Mankhwala a chithokomiro amapezeka ndipo ambiri amakhala abwino (osakhala khansa). Koma kudziŵa kuti ndi zinthu ziti zomwe zimayambitsa khansa zingakhale zodabwitsa.
Ichi ndi chifukwa chake ofufuzira apanga mayesero osiyanasiyana a maselo omwe amagwiritsidwa ntchito pa zitsanzo za selo zomwe zimapezeka kuchokera kumtundu wa chithokomiro. Mayeserowa amathandiza dokotala kudziwa ngati chithokomiro chikhoza kukhala chimfine kapena ayi, chomwe nthawi zambiri chimakhudza kapena ayi munthu amachita opaleshoni ya chithokomiro.
Kupeza Maselo a Chithokomiro: Nzeru Zabwino Kutentha Kwambiri
Njira yochotsera maselo a chithokomiro kuchokera kumimba, yomwe imatchedwa zabwino zabwino zokhudzana ndi singano kapena FNA, ndi yosavuta, yotetezeka, ndipo imachitidwa ku ofesi ya dokotala.
Panthawi ya FNA, dokotala amagwiritsa ntchito singano kuti achotse ("aspirate") maselo kuchokera ku nodules. Poonetsetsa kuti singano ikulowa mu dongo, dokotala amagwiritsa ntchito ultrasound kuti amutsogolere.
Maselowo akakhala ndi aspirated, amafufuzidwa ndi kachipangizo kakang'ono ka dokotala (wotchedwa pathologist) kuti adziwe ngati nthendayi imakhala yoipa ( khansara ya khate ) kapena yowononga.
Nthawi zina, zotsatira za FNA ndi "zopanda malire" kutanthauza kuti sizodziwika ngati nodules ndi khansa kapena ayi.
Pankhani ya zitsanzo zosadziwika, chiwerengerochi chimabwerezedwa mobwerezabwereza. Ngati nthawi yachiwiri imakhala yachiwiri, dokotala angakambirane za biopsy yachitatu kapena opaleshoni.
Ngati munthu atha kuchitidwa opaleshoni ndipo khansa ya chithokomiro imapezeka, chithokomiro chimatengedwa ngati chofunikira komanso choyenera kuchipatala.
Komabe, pamene palibe khansa ya chithokomiro itapezeka (ndipo nodule ndi yowonongeka), wodwalayo wataya thupi lofunika kwambiri, ndipo pakuchitika, amakhala hypothyroid kwa moyo. Komanso, opaleshoni ya chithokomiro imakhala yoopsa ndipo imayanjanitsidwa ndi zoopsa monga chiwonongeko cha mtundu wako wa parathyroid ndi mitsempha yomwe imalamulira mawu anu bokosi
Kuyezetsa Maselo Maselo Kuchokera Kumayodyu a Chithokomiro
Ndi vuto lalikulu la zomwe mungachite pamene FNA biopsy ibwereranso, ochita kafukufuku ayamba kukonza mayesero kuti apitirize kufufuza za matendawa.
Chida chimodzi, chomwe chimatchedwa Afirma Thyroid FNA Analysis, ndi mayesero oyeza maselo omwe amachititsa kuti majini azitsatira m'kati mwachitsanzo cha FNA kuti azindikire kuti ndi "oopsa" kapena "okayikitsa chifukwa cha zoipa."
Ngati kusanthula kukuwonetseratu kuti nthendayi imakhala yowonongeka, ndiye kuti nthawi yotsatila ndikutsata ndondomeko ya nodule imavomerezedwa (zomwe zimakhala zoyipa kwambiri). Ngati nkhonoyi ikukayikitsa chifukwa cha malungo, kuposa momwe munthu angapitirire ndi opaleshoni.
Kafukufuku akusonyeza kuti mayeso a Afirma ndi abwino kuti "awonongeke" khansara, kutanthauza kuti ali ndi ubwino wabwino kwambiri wotsutsa.
Mayesero ena akuphatikizapo mayesero anu a ThyGenX ndi ThyroSeq. Mayeso a ThyGenX akuyesa selo yeniyeni ya kusintha kwa jini ndi zizindikiro kuti athe kupeza chiopsezo cha khansa. Mayesowa ndi abwino kwambiri "kulamulira" khansara, kotero ali ndi ubwino wodalirika wotsutsa.
Ngakhale koyeretsedwa kwambiri, mayeso anu a ThyroSeq ndi abwino pa "olamulira" komanso "olamulira" khansa.
Kodi izi zingatanthauze bwanji chithandizo cha chithokomiro kuti ngati mutakhala kale ndi FNA yomwe imapezeka kuti imakhala ndi chithokomiro chosakwanira, ndipo dokotala akulangiza chithokomiro, mukhoza kukhala ndi FNA ina yomwe imagwira ntchito ndi dokotala yemwe amagwiritsa ntchito imodzi mwa maselo mayesero.
Pamapeto pake, kukhala ndi zotsatira zowonjezereka zingathe kupeletsa opaleshoni yosafunikira.
Mawu Ochokera
Ngakhale kuti mayeso a maselo ndi maselo odabwitsa, ndizofunika kukumbukira kuti kufufuza kwa iwo kukupitirirabe.
Mwa kuyankhula kwina, mayeserowa sali angwiro-madokotala akufunikanso kufufuza zoopsa zapadera za wodwalayo ndikugwirizanitsa momwe angagwiritsire ntchito zipangizozi zowunikira.
> Zotsatira:
> American Thyroid Association. (2018). Nzeru zabwino Zopatsa Nthenda Zambiri za Nkhono Zodzoketsa: Njira ndi kutanthauzira zotsatira.
> Baca SC ndi al. Ophunzira a atypia mu cytologic matenda a mitsempha ya chithokomiro amagwirizanitsidwa ndi zosiyana za Afirma gene zofotokozera zotsatira ndi zotsatira za matenda. Khansa ya Cytopathol . 2017 May; 125 (5): 313-22. dx.doi.org/10.1002/cncy.21827.
> Ferris et al. Buku la American Thyroid Association Statement of Surgery Application of Molecular Profiling kwa Mankhwala a Chithokomiro: Zomwe Zilipo Pano pa Kusankha Perioperative kupanga. Chithokomiro . 2015 Jul 1; 25 (7): 760-68. dx.doi.org/10.1089/thy.2014.0502.
> Zhang M, Lin O. Kuyeza kwa maselo a mitsempha ya chithokomiro: Kuwunika zowonetsera zamakono zowonetsera zitsanzo zabwino za singano. Arch Pathol Lab Lab . Dec. 2016; 140 (12): 1338-44.