Abantu bagera kuri 1,2% bazasuzumwa na kanseri ya tiroyide mu buzima bwabo. Mu myaka 40 ishize, kubera gukoresha amashusho menshi ndetse no gushyiraho biopsy nziza y'urushinge rwiza, umubare wa kanseri ya tiroyide wiyongereye cyane, kandi na kanseri ya tiroyide yiyongereyeho gatatu. Umuti wa kanseri ya tiroyide wateye imbere byihuse mumyaka 5 kugeza 10 ishize, hamwe na protocole nshya zitandukanye zemewe n'amategeko
Guhura n'imirasire ya ionizing mugihe cy'ubwana byari bifitanye isano cyane na kanseri ya papillary tiroyide (1.3 kugeza 35.1 / abantu 10,000-imyaka). Ubushakashatsi bwakozwe bwerekanye abana 13.127 bari munsi y’imyaka 18 baba muri Ukraine nyuma y’impanuka ya kirimbuzi ya Chernobyl yo mu 1986 yatewe na kanseri ya tiroyide yasanze abantu 45 bose barwaye kanseri ya tiroyide bafite ibyago byinshi birenze 5.25 / Gy kuri kanseri ya tiroyide. Hariho kandi isano-yogusubiza hagati yimirasire ya ionizing na kanseri ya tiroyide. Uko imyaka yakira imishwarara ya ionizing yakiriwe, niko ibyago byinshi byo kwandura kanseri ya tiroyide iterwa n'imirasire, kandi iyi ngaruka yakomeje kubaho nyuma yimyaka 30 nyuma yo guhura.
Impamvu nyinshi zishobora gutera kanseri ya tiroyide ntizihinduka: imyaka, igitsina, ubwoko cyangwa ubwoko, n'amateka yumuryango wa kanseri ya tiroyide nibyo byingenzi byerekana abahanuzi. Uko imyaka igenda ikura, niko bigenda byiyongera kandi bikagabanuka. Kanseri ya tiroyide ikunze kugaragara ku bagore inshuro eshatu kurusha iy'abagabo, igipimo gihora ku isi hose. Guhindagurika kwa geneti kumurongo wa mikorobe ya 25% byabarwayi barwaye kanseri ya medullary ya tiroyide ifitanye isano na syndromes nyinshi ya endocrine yibibyimba yo mu bwoko bwa 2A na 2B. 3% kugeza 9% by'abarwayi bafite kanseri ya tiroyide itandukanye neza bafite irage.
Ubushakashatsi bwakorewe ku baturage barenga miliyoni 8 muri Danimarike bwerekanye ko indwara ya nodular idafite ubumara ifitanye isano no kwiyongera kwa kanseri ya tiroyide. Mu bushakashatsi bwakozwe ku bushakashatsi bwakozwe ku barwayi 843 barimo kubagwa tiroyide ku buryo bumwe cyangwa bubiri bwa tiroyide nodule, goiter, cyangwa autoimmune tiroyide, urugero rwinshi rwa serumu thyrotropine (TSH) rwibanze rwa kanseri ya tiroyide: 16% by'abarwayi bafite TSH iri munsi ya 0.06 mIU / L barwaye kanseri ya tiroyide, mu gihe 52% by'abarwayi ba kanseri ya TSU.
Abantu barwaye kanseri ya tiroyide akenshi nta bimenyetso bafite. Ubushakashatsi bwakozwe ku barwayi 1328 barwaye kanseri ya tiroyide mu bigo 16 byo mu bihugu 4 bwerekanye ko 30% gusa (183/613) aribo bafite ibimenyetso byo gusuzuma. Abarwayi bafite ijosi ryinshi, dysphagia, kumva umubiri wamahanga no gutontoma mubisanzwe barwaye cyane.
Kanseri ya tiroyide isanzwe igaragaza nka tiroyide ya tiroyide. Indwara ya kanseri ya tiroyide muri nodules ishobora kuvugwa ko igera kuri 5% na 1%, ku bagore n'abagabo mu bice bihagije bya iyode ku isi. Kugeza ubu, 30% kugeza 40% bya kanseri ya tiroyide iboneka binyuze muri palpation. Ubundi buryo busanzwe bwo kwisuzumisha burimo amashusho adafite tiroyide (urugero, ultrasound ya karotide, ijosi, umugongo, no kwerekana igituza); Abarwayi bafite hyperthyroidism cyangwa hypotherroidism batigeze bakora kuri node bahabwa ultrasonography ya tiroyide; Abarwayi bafite tiroyide ya tiroyide basubiwemo na ultrasound; Ubuvumbuzi butunguranye bwa kanseri ya tiroyide yakozwe mugihe cyo kwisuzumisha nyuma yo kubagwa.
Ultrasound nuburyo bwatoranijwe bwo kwisuzumisha kuri tiroyide ya tiroyide cyangwa ibindi bisobanuro byerekana amashusho ya tiroyide. Ultrasound yunvikana cyane mukumenya umubare nibiranga tiroyide ya tiroyide kimwe nibishobora guteza ibyago byinshi bifitanye isano n’ibyago byo kurwara nabi, nko kutubahiriza amategeko, guhagarika ibitekerezo bya echoic, no gutera tiroyide idasanzwe.
Kugeza ubu, gusuzuma no kuvura kanseri ya tiroyide ni ikibazo abaganga n’abarwayi benshi bitondera cyane, kandi abaganga bagomba kugerageza kwirinda kwisuzumisha birenze. Ariko iyi mpirimbanyi iragoye kuyigeraho kuko ntabwo abarwayi bose barwaye kanseri ya tiroyide yateye imbere, metastatike ishobora kumva nodules ya tiroyide, kandi ntabwo indwara zose ziterwa na kanseri ya tiroyide ishobora kwirindwa. Kurugero, rimwe na rimwe microcarcinoma ya tiroyide idashobora na rimwe gutera ibimenyetso cyangwa urupfu irashobora gupimwa mumateka nyuma yo kubagwa indwara ya tiroyide nziza.
