Kanesa thyroid - papillary carcinoma

ʻO ka maʻi puʻupaʻa papillary o ka thyroid ka maʻi ʻaʻai maʻamau o ka gland thyroid. Aia ka gland thyroid ma loko o ka mua o ka ʻāʻī lalo.

Ma kahi o 85% o nā maʻi ʻaʻai thyroid i ʻike ʻia ma ʻAmelika Hui Pū ʻIa nā ʻano papillary carcinoma. ʻOi aku ka maʻamau i nā wahine ma mua o nā kāne. Kū ʻia ia i ka wā kamaliʻi, akā ʻike pinepine ʻia i nā mākua ma waena o nā makahiki 20 a me 60.

ʻAʻole ʻike ʻia ke kumu o kēia maʻi ʻaʻai. ʻO kahi kīnā kūpuna a i ʻole ka mōʻaukala ʻohana o ka maʻi he mea weliweli paha.

Hoʻonui ka radiation i ka makaʻu o ka ulu ʻana i ka maʻi ʻaʻai thyroid. Hōʻike ʻia paha ka hōʻike ʻana mai:

• ʻO nā hōʻailona radiation kiʻekiʻe o ka ʻāʻī i ka ʻāʻī, keu hoʻi i ka wā kamaliʻi, hoʻohana ʻia e mālama i ka maʻi ʻaʻa kamaliʻi a i ʻole nā ​​ʻano kamaliʻi noncancerous
• Hōʻike ka uila mai nā pōʻino mea kanu nukelea

Hāʻawi ʻia ka radiation ma o kahi aa (ma o ka IV) i ka wā o nā hoʻokolohua olakino a me nā mālama ʻana ʻaʻole e hoʻonui i ka makaʻu o ka ulu ʻana i ka maʻi ʻaʻai thyroid.

Hoʻomaka pinepine ka maʻi kanesa thyroid ma ke ʻano he puʻupuʻu liʻiliʻi (nodule) i ka pona thyroid.

ʻOiai paha he maʻi ʻaʻai kekahi mau puʻupuʻu liʻiliʻi, ʻo ka hapa nui (90%) thyroid nodules he mea makaʻu ʻole a ʻaʻohe maʻi ʻaʻai.

ʻO ka hapanui o ka manawa, ʻaʻohe ʻōuli ʻē aʻe.

Inā loaʻa kahi puʻupuʻu ma kāu thyroid, e kauoha paha kāu mea mālama ola i kēia mau hōʻike aʻe:

• Nā hoʻāʻo koko.
• ʻO ke kaha uila o ka thyroid a me ka ʻāʻī ʻāʻī.
• CT scan o ka ʻāʻī a i ʻole MRI e hoʻoholo ai i ka nui o ka tumo.
• Laryngoscopy e loiloi i ka neʻe ʻana o ke kaula leo.
• ʻO ka biopsy makemake nui o ka nila (FNAB) e hoʻoholo ai inā he maʻi maʻi ka maʻi. Hana ʻia paha ʻo FNAB inā hōʻike ka ultrasound i ka liʻiliʻi o ka puʻupuʻu ma mua o 1 kenimika.

Hana ʻia paha ka hoʻāʻo genetic ma ka laʻana biopsy e ʻike ai i nā loli kūpili (mutation) e noho nei. Hiki ke ʻike i kēia i ke alakaʻi ʻana i nā ʻōlelo aʻoaʻo.

ʻO nā hoʻokolohua hana thyroid he maʻamau maʻamau i ka poʻe me ka maʻi ʻaʻai thyroid.

Hiki ke hoʻopili ʻia i ka mālama ʻana i ka maʻi ʻaʻai thyroid:

• ʻOki kino
• Hoʻoikaika radiood iodine
• ʻO ka hoʻōla pākiko thyroid (ʻo ka thyroid hormone replacement therapy)
  
• Waho kukuna radiation radiation (EBRT)
  

Hana ʻia ke ʻoki e wehe i nā maʻi ʻaʻai e like me ka hiki. ʻO ka nui o ka puʻupuʻu, pono e hemo i ka nui o ka gland thyroid. ʻO ka pinepine, lawe ʻia ka gland holoʻokoʻa i waho.

Ma hope o ke kahakaha ʻana, hiki iā ʻoe ke loaʻa i ka radioiodine therapy, i lawe pinepine ʻia e ka waha. Pepehi kēia mea i nā koʻa thyroid i koe. Kōkua pū ia i ka hoʻomaʻemaʻe ʻana i nā kiʻi olakino, no laila hiki i nā kauka ke ʻike inā aia kekahi maʻi ʻaʻai i waiho ʻia a i ʻole inā hoʻi mai ia ma hope.

ʻO ka mālama hou ʻana i kāu maʻi ʻaʻai e hilinaʻi ʻia i nā kumu he nui e like me:

• Ka nui o kēlā me kēia tumo i kēia manawa
• Kahi o ka tumo
• ʻO ka ulu o ka tumo
• Nā hōʻailona e loaʻa iā ʻoe
• ʻO kāu makemake ponoʻī

Inā ʻaʻole koho ke ʻoki, hiki ke pono i ka radiation radiation kūwaho.

