Chirwere chetachiona ndicho chechitatu chinowanzosemesa chirwere chinoparadza vana. Uyu mukenza wepamuviri unobatanidza hutano hwakawanda nevarwere vane chirwere chekenza yekare, kusanganisira subtypes dzakawanda dzinosanganisira papillary, follicular uye medullary; uye musikana kuhurume kuenzanisa inenge 6: 1, pakati pevamwe.
Kunyange zvazvo kupona kwenguva refu kwechirwere chetachiona hwepachiviri kunonzi kwakanaka kwazvo, pane zvishoma zvidzidzo zvikuru zvinoratidzira zvikwereti zvechirwere zvehutano hwehuduku huno.
Zviongorori zvakawanda zvakave zvichishandiswa kusarudzwa kwemahofisi maviri. Zvidzidzo zvakawanda zvekugadzira zviitiko zvakaitika asi kuedza kwekugadzira database yakakura kunogona kugadziriswa nedzimwe nharaunda kana nzvimbo dzenharaunda. Muenzaniso wekukwanisa kukwaniswa mune zvidzidzo izvi, pamwe nekudiwa kwenguva refu yekutevera kwechirwere nechirwere chiduku chekudzokorora, kwakaguma nezvinetso pakutsvaga maitiro akanaka uye asina kunaka ekugadzirisa kurapwa.
Otolaryngologisthead maviri nemitsipa yepamutsipa yakagadzirirwa kutarisa zvinokonzerwa nemigumisiro yakadaro kuburikidza nekutevera nhamba yakawanda yevarwere kwenguva yakareba inofanira kuongororwa iyo inodzivisa masangano ehurumende uye enyika. Vakatarisisa dhamasiko huru yenyika pamusoro pemakore gumi nemaviri muchiedza chekunzwisisa zviri nani kwenguva refu yezvipatara zvekugadzikana kweizvi, kunyange zvazvo dzimwe nguva zvinouraya, zvirwere munyika yose muhutachiwana hwevanhu. Kureba kwechidzidzo ichi kwakadzivisa kushandiswa kwezvinyorwa mumhando iyi yekutsvakurudza.
Vanyori veVanhu-based Outcomes for Pediatric Thyroid Carcinoma, ndevamwe Nina L. Shapiro MD, Dhauriro reMusoro neMakumbo Okuvhiya, UCLA School of Medicine, Los Angeles, CA; uye Neil Bhattacharyya MD, kuDhipatimendi reOtolaryngology, Brigham neMadzimai eWomens, uye Dhipatimendi reOtology neLaryngology, Harvard Medical School, Cambridge, MA.
Zvakawanikwa zvavo zvinofanira kuiswa pa19th Annual American Society of Pediatric Otolaryngology http://www.aspo.us musangano unoitwa May 2-3, 2004, paJW Marriott Desert Ridge Resort & Spa muPenienix, AZ.
Methodology: The Surveillance, Epidemiology, uye End Results (SEER) database (1988-2000) yakaongororwa, ichibvisa vose vanachiremba vane utachiona hwekemikari maererano nezvinotevera: (1) Zera rekuongororwa kubva pakuberekwa kusvika pamakore 18; (2) Kunyanya kuwedzera kwechirwere chetachiona chakaipa; (3) Zvakanyatsosiyanisa thyroid carcinoma (papillary kana follicular) uye (4) Gore rekuongororwa pakati pa1988 na2000. Varwere vane mamwe maitiro akadai seaplastic kana medullary carcinoma havana kubviswa. Chipatara uye dumbu-data yakadonhedzerwa kubva kune dhesi yakaisa makore ekuongorora, hutano, tumortura yaketolosi, chiremera chemaitiro, uwandu hwehutachiona hwehutachiona, hutachiona hwehutachiona, kurapwa nekuvhiyiwa uye / kana iodine inokonzerwa nemhepo, uye mararamiro ehupenyu.
Dhiyabhorosi yakaiswa uye yakatorwa muSSPSS version 10.0. Kubva pahutachiona hutachiona, huwandu hwehutachiwana hwepachirwere hutachiona hwakave hwakaitwa sezvakafanotaurwa. Nodal chirwere chakanyorwa sekuvapo kana kusavapo kwekodhi nodes panguva yekufungidzirwa kwekutanga.
Nhamba yepamusoro-soro nzvimbo yekuvhiya kurapwa yakarongerwa sebiopsy chete, lobectomy, inotora thyroidectomy, kana kuti thyroidectomy yakazara.
