KANSA YA THYROID

Khansara ya chithokomiro ndi mtundu wa khansa yomwe imayambira m'chithokomiro, chiwalo chooneka ngati gulugufe chomwe chili m'munsi mwa khosi. Chithokomiro chimagwira ntchito yofunika kwambiri pakuwongolera kagayidwe, kugunda kwa mtima, ndi kutentha kwa thupi kudzera mukupanga mahomoni. Khansara ya chithokomiro ndiyosowa kwambiri poyerekeza ndi khansa ina koma yawonetsa kuchuluka kwa anthu padziko lonse lapansi. Makhansa ambiri a chithokomiro amatha kuchiza, makamaka akapezeka msanga.

Mitundu ya Khansa ya Chithokomiro

1. Khansa ya Papillary Thyroid (PTC):

• Mtundu wofala kwambiri, wowerengera pafupifupi 80-85% ya milandu.

• Nthawi zambiri imakula pang'onopang'ono ndipo imakhala ndi chidziwitso chabwino kwambiri.

• Nthawi zambiri amafalira ku ma lymph nodes oyandikana nawo koma sapha.

2. Follicular Thyroid Cancer (FTC):

• Amawerengera pafupifupi 10-15% ya milandu.

• Zitha kufalikira ku ziwalo zakutali monga mapapu kapena mafupa.

• Mtundu wochepa, Hurthle cell carcinoma, ndi wovuta kwambiri.

3. Medullary Thyroid Cancer (MTC):

• Amawerengera 3-5% ya milandu.

• Amachokera ku ma C cell omwe amapanga calcitonin (hormone yomwe imakhudzidwa ndi kayendedwe ka calcium).

• Zitha kuchitika mwa apo ndi apo kapena ngati mbali ya ma genetic syndromes monga Multiple Endocrine Neoplasia (MEN).

4. Anaplastic Thyroid Cancer (ATC):

• Zosowa, zowerengera zosakwana 2% ya milandu.

• Waukali kwambiri komanso wovuta kuchiza.

• Zimakhudza anthu akuluakulu.

5. Chithokomiro Lymphoma:

• Mtundu wosowa wa non-Hodgkin lymphoma umene umatuluka mu chithokomiro.

Zowopsa

1. Zosasinthika Zowopsa:

• Jenda: Nthawi zambiri akazi kuposa amuna.

• Zaka: Kuchuluka kwa anthu a zaka zapakati pa 30-50 kwa khansa ya papillary ndi follicular; Mitundu ya medullary ndi anaplastic ndiyofala kwambiri mwa anthu okalamba.

• Mbiri Yabanja:

• Kusintha kwa majini (monga RET proto-oncogene mu medullary chithokomiro khansa).

• Mbiri ya banja la khansa ya chithokomiro kapena ma genetic syndromes monga MEN2.

2. Zosintha Zowopsa:

• Kuwonekera kwa radiation:

• Kale mankhwala opangira ma radiation pakhosi kapena kukhudzana ndi kugwa kwa nyukiliya.

• Kuperewera/Kuchuluka kwa ayodini:

• Miyezo ya ayodini imatha kuyambitsa chiwopsezo cha khansa ya follicular ndi papillary chithokomiro.

3. Zomwe Zimayambitsa Matenda a Chithokomiro:

• Matenda a chithokomiro (Hashimoto's thyroiditis) amawonjezera chiopsezo cha lymphoma ya chithokomiro.

zizindikiro

Makhansa ambiri a chithokomiro sakhala ndi chizindikiro akamayambilira ndipo amapezeka nthawi zonse pakuwunika khosi kapena kujambula pazifukwa zina. Zizindikiro zodziwika bwino ndi izi:

• Chotupa kapena kutupa m'khosi.

• Kuvutika kumeza kapena kupuma.

• Kukweza mawu kapena kusintha kwa mawu.

• Kutsokomola kosalekeza kosagwirizana ndi matenda a kupuma.

• Kutupa kwa ma lymph nodes m'khosi.

Zizindikiro Zapamwamba:

• Ululu pakhosi kapena pakhosi.

• Zizindikiro za metastasis (mwachitsanzo, kupweteka kwa mafupa kapena kupuma movutikira chifukwa chogwira ntchito m'mapapo).

Kusinthana

Khansara ya chithokomiro imachitika pogwiritsa ntchito njira ya TNM:

• T: Kukula ndi kukula kwa chotupa chachikulu.

• N: Kufalikira ku ma lymph nodes.

• M: Kukhalapo kwa ma metastases akutali.

Magawo amachokera ku Gawo I (lokhazikika) kupita ku Gawo IV (lotsogola/metastatic).

Njira yathu yowunikira yonse ikuphatikiza:

• Kuyeza kwakuthupi kwa akatswiri
• Kujambula kwapamwamba kwa ultrasound ndi akatswiri a sonologists
• Fine Needle Aspiration Cytology (FNAC)
• Kuyesa kwa ma genetic kwa zolembera za majini
• Kujambula kwapamwamba ndi CT, MRI, ndi PET scanning
• Kuyeza kwa calcitonin ndi calcium level

Njira zochiritsira zimatengera momwe wodwala aliyense alili:

• Kuchotsa chithokomiro chonse kapena pang'ono pogwiritsa ntchito njira zolondola
• Njira zochepetsera maopaleshoni ocheperako
• Machitidwe apamwamba oyendetsa maopaleshoni
• Chithandizo cha radioactive ayodini
• Zochizira zomwe zimayang'aniridwa ndi maselo
• Thandizo m'malo mwa mahomoni

Proton Therapy imapereka zabwino zambiri pakuchiza khansa ya chithokomiro:

• Kulondola kwambiri pakulondolera ma cell chotupa
• Kuchepetsa ma radiation kuzinthu zofunika kwambiri monga esophagus ndi trachea
• Kukhudza kochepa pa kumeza ndi kulankhula
• Kutetezedwa bwino kwa moyo wabwino
• Kuchepetsa chiopsezo cha zovuta zachiwiri

Kuthamangitsani

• Khansa ya Papillary ndi Follicular Thyroid:

• Kudziwiratu kwabwino kwambiri ndi zaka 5 za moyo> 95%, makamaka kumayambiriro.

• Medullary Thyroid Cancer:

• Kudziwiratu kumadalira kuzindikira msanga ndi zinthu zachibadwa.

• Khansa ya Chithokomiro cha Anaplastic:

• Kusauka kwachidziwitso ndi zaka 5 za moyo wa <10% chifukwa cha kupita patsogolo mofulumira.

Kupewa ndi Kuchepetsa Zowopsa

1. Pewani Kuwonetsedwa ndi Ma radiation:

• Chepetsani ma radiation osafunikira pakhosi, makamaka kwa ana.

2. Pitirizani Kusamala za ayodini:

• Kumwa ayodini wokwanira kudzera muzakudya kapena zowonjezera.

3. Uphungu wa Genetic:

• Kwa anthu omwe ali ndi mbiri yabanja kapena chibadwa (monga matenda a MEN2).

4. Kuwunika Koyambirira kwa Tizilombo ta Chithokomiro:

• Kuwunika pafupipafupi kwa anthu omwe ali pachiwopsezo.