Ma hope o ke kaha ʻana a i ʻole ka radioiodine therapy, pono ʻoe e lawe i ka lāʻau i kapa ʻia ʻo levothyroxine no ke koena o kou ola. Hoʻololi kēia i ka hōmona a ka thyroid e hana maʻamau ai.

E lawe paha kāu mea lawelawe iā ʻoe i kahi hoʻokolohua koko i kēlā me kēia mau mahina e nānā i nā pae o ka hormone thyroid. Nā hoʻokolohua ukali ʻē aʻe e hiki ke hana ʻia ma hope o ka mālama ʻana no ka maʻi ʻaʻai thyroid me:

• Ultrasound o ka thyroid
• Ua kāhea ʻia kahi hoʻokolohua kiʻi ʻana i kahi iodine radioactive (I-131)
• E hana hou iā FNAB

Hiki iā ʻoe ke hoʻomāmā i ke koʻikoʻi o ka maʻi ma ke komo ʻana i kahi hui kākoʻo maʻi ʻaʻai. ʻO ke kaʻana ʻana me nā poʻe ʻē aʻe i loaʻa nā ʻike a me nā pilikia maʻamau e hiki ke kōkua iā ʻoe e noʻonoʻo ʻole.

ʻO ke ola ola no ka maʻi ʻaʻai papillary thyroid maikaʻi loa. Ma mua o 90% o nā mākua i loaʻa i kēia maʻi ʻaʻai e ola ma kahi o 10 a 20 mau makahiki. ʻOi aku ka maikaʻi o ka wānana no ka poʻe ʻōpio ma mua o 40 a no ka poʻe me nā tumors liʻiliʻi.

Hiki i nā mea aʻe ke hōʻemi i ka helu ola.

• ʻOi aku ma mua o 55 mau makahiki
• Ua pālahalaha ka maʻi ʻaʻai i nā ʻāpana mamao o ke kino
• Ua pālahalaha ʻia ka maʻi ʻaʻai i nā ʻaʻa palupalu
• Tumo nui

Komo pū nā pilikia:

• ʻO ka hemo ʻana o nā gland parathyroid, ka mea e kōkua ai i ka mālama ʻana i nā pae calcium o ke koko
• Poino i ke aʻalolo e mālama ana i nā kaula leo
• Ke hohola nei i ka maʻi ʻaʻai i nā lymph nodes (rare)
• Ke hoʻolaha nei i ka maʻi ʻaʻai i nā pūnaewele ʻē aʻe (metastasis)

Kāhea i kāu mea hāʻawi inā loaʻa kahi puʻupuʻu i kou ʻāʻī.

Papillary carcinoma o ka thyroid; Maʻi ʻaʻai thyroid papillary; ʻO ka lāʻau thyroid papillary

• Nānā Endocrine
• Ka maʻi ʻaʻai thyroid - CT scan
• Ka maʻi ʻaʻai thyroid - CT scan
• Hoʻonui ka thyroid - scintiscan
• Kelepaʻi thyroid

Haddad RI, Nasr C, Bischoff L. NCCN Nā Kuhi ʻIke: Tyroid Carcinoma, Mana 2.2018. ʻO J Natl Compr Canc Netw. 2018; 16 (12): 1429-1440. PMID: 30545990 pubmed.ncbi.nlm.nih.gov/30545990/.

Haugen BR, Alexander Erik K, Bible KC, et al. Nā Kālā Hoʻolālā ʻAmelika Hui Pū ʻIa ʻo 2015 no nā mea maʻi makua me ka thyroid Nodules a me ka maʻi ʻaʻa thyroid like ʻole. ʻOhana. 2016; 26 (1): 1-133. PMID: 26462967 pubmed.ncbi.nlm.nih.gov/26462967/.

ʻO Kwon D, ʻo Lee S. Ka maʻi ʻaʻai thyroid. I: Myers EN, Snyderman CH, eds. ʻO ke keʻoki Otolaryngology Operative a me ka ʻoki ʻāʻī. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2018: chap 82.

Pūnaewele ʻo National Cancer Institute. ʻO ka mālama ʻana i ka maʻi ʻaʻai thyroid (makua) (PDQ) - mana kūlohelohe olakino. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Hoʻohou i Ianuali 30, 2020. Loaʻa iā Pepeluali 1, 2020.

ʻO Thompson LDR. Nā neoplasma malignant o ka gland thyroid. I: Thompson LDR, Bishop JA, hua. ʻO ke poʻo a me ka neck pathology. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2019: chap 25.

ʻO Tuttle RM lāua ʻo Alzahrani AS. ʻO ka stratification makaʻu ʻana i ka maʻi ʻaʻai thyroid like ʻole: mai ka ʻike ʻana i ka hopena hope loa. ʻO J Clin Endocrinol Metab. 2019; 104 (9): 4087-4100. PMID: 30874735 pubmed.ncbi.nlm.nih.gov/30874735/.