Umhlaza wedlala lengqula - papillary carcinoma

I-Papillary carcinoma ye-thyroid ngumhlaza oqhelekileyo we-thyroid gland. Idlala lengqula libekwe ngaphakathi ngaphambili entanyeni.

Malunga ne-85% yazo zonke i-cancer zomhlaza ezifunyenwe e-United States zii-papillary carcinoma type. Kuqheleke kakhulu kubafazi kunamadoda. Inokwenzeka ebuntwaneni, kodwa ihlala ibonwa kubantu abadala abaphakathi kweminyaka engama-20 nama-60.

Unobangela walo mhlaza awaziwa. Isiphene semfuza okanye imbali yosapho yesi sifo inokuba ngumngcipheko.

Imitha yonyusa umngcipheko wokuba nomhlaza wedlala lengqula. Ukubonakaliswa kunokuvela:

• Unyango lwedosi ephezulu yonyango lwentamo, ngakumbi ebuntwaneni, esetyenziselwa ukunyanga umhlaza wabantwana okanye iimeko ezithile zobuntwana
• Ukukhanya kwemitha kwintlekele yezityalo zenyukliya

Imitha enikezelwa ngomthambo (nge-IV) ngexesha lovavanyo lwezonyango kunye nonyango ayonyusi umngcipheko wokuba nomhlaza wedlala lengqula.

Umhlaza wedlala lengqula uhlala uqala njengeqhuma elincinci (nodule) kwidlala lengqula.

Ngelixa amanye amaqhuma amancinci enokuba ngumhlaza, uninzi (90%) lwamaqhuqhuva e-thyroid akayongozi kwaye awunomhlaza.

Uninzi lwexesha, azikho ezinye iimpawu.

Ukuba uneqhuma kwi-thyroid yakho, umboneleli wakho wezempilo unokuyalela ezi mviwo zilandelayo:

• Uvavanyo lwegazi.
• I-Ultrasound yommandla wedlala lengqula kunye nentamo.
• Ukuvavanywa kwe-CT entanyeni okanye kwi-MRI ukumisela ubungakanani besisu.
• I-Laryngoscopy yokuvavanya ukuhamba kwentambo yelizwi.
• Isaliti esinqwenelekayo i-biopsy (FNAB) ukumisela ukuba iqhuma linomhlaza na. I-FNAB inokwenziwa ukuba i-ultrasound ibonakalisa ukuba iqhuma lingaphantsi kwesentimitha enye.

Ukuvavanywa kwemfuza kungenziwa kwisampulu ye-biopsy ukubona ukuba loluphi utshintsho olwenzeka kwimfuza (utshintsho) olunokubakho. Ukwazi oku kunokunceda ukukhokela iingcebiso zonyango.

Uvavanyo lwe-thyroid luhlala luqhelekileyo kubantu abanomdlavuza we-thyroid.

Unyango lwe-thyroid lungabandakanya:

• Ugqirha
• Unyango lwe-iodine
• Unyango lokucinezela i-thyroid (unyango lwe-thyroid endaweni yonyango)
  
• Unyango lwangaphandle lwemitha (EBRT)
  

Utyando lwenziwe ukususa umhlaza kangangoko kunokwenzeka. Eyona nto inkulu njengeqhuma, kokukhona kuya kufuneka kususwe idlala lengqula. Rhoqo, le ndlala iyakhutshwa.

Emva kotyando, unokufumana unyango lwe-radioiodine, edlalwa ngomlomo. Le nkunkuma ibulala nayiphi na i-thyroid. Kuyanceda ukwenza imifanekiso yezonyango icace gca, ke oogqirha banokubona ukuba ukhona na umhlaza oshiyekileyo okanye ukuba ubuya kamva.

Ulawulo oluqhubekayo lomhlaza wakho luya kuxhomekeka kwizinto ezininzi ezinje:

• Ubungakanani bayo nayiphi na ithumba ekhoyo
• Indawo yethumba
• Izinga lokukhula kwethumba
• Iimpawu onokuba nazo
• Ukhetho lwakho

Ukuba utyando alunakukhetha, unyango lwangaphandle lwemitha lunokuba luncedo.