Ubuvuzi bwa interineti bugaragara cyane nka ultrasound-iyobowe na radiofrequency yogukuraho, gukuraho microwave no gukuraho laser bitanga ubundi buryo butanga ikizere cyo kubagwa mugihe kanseri ya tiroyide ishobora kuba ikeneye kuvurwa. Nubwo uburyo bwibikorwa byuburyo butatu bwo gukuraho butandukanye gato, burasa cyane mubijyanye no guhitamo ibibyimba, ibisubizo byibibyimba, hamwe nibibazo nyuma yo kubagwa. Kugeza ubu, abaganga benshi bemeza ko ikintu cyiza cyibibyimba biterwa no gutabarwa byoroheje ari kanseri yo mu bwoko bwa papillary kanseri yo mu nda
Ubushakashatsi butari buke bwerekanye ko kwivanga mu buryo bworoshye mu kuvura microcarcinoma ya tiroyide ya tiroyide bifite ingaruka nziza n'umutekano. Nubwo ingamba zoroheje ziterwa na kanseri ya papillary tiroyide ishobora gutanga umusaruro ushimishije, ubushakashatsi bwinshi bwagiye busubira inyuma kandi bwibanze ku Bushinwa, Ubutaliyani, na Koreya yepfo. Byongeye kandi, nta kugereranya kweruye hagati yo gukoresha interineti yibasiwe cyane no kugenzura neza. Kubwibyo, ultrasound-yayobowe nubushyuhe bwo gukwirakwiza ubushyuhe bukwiye gusa kubarwayi bafite kanseri ya tiroyide ifite ibyago bike badashaka kwivuza cyangwa bahitamo ubu buryo bwo kuvura.
Mu bihe biri imbere, ku barwayi bafite kanseri ya tiroyide ifite akamaro gakomeye, kuvura indwara zidasanzwe zishobora kuba ubundi buryo bwo kuvura bufite ibyago bike byo guhura n'ibibazo kuruta kubagwa. Kuva mu 2021, uburyo bwo gukuraho ubushyuhe bwakoreshejwe mu kuvura abarwayi ba kanseri ya tiroyide iri munsi ya mm 38 (T1b ~ T2) bafite ibyago byinshi. Nyamara, ubu bushakashatsi bwisubireho bwarimo itsinda rito ryabarwayi (kuva kuri 12 kugeza 172) nigihe gito cyo gukurikirana (bivuze amezi 19.8 kugeza 25.0). Niyo mpamvu, hakenewe ubushakashatsi bwinshi kugirango wumve agaciro ko gukuraho amashyuza mu kuvura abarwayi bafite kanseri ya tiroyide ikomeye.
Kubaga bikomeje kuba uburyo bwambere bwo kuvura abakekwaho cyangwa barwaye kanseri ya tiroyide itandukanye. Habayeho impaka kurwego rukwiye rwa tiroyide (lobectomy na tiroyide yose). Abarwayi baterwa na tiroyide yose bafite ibyago byinshi byo kubaga kurusha ababana na lobectomie. Ingaruka zo kubagwa tiroyide zirimo kwangirika kw'imitsi ya laryngeal, hypoparathyroidism, ingorane zo gukomeretsa, ndetse no gukenera imisemburo ya tiroyide. Mubihe byashize, tiroyideyose yuzuye niyo yatoranijwe kuvura kanseri zose zitandukanye za tiroyide> mm 10. Nyamara, ubushakashatsi bwakozwe na 2014 n'abandi. yerekanye ko nta tandukanyirizo rishingiye ku mibare ryabayeho mu kubaho no kongera kubaho hagati y’abarwayi batewe na lobectomie na tiroyideyide yose ya kanseri ya mm 10 kugeza kuri mm 40 ya kanseri ya papillary ya tiroyide idafite ibimenyetso by’indwara nyinshi.
Kubwibyo, kuri ubu, lobectomy isanzwe ikundwa na kanseri ya tiroyide itandukanijwe neza <40 mm. Indwara ya tiroyideyose irasabwa muri rusange gutandukanya kanseri ya tiroyide ya mm 40 cyangwa irenga kanseri ya tiroyide. Niba ikibyimba kimaze gukwirakwira mu karere ka lymph node, hagomba gukorwa gutandukana hagati ya lymph yo hagati no kuruhande. Gusa abarwayi bafite kanseri ya medullary ya tiroyide hamwe na kanseri nini itandukanye cyane ya kanseri ya tiroyide, kimwe n’abarwayi bafite tiroyide yo hanze, bakeneye gutandukana hagati ya lymph node. Prophylactic lateral cervical lymph node gutandukana irashobora gufatwa kubarwayi barwaye kanseri ya medullary. Ku barwayi bakekwaho kuba barwaye kanseri ya tiroyide, kanseri ya plasma ya norepinephrine, calcium, na hormone ya parathiyide (PTH) igomba gusuzumwa mbere yo kubagwa kugira ngo hamenyekane syndrome ya MEN2A kandi wirinde kubura pheochromocytoma na hyperparathyroidism.
Intubation ya nervice ikoreshwa cyane cyane muguhuza na monitor ikwiye kugirango itange inzira yumuyaga idahwitse no gukurikirana imitsi idakorana nigikorwa cyimyakura mumitsi.
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