Kodi Mukusowa Thandizo Lonse la Chithokomiro? Nanga Bwanji Radioiodine (RAI)?
Papillary microcarcinoma ndi mtundu wa kansa ya kanseri yomwe imakhala yochepa kwambiri. Mankhwala a khansa aang'ono - microcarcinomas - amapanga pafupifupi hafu ya khansa ya chithokomiro yomwe imapezeka ku United States ndi Europe zaka makumi atatu zapitazo.
Kodi Mchenga Amakhala Bwanji ndi Papcarry Microcarcinoma?
Ndi ochepa bwanji? Malangizo akunena kuti kansa ya papillary ndi "microcarcinoma" ngati yaying'ono kuposa inchimita imodzi (1 sentimita) kukula kwake.
Chikoka ndi Kuzindikira
Chiwerengero cha microcarcinoma chikuwonjezeka, makamaka chifukwa chozindikira bwino. Matenda aang'ono awa, amapezeka panthawi yamakono ndi X-ray ya kumutu ndi kumutu.
Mikangano Yothandizira
Papillary microcarcinoma imaonedwa kuti ili ndi chiwopsezo chochepa cha kufa. Komabe, ndizofala kuti zibwererenso, kapena zipitirire, kotero opaleshoni nthawi zambiri amalimbikitsidwa.
Ofufuza pa 10th European Congress of Endocrinology (ECE) adafotokoza kafukufuku wotsatira omwe adawona zotsatira za odwala chipatala cha Mayo ndi microcarcinoma. Phunzirolo linapeza kuti:
- Pa odwala pafupifupi 900 omwe anadwala opaleshoni, opaleshoniyi inafafanizidwa pakatha zaka 20 zotsatila
- Zaka 20 ndi zaka 40 zowonongeka kwa matenda a chithokomiro zinali 6% ndi 9%.
- Pakati pa anthu onse owerengera, odwala atatu okha (0.3%) anafa ndi microcarcinoma ya chithokomiro
- Mapulumulo ndi kufa kwa gulu la maphunziro sizinali zosiyana kwambiri ndi anthu omwe akulamulira
Ofufuzawo anapeza kuti zomwe anapezazo zimatsimikizira izi:
- Kachilombo kamakono kakang'ono kamene kachipatala kamakhala ndi chithunzithunzi chabwino kwambiri ngati chotupa chachikulucho chichotsedwa kwathunthu pa opaleshoni.
- Odwala oposa 99% omwe ali ndi tizilombo toyambitsa matenda a chithokomiro sangayambe kufalikira kwa khansa kapena kufa kwa khansa ya chithokomiro.
- Kusagwiritsidwa ntchito kwapadera kwa radioyodine sikunapangitse kuti pakhale ngozi ya kubwereranso kapena kufa kwa khansa ya chithokomiro ya papilisi kwazaka 40.
Malangizo a American Thyroid Association amasonyeza kuti mumakhala ndi chithokomiro chokwanira cha microcarcinoma yomwe imapezeka kuti musanayambe opaleshoni, komanso chifukwa cha zotupa zomwe zimakhala zovuta kapena zowonongeka, zothandizira kutsimikizira kuti chotupacho chatsuka kwathunthu.
Komiti ya European Thyroid Association (ETA) ndi British Thyroid Association (BTA), komabe amalimbikitsa chithandizo cha thyroidectomy ndi lobectomy mwachindunji kwa odwala omwe sakhala ndi mbiri ya kutuluka kwa dzuwa. Ndipo bungwe la American Association of Clinical Endocrinologists likusonyeza kuti lobectomy (kuchotsa theka la chithokomiro) pamodzi ndi isthmectomy (kuchotsa mphuno yomwe imagwirizanitsa ndi lobes) ikulimbikitsidwa ndi odwala a microcarcinoma omwe ali ochepa kwambiri.
