Na U Hloka Likokoana-hloko Tsohle? Ho thoe'ng ka Radioiodine (RAI)?
Papillary microcarcinoma ke mofuta oa kankere ea qoqotho ea papilla e nyenyane haholo ka boholo. Li-kankere tsena tse nyane - microcarcinomas - li etsa hoo e batlang e le halofo ea lik'hemik'hale tsohle tsa qoqotho tse fumanoang United States le Europe lilemong tse mashome a mararo tse fetileng.
Kamoo e nyenyane e leng Papillary Microcarcinoma?
E nyane hakae? Litaelo li re kankere ea papilla ke "microcarcinoma" haeba e nyenyane ho feta li-inchithara tse 1 ka boholo.
Kotsi le Tlhahlobo
Sekhahla sa microcarcinoma se ntse se eketseha, haholo-holo ka lebaka la ho lemoha hamolemo. Likokoana-hloko tsena tse nyenyane, tse sa tšoaneng li atisa ho fumanoa nakong ea li-ultrasound le X-rays tsa libaka tsa hlooho le melala.
Phekolo ea Likhang
Papillary Microcarcinoma e nkoa e na le kotsi e tebileng ea ho shoa. Leha ho le joalo, ho tloaelehile hore e khutlele, kapa e phehe, kahoo ho buuoa hangata ho buelloa.
Bafuputsi ba lekholong la bo10 la European Congress of Endocrinology (ECE) ba ile ba tlaleha ka phuputso ea nako e telele ea boithuto e ileng ea sheba liphello tsa bakuli ba Mayo Clinic ba nang le li-microcarcinoma tsa thyroid. Phuputso eo e fumane hore:
- Har'a bakuli ba ka bang 900 ba neng ba e-na le maloetse a hlalositsoeng ka bongaka, ha ho na ho ata ha kankere ka mor'a lilemo tse 20 tse latellanang
- Lilemo tse 20 tsa lilemo tse 20 le tsa lilemo tse 40 tsa boithaopo ba li-tumor tsa qoqotho li ne li le 6% le 9%.
- Har'a batho bohle ba ithutoang, bakuli ba fokolang ba 3 (0.3%) ba bolailoe ke microcarcinoma ea thyroid
- Lipalo tsa ho pholoha le ho shoa ha sehlopha sa thuto ha lia ka tsa fapana haholo le batho ba laolang
Bafuputsi ba ile ba etsa qeto ea hore liphuputso tsa bona li tiisa se latelang:
- Papillary thyroid microcarcinoma e na le ts'ebetso e ntle ea hore haeba hlahala e khōlō e tlosoa ka ho feletseng nakong ea ho buuoa.
- Bakuli ba fetang 99% ba nang le qoqotho ea likokoana-hloko tsa papilla ha ba kotsing ea ho ata ha kankere kapa ho bolaoa ke kankere ea qoqotho.
- Ts'ebetso ea masala ea radioiodine ea postoperative ha ea ka ea ntlafatsa kotsi ea ho khutla kapa ho bolaoa ke kankere ea qoqotho ea papilori ka lilemo tse 40.
Litaelo tsa American Thyroid Association li bontša hore u na le thyroidectomy e ngata bakeng sa microcarcinoma ea papilla e fumanoang pele ho buuoa, le bakeng sa lihlahala tse nang le metastatic kapa tse hlaselang, ho thusa ho tiisa hore hlahala e tlosoa ka ho feletseng.
Mokhatlo oa Europe Thyroid Association (ETA) le British Thyroid Association (BTA), leha ho le joalo, li khothalletsa hore qoqotho ea hau e be e sa lebelloang ka ho khetheha ho bakuli ba tlaase ba se nang phihlelo ea mahlaseli a kotsi. 'Me Mokhatlo oa American oa Clinic Endocrinologists o bontša hore lobectomy (ho tlosoa halofo ea qoqotho ea qoqotho) hammoho le isthmectomy (ho tlosa mochopho o kopanyang le lobes) ho khothalletsoa bakuli ba tlaase ba microcarcinoma ba nang le kotsi e tlaase.
