Izindebe ze-thyroid zivamile futhi iningi liyingozi (engeyona umdlavuza). Kodwa ukucacisa ukuthi yiziphi izici ezinomthelela olwa nomdlavuza kungaba inqubo ekhohlisayo.
Yingakho uphenyo bekwenzile ukuhlolwa okuhlukahlukene kwamangqamuzana asetshenziselwa amasampula eseli atholakale emgqonyeni wegciwane. Lezi zivivinyo zisiza udokotela ukuba anqume ukuthi ngabe i-nodule ye-thyroid ingase ibe nomdlavuza noma cha, okuvame ukuthinta noma ngabe umuntu uhlinzwa yini noma cha.
Ukuthola Amaseli E-Thyroid: I-Needle Fine Aspiration Biopsy
Inqubo yokususa amangqamuzana e-thyroid kusuka e-nodule, ebizwa ngokuthi ama-suction aspiration biopsy noma i-FNA, ilula, iphephile futhi yenziwa ehhovisi likadokotela.
Ngesikhathi se-FNA, udokotela uzosebenzisa inaliti ukususa ("aspirate") amaseli avela ku-nodule. Ukuqinisekisa ukuthi inaliti iyangena, udokotela uzosebenzisa i-ultrasound ukuze imhole.
Uma selifakwe amaseli, ahlolwa ngaphansi kwe-microscope udokotela (obizwa ngokuthi i-pathologist) ukuze anqume ukuthi i-nodule iyingozi ( umdlavuza wegciwane ) noma unobungozi.
Ngezinye izikhathi, kodwa imiphumela ye-FNA "ayinqamuli" kusho ukuthi akucaci ukuthi i-nodule ingumdlavuza noma cha.
Endabeni yamasampuli angakapheli, i-biopsy ivame ukuphindaphindiwe. Uma kungakapheli okwesibili, udokotela uzocabangela i-biopsy yesithathu noma ukuhlinzwa njalo.
Uma umuntu eqeda ukuhlinzwa okuqhubekayo nomdlavuza wegciwane kutholakala, i-thyroidectomy ithathwa njengesinyathelo esibalulekile futhi esifanele ekwelapheni.
Kodwa-ke, lapho kungatholakali umdlavuza we-thyroid (futhi i-nodule iyinhlonipho), isiguli siye salahlekelwa ngokungadingekile isitho esibalulekile, futhi kule nqubo, iba yi- hypothyroid yokuphila. Ngaphezu kwalokho, ukuhlinzwa kwe-thyroid kuyaphazamiseka futhi kuhlotshaniswa nezingozi ezifana nomonakalo kumgogodla wakho we-parathyroid kanye nesibindi esilawula ibhokisi lakho lezwi
Ukuvivinya Kwama-Molecular Amaseli Kusuka Emadodeni E-Thyroid
Ngenkinga yokuthi yini okufanele yenziwe lapho i-FNA biopsy ibuya ingakapheli, abacwaningi sebeqalile ukuthuthukisa izivivinyo ukuze kuthuthukiswe ukuhlolwa kokuxilongwa kwalezi zinambuzane ezingavamile.
Ithuluzi elilodwa, okuthiwa yi-Afirma Thyroid FNA Analysis, livivinyo lokuhlola i-molecule elenza amaphethini wokukhuluma ngegenefu kusampula ye-FNA ukuze kutholakale ukuthi "uyinhlonipho" noma "uyasolisa ngenxa yokulimala."
Uma ukuhlaziywa kubonisa ukuthi i-nodule ibe yinhlonipho, khona-ke ukulandelelwa nokuqapha kwesikhombisa kuvame ukuphakanyiswa (okuyinto evamile kumigqomo emincane). Uma i-nodule isolisa ngokuhlukunyezwa, kunokuba umuntu aqhubeke nokuhlinzwa.
Ucwaningo lubonisa ukuthi ukuhlolwa kwe-Afirma kungcono kakhulu ekuqedeni umdlavuza, okusho ukuthi unomphumela omubi kakhulu wokubikezela.
Okunye ukuhlolwa kufaka phakathi izivivinyo ze-ThyGenX ne-ThyroSeq. Isivivinyo se-ThyGenX sicubungula isampuli yeseli yokuguqula izakhi kanye namakhamera ukufinyelela engozini yomdlavuza. Loluhlolo luhle kakhulu "ekubuseni" emdlalweni, ngakho-ke lunenani elihle kakhulu lokubikezela.
Ukucwengisisa nakakhulu, isilingo sakho se-ThyroSeq sikhulu kokubili "kokubusa" nokuqeda umdlavuza.
Lokho okusho ukuthini ukunakekelwa kwegciwane lakho ukuthi uma usuvele unayo i-FNA biopsy eyathola indundane ye-thyroid engaqinisekisiwe, kanti udokotela wakho uyancoma i-thyroidectomy, ungase ube nesithakazelo sokuthola enye i-FNA eyenziwa nodokotela osebenzisa enye yalezi zinqamuzana ukuhlolwa.
Ekugcineni, ukuba nomphumela ophelele kunalokho kungavimbela ukuhlinzwa okungadingekile.
Izwi elivela
Nakuba lezi zivivinyo zamangqamuzana ziyizivivinyo eziphawulekayo, eziguquguqukayo, kubalulekile ukukhumbula ukuthi ucwaningo oluqhubekayo luyaqhubeka.
Ngamanye amazwi, lezi zivivinyo aziphelele-odokotela basadingeka bahlole izingozi eziyingqayizivele zesiguli ngasinye bese baqoqa ndawonye ukuthi bangakufaka kanjani kahle la mathuluzi okuxilonga ekunakekeleni kwabo.
> Imithombo:
> I-American Thyroid Association. (2018). Ukuphefumula Okuhle Kwesidingo Ukuphikisana kwamaNodules we-Thyroid: Inqubo nokuchazwa kwemiphumela.
> Baca SC et al. Iziqu ze-atypia ekuxilongweni kwe-cytologic ye-nodules ye-thyroid zihlotshaniswa nemiphumela ehlukile ye-Afirma ye-gene expression expression and imiphumela yomtholampilo. I-Cantop Cytopathol . 2017 Meyi; 125 (5): 313-22. dx.doi.org/10.1002/cncy.21827.
> Ferris et al. Isitatimende se-American Thyroid Association Isitatimende Sokuhlinzwa Okusetshenziswa Kwama-Molecular Profiling for Nodules Ye-Thyroid: Impikiswano Yamanje Ekusebenzeni Kwezinqumo ZePerioperative. I-Thyroid . 2015 Jul 1; 25 (7): 760-68. dx.doi.org/10.1089/thy.2014.0502.
> I-Zhang M, i-Lin O. Ukuhlolwa kwamangqamuzana ama-nodules we-thyroid: Ukubuyekezwa kwezivivinyo zamanje ezitholakalayo zezimpawu zokufisa izinaliti. I-Arch Pathol Lab Med . 2016 Dec; 140 (12): 1338-44.