replacement therapy)
  
• Ukwelashwa kwemisebe yangaphandle (EBRT)
  

Kuhlinzwa ukwenziwa ukukhipha umdlavuza omningi ngangokunokwenzeka. Uma isigaxa sisikhulu, indlala yegilo kufanele isuswe. Imvamisa, kukhishwa yonke indlala.

Ngemuva kokuhlinzwa, ungathola i-radioiodine therapy, evame ukuphuzwa ngomlomo. Le nto ibulala noma yiziphi izicubu ze-thyroid ezisele. Kuyasiza futhi ukwenza izithombe zezokwelapha zicace, ngakho-ke odokotela bayabona uma ngabe kukhona umdlavuza osele ngemuva noma uma ubuya emuva kwesikhathi.

Ukuphathwa okwengeziwe komdlavuza wakho kuzoncika ezintweni eziningi ezinjenge:

• Usayizi wanoma yisiphi isimila esikhona
• Indawo yesimila
• Izinga lokukhula kwesimila
• Izimpawu ongahle ube nazo
• Okuthandayo

Uma ukuhlinzwa kungeyona inketho, ukwelashwa ngemisebe yangaphandle kungasiza.

Ngemuva kokuhlinzwa noma ukwelashwa nge-radioiodine, uzodinga ukuthatha umuthi obizwa nge-levothyroxine impilo yakho yonke. Lokhu kufaka esikhundleni se-hormone evame ukwenziwa yi-thyroid.

Umhlinzeki wakho kungenzeka ukuthi ahlolwe igazi njalo ezinyangeni ezimbalwa ukuze ahlole amazinga ama-hormone e-thyroid. Ezinye izivivinyo zokulandelela ezingenziwa ngemuva kokwelashwa komdlavuza we-thyroid zifaka:

• I-Ultrasound yegilo
• Isivivinyo se-imaging esibizwa nge-radioactive iodine (I-131) scan scan
• Phinda i-FNAB

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Izinga lokusinda komdlavuza wegilo we-papillary lihle kakhulu. Abantu abadala abangaphezu kwama-90% abanalo mdlavuza baphila okungenani iminyaka eyishumi kuya kwengu-20. Isibikezelo singcono kubantu abangaphansi kweminyaka engama-40 nalabo abanamathumba amancane.

Izici ezilandelayo zinganciphisa izinga lokusinda:

• Mdala kuneminyaka engu-55 ubudala
• Umdlavuza osabalalele ezingxenyeni ezikude zomzimba
• Umdlavuza osudlulele ezicutshini ezithambile
• Isigaxa esikhulu

Izinkinga zifaka:

• Ukususwa ngengozi kwezindlala ze-parathyroid, ezisiza ukulawula amazinga e-calcium egazi
• Ukulimala kwenzwa elawula imisipha yezwi
• Ukusakazeka komdlavuza kuma-lymph node (akuvamile)
• Ukusatshalaliswa komdlavuza kwamanye amasayithi (i-metastasis)

Shayela umhlinzeki wakho uma unesigaxa entanyeni yakho.

I-papillary carcinoma yegilo; Umdlavuza wegciwane le-papillary; I-papillary thyroid carcinoma

• Izindlala ze-Endocrine
• Umdlavuza wegilo - CT scan
• Umdlavuza wegilo - CT scan
• Ukwandiswa kwe-thyroid - i-scintiscan
• Indlala yegilo

IHaddad RI, Nasr C, Bischoff L. NCCN Imihlahlandlela Yemininingwane: I-Thyroid Carcinoma, Inguqulo 2.2018. UJ Natl Compr Cancer Netw. I-2018; 16 (12): 1429-1440. I-PMID: 30545990 pubmed.ncbi.nlm.nih.gov/30545990/.

UHaugen BR, u-Alexander Erik K, u-Bible KC, et al. Imihlahlandlela Yokuphathwa Kombutho We-American Thyroid Association weziguli zabantu abadala ezinamaqhuqhuva e-Thyroid kanye ne-Cancer ye-Thyroid ehlukanisiwe: I-American Thyroid Association Guidelines Task Force on the Thyroid Nodules and Differentiated Thyroid Cancer. Indlala yegilo. 2016; 26 (1): 1-133. I-PMID: 26462967 pubmed.ncbi.nlm.nih.gov/26462967/.

I-Kwon D, Lee S. Umdlavuza we-thyroid ohlaselayo. Ku: Myers EN, Snyderman CH, eds. I-Operative Otolaryngology Head kanye ne-Neck Surgery. 3rd ed. IPhiladelphia, PA: Elsevier; 2018: isahluko 82.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza wegilo (omdala) (PDQ) - inguqulo yesikhashana yezempilo. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Kubuyekezwe ngoJanuwari 30, 2020. Kufinyelelwe ngoFebhuwari 1, 2020.

Thompson LDR. Ama-neoplasms amabi endlala yegilo. Ku: Thompson LDR, uMbhishobhi JA, ama-eds. IPathology neNhloko. 3rd ed. IPhiladelphia, PA: Elsevier; 2019: isahluko 25.

UTuttle RM no-Alzahrani AS. Ukuhlukaniswa kobungozi kumdlavuza we-thyroid ohlukanisiwe: kusuka ekutholeni kuya ekulandeleni kokugcina. UJ Clin Endocrinol Metab. 2019; 104 (9): 4087-4100. I-PMID: 30874735 pubmed.ncbi.nlm.nih.gov/30874735/.