Emva kotyando okanye unyango lwe-radioiodine, kuyakufuneka uthathe iyeza elibizwa ngokuba yi-levothyroxine ubomi bakho bonke. Oku kufaka indawo yehomoni eyayiqhele ukwenziwa yihomoni.

Umboneleli wakho uya kuba novavanyo lwegazi rhoqo kwiinyanga ezininzi ukujonga amanqanaba ehomoni ye-thyroid. Olunye uvavanyo olulandelayo olunokuthi lwenziwe emva konyango lomhlaza we-thyroid lubandakanya:

• I-Ultrasound ye-thyroid
• Uvavanyo lokucinga olubizwa ngokuba yi-radioactive iodine (I-131)
• Phinda FNAB

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lokuxhasa umhlaza. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Izinga lokusinda lomhlaza wedlala lengqula libalaseleyo. Ngaphezulu kwama-90% abantu abadala abanomhlaza abaphila iminyaka eli-10 ukuya kwengama-20 ubuncinci. Ukuxela kubhetele kubantu abangaphantsi kwe-40 kunye nakwabo banezicubu ezincinci.

Ezi zinto zilandelayo zinokunciphisa izinga lokusinda:

• Kudala uneminyaka engama-55 ubudala
• Umhlaza osasazeke waya kwiindawo ezikude zomzimba
• Umhlaza osasazeke kwizihlunu ezithambileyo
• Ithumba elikhulu

Iingxaki zibandakanya:

• Ukususwa ngengozi kwamadlala afanayo, anceda ekulawuleni amanqanaba e-calcium egazini
• Ukonakala kwimithambo-luvo elawula iintambo zamagama
• Ukusasazeka komhlaza kwii-lymph node (ezinqabileyo)
• Ukusasazeka komhlaza kwezinye iisayithi (metastasis)

Biza umboneleli wakho ukuba uneqhuma entanyeni yakho.

I-papillary carcinoma ye-thyroid; Umhlaza papillary lengqula; Ipapillary thyroid carcinoma

• Amadlala endocrine
• Umhlaza wegciwane le-thyroid-CT scan
• Umhlaza wegciwane le-thyroid-CT scan
• Ukwandiswa kwe-thyroid-scintiscan
• Idlala lengqula

IHaddad RI, uNasr C, uBischoff L. Izikhokelo zeNCCN zokuqonda: iTyroid Carcinoma, Inguqulelo 2.2018. J Natl Compr Umhlaza weNetw. 2018; 16 (12): 1429-1440. IINKCUKACHA: 30545990 pubmed.ncbi.nlm.nih.gov/30545990/.

IHaugen BR, uAlexander Erik K, iBhayibhile KC, et al. Izikhokelo zoLawulo lweMbumba yaseMelika ye-Thyroid ye-2015 yeziGulana eziDala ezinamaqhuqhuva e-Thyroid kunye neCancer Cancer eyahlukileyo: I-American Thyroid Association Guidelines Task Force kwi-Thyroid Nodules kunye neCancer Cancer eyahlukileyo. Idlala lengqula. Ngo-2016; 26 (1): 1-133. IINKCUKACHA: 26462967 pubmed.ncbi.nlm.nih.gov/26462967/.

Kwon D, Lee S. Umhlaza wedlala lengqula. Ku: Myers EN, Snyderman CH, ii-eds. Umsebenzi weNtloko yeOtolaryngology kunye nokuhlinzwa kotyando. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; I-2018: isahluko 82.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lomhlaza wedlala lengqula (yabantu abadala) (PDQ) -uhlobo lonikezelo lwempilo. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Ukuhlaziywa ngoJanuwari 30, 2020. Ifikeleleke ngoFebruwari 1, 2020.

I-Thompson LDR. Neoplasms amabi ndlala lengqula. Ku: Thompson LDR, uBhishophu JA, ii-eds. INtloko kunye neNeck Pathology. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; I-2019: isahluko 25.

I-Tuttle RM kunye neAlzahrani AS. Ukwahlulahlulwa komngcipheko kukwahlulahlula umhlaza wedlala lengqula: ukusuka ekufumaneni ukuya kulandelelo lokugqibela. J Ikliniki ye-Endocrinol Metab. Ngo-2019; 104 (9): 4087-4100. IINKCUKACHA: 30874735 pubmed.ncbi.nlm.nih.gov/30874735/.