Zotsutsana kwambiri ndizoti iodine yothamanga kwambiri (RAI) - yomwe imadziwikanso ngati radioiodine - mankhwala akufunikanso operekera opaleshoni kuti apereke zotsatira zabwino. Ngakhale kuti maphunziro a Mayo sanapeze phindu, amavomerezana kuti akulimbikitsidwa ndi odwala omwe amagwiritsa ntchito papillary microcarcinoma odwala, mwachitsanzo, iwo omwe ali ndi zobwereza, amakhala ndi zotupa zambiri, zithunzithunzi zabwino, ndi / kapena umboni uliwonse wa kufalikira .
Phunziro la 2009 lomwe linasindikizidwa mu nyuzipepala ya Thyroid linali ndi zotsatira zodabwitsa zomwe zinatsutsana ndi kuphunzira kwa Mayo Clinic. Kafukufuku wa 2009 adapeza kuti 43 peresenti ya odwala microcarcinoma omwe amaphunzira anafalitsa khansara yawo ku maselo am'kati mwa zaka zitatu za opaleshoni komanso kuti njira zosautsa zachiwawa zomwe siziphatikizapo ayodini ya radioactive sizingakhale zoyenera.
Nkhani ya 2012 mu Journal of Oncology , komabe, inapeza kuti chithandizo cha radioiodine sichiri chofunikira ndipo sichikuthandizani zotsatira / kufotokozera kwa microcarcinoma pamapepala - ndipo zinali zothandiza pokhapokha odwala omwe ali ndi zotupa zazikulu, komwe RAI inachepetsa miyeso yowonjezera.
Zotsatira kwa Odwala
Ambiri mwa odwala omwe ali ndi chithokomiro chochepa chakumapeto amatha kukhala ndi mankhwala osokoneza bongo. Kotero zingakhale zomveka, ngati mukuchita opaleshoni, ndipo mumadalira mankhwala pambuyo pake, kuti mukambirane za ubwino ndi chiopsezo cha chithokomiro chanu chokhazikika ndi dokotala wanu.
Malinga ndi RAI, muyenera kukambirana za phindu lokhazikika ngati muli ndi zifukwa zilizonse zoopsya, kuphatikizapo mbiri ya banja, kutsekula kwa dzuwa, kansa ya chithokomiro, kapena zina. Ndipo onetsetsani kuti dokotala wanu akudziwa malangizo atsopano kuti athe kuyesa zinthu zomwe zingakuchititseni chiopsezo, ndipo apange ndondomeko yabwino yokhudzana ndi RAI yothandizira.
> Zotsatira:
> Arora, N et. al. "Papillary thyroid carcinoma ndi microcarcinoma: kodi pakufunika kusiyanitsa awiriwa? Chithokomiro 2009; 19: 473-77 PDF
> Carballo, Marilee et. al. "Kuchiza kapena Kusayenera Kuchitidwa: Udindo wa Adjuvant Radioiodine Thandizo la Matenda a Khansa ya Chithokomiro," Journal of Oncology . September 2012, Online
> Hay, Ian ndi. al. "Palibe chithokomiro chonse chokhachokha kapena kupuma kwa radioiodine komwe kumakhalako kwabwino kwa nthawi yaitali mu odwala 900 omwe ali ndi tizilombo toyambitsa matenda otchedwa papillary microcarcinoma omwe anachitidwa mu 1945 mpaka 2004," Endocrine Abstracts , (2008) 16 P685 Online
> Noguchi, S. ndi. al. "Papillary microcarcinoma." World Journal of Surgery , Voliyumu 32, Magazini 5, masamba 747-53. May 2008, Zosintha
> Pearce, E. ndi Braverman, L. "Maphunziro a Papillary Thyroid Microcarcinoma ndi Zotsatira za Chithandizo," Journal of Clinical Endocrinology & Metabolism , July 02, 2013 Online
> Roti, Elio (2008) Chithokomiro cha papyrus microcarcinoma: phunziro lofotokozera komanso lachidule. European Journal of Endocrinology, (2008) 159 659-673