Ntho e tsitsitseng haholo ke hore na iodine ea mahlaseli (RAI) - e tsejoang hape e le radioiodine - kalafo e hlokahalang ka morao ho buuoa ho fana ka se molemo ka ho fetisisa. Le hoja thuto ea Mayo e sa fumane molemo, hangata ho lumellanoa hore ho khothalletsoa bakuli ba bangata ba nang le kotsi ea papillary microcarcinoma, ke hore, ba nang le ts'oaetso, ba na le lihlahala tse ngata, lymph nodes tse ntle, le / kapa bopaki bo bong ba ho ata .
Phuputso ea 2009 e hatisitsoeng koranteng ea Thyroid e bile le liphello tse hlollang tse khahlanong le thuto ea Mayo Clinic. Phuputso ea 2009 e fumanoe hore bakuli ba 43% ba bakuli ba microcarcinoma ba neng ba ithutile ba ile ba jala kankere ea bona lithong tsa lymph ka hare ho lilemo tse 3 tsa ho buuoa le hore mekhoa e mebe e sa kenyeletsang iodine ea radioactive e ka 'na ea se ke ea nepahala.
Sehlooho sa 2012 se Journal of Oncology , leha ho le joalo, se fumane hore phekolo ea radioiodine ha e hlokehe ebile ha e ntlafatse liphello / ho hlahisa likokoana-hloko tsa microcarcinoma ka kakaretso - 'me e ne e le molemo feela ho bakuli ba nang le likotsi tse kholoanyane moo RAI e ileng ea fokotsa litefiso tsa bocha.
Liphello tsa bakuli
Bongata ba bakuli ba nang le thyroidectomy e sa fellang ba ntse ba qetella ba hloka meriana ea qoqotho ea phetoho ea li-thyroid. Kahoo e ka ba ntho e utloahalang, haeba o tla buuoa, 'me u hloka meriana ka mor'a moo, ho buisana ka melemo le boiketlo ba thyroidectomy ka ho feletseng le ea karolo e itseng le ngaka ea hau.
Ho ea fihla RAI, o lokela ho bua ka melemo e ka khoneha haeba u e-na le mabaka a kotsi, ho kenyeletsa histori ea malapa, ho pepeseha ha mahlaseli a mahlaseli, kankere ea qoqotho e fetileng kapa lintho tse ling. Hape etsa bonnete ba hore ngaka ea hau e tseba mekhoa ea morao-rao e le hore a tsebe ho hlahloba lisosa tsa hau, le ho etsa tlhahiso e ntle ka ho fetisisa mabapi le RAI ea mosebetsing.
> Mehloli:
> Arora, N et. al. "Papillary thyroid carcinoma le microcarcinoma: na ho na le tlhokahalo ea ho khetholla tse peli? Thyroid 2009; 19: 473-77 PDF
> Carballo, Marilee le. al. "Ho Tšoara kapa ho se Tšoaroe: Karolo ea Phekolo ea Radiodiodine ea Adjuvant Kankere ea Thyroid," Journal ea Oncology . September 2012, Inthaneteng
> Hay, Ian le. al. "Thyroidectomy kapa methapo ea radioiodine e setseng e ntlafalitse liphello tsa nako e telele ho bakuli ba 900 ba nang le likokoana-hloko tsa likokoana-hloko microcarcinoma tse ileng tsa tšoaroa ka 1945 ho ea ho 2004," Endocrine Abstracts , (2008) 16 P685 Online
> Noguchi, S. le. al. "Papillary microcarcinoma." World Journal of Surgery , Buka ea 32, Khatiso ea 5, leqepheng la 747-53. Ka May 2008, Sephiri
> Pearce, E. le Braverman, L. "Liphello tsa Papillary Thyroid Microcarcinoma le liphello tsa phekolo," Journal of Clinical Endocrinology & Metabolism , la 2 July, 2013 Online
> Roti, Elio (2008) Thyroid papillary microcarcinoma: thuto e hlalosang le e hlalosang litlhaku. Europe Journal of Endocrinology, (2008) 159 659-673