Migumisiro: Vatsvakurudzi vakaona 566 chirwere chetachiona checarcinomas mumakore gumi nemaviri. Nguva yekutaura pahurukuro yaiva makore 16.0, uye 84 muzana yevarwere vakadzi. Zvinyorwa zvinokwana 378 (66,8 muzana) papillary carcinomas, 137 (24.2 muzana) papillary carcinomas ne follicular variant, uye 51 (9,0 muzana) follicular carcinomas. Kakawanda, chiyero chemuviri wekukura pahurukuro chaive 2.6 centimita. Nekutanga kwechirwere nzvimbo, vazhinji vevarwere (74.2 muzana) vane chirwere chinonzi intrathyroidal chete.
Boka duku raiva neruzhinji rwekuwedzera (12.5 muzana), uye vashomanana vaive nekuwedzera kukuru kana kuwedzera (5.4 muzana). Chirwere chinonzi nodal muhuro chakavapo muna 37.1 muzana yevarwere pavanotanga kurapwa. Nhamba yakawanda yevarwere yakarapwa nehutachiona hwehutachiona (72,8 kubva muzana) yakateverwa ne-subtotal thyroidectomy (13.4 kubva muzana) yakatevedzerwa ne simple lobectomy (7.2 muzana). Utachiona hwehutachiona hwehuodhi hwakaitirwa 51.4 muzana yevarwere.
Kuparara kweboka rose kweboka rose kwaiva nemwedzi 153.8, kunopera kumwedzi 155 yekutevedzana kwakanyanya. Papillary carcinomas (kuponeswa kwemazuva, 155.3 mwedzi) yakakonzerwa kupfuura follicular carcinomas Murefu wezera, kuvapo kwechirwere chekodhivo, maitiro ekuvhiya, uye kushandiswa kweradio inodhaka yakawanda haina kuchinja zvikuru kurarama kwehupenyu hwose. Mukadzi wechikadzi, follicular histology, uye kutanga kwepachirwere chekuuya kwezvirwere zvaiva nemigumisiro yakawanda pakuderedza kupona kwenguva refu.
Zvigumisiro zvinopindirana nezvakawanikwa kubva kune zvimwe zvidzidzo zvinotaura kuti chirwere chepachirwere chetachiona chinowanzosangana zvikuru mumakore ekuyaruka, uye kunyanya kuvakadzi. Inonyanya kukosha histologic yeropa ipillary, sezvinoonekwa kune vanhu vakuru. Kuparidzirwa kwechirwere chinonzi nodal (37.1 muzana) kwakafananawo nezvakaonekwa mune zvidzidzo zvepakutanga. Tsvakurudzo iyi yakaratidza kuti apo kurapwa kwemuviri wepamuviri kwakabva kune-lobectomy iri nyore kusvika kuhutachiona hwehutachiona hwehutano, huwandu hwekupindira kwekuvhiya hwakanga husina hunoita kuti zvigone kuitika. Izvi zvinopesana nemitemo yakawanda inotangira iyo inotsanangura zvinowanikwa zvakanyanya kune varwere vanowedzera zvakanyanya resection zvakadai se-sub-total kana kuti thyroidectomy yakazara. Zera panguva yekuongororwa, chirwere chinonzi nodal, uye kuwedzera kweradio iodine remishonga yakange isisina simba guru pakupona. Chikadzi, chirwere chepachirwere chekutsvaga, uye follicular subtype zvose zvaive nemagariro asina kunaka ekupona zvichienzaniswa nezvimwe zvirwere zvekutsvaga nzvimbo. Mhedziso: Pediatric thyroid carcinoma inoratidza maitiro akanaka ekugara kwenguva refu. Varwere vane mapurisa akasiyana-siyana vanoratidzira zvishoma nezvishoma pane avo vane mapurisa akasiyana-siyana. Kunyange zvazvo chirwere ichi chinonyanya kuwanikwa kune vakadzi kunze kwevarume, varume vane chirwere chetachiona vane zvinotambudza kupfuura vakadzi. Locally advanced primary disease site extension inotakurawo zvirwere zvinotambudza kana zvichienzaniswa nechirwere chinonzi intrathyroidal chete. Kunyange zvazvo chirongwa chekuongorora nekugadzirisa chinofanirwa kuve chekutarisa kune murwere mumwe nomumwe, kuverenga kwezvingave zvishoma-uye zvinogara kwenguva refu, tsvakurudzo itsva iyi inopa hupenyu hwekuchengetedza ruzivo rwezvinoitika kune varwere vane chirwere chetachiona chetachiona nekuremekedza kurarama uye zvipatara zvinokonzera kuguma.