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Qiyaastii 1.2% dadka waxaa lagu ogaan doonaa kansarka qanjirka thyroid inta ay nool yihiin. 40-kii sano ee la soo dhaafay, iyadoo ay ugu wacan tahay isticmaalka baahsan ee sawir-qaadista iyo soo-bandhigidda dheecaan-ka-qaadista irbadda ganaaxa, heerka ogaanshaha kansarka qanjirka 'thyroid' ayaa si aad ah u kordhay, iyo dhacdooyinka kansarka tayroodhka ayaa kordhay saddex laab. Daawaynta kansarka qanjirka 'thyroid' ayaa si degdeg ah u horumaray 5 ilaa 10 sano ee la soo dhaafay, iyada oo noocyo kala duwan oo borotokool ah oo cusub ay heleen oggolaansho sharci.

Soo-gaadhista shucaaca ionizing inta lagu guda jiro carruurnimada ayaa si xooggan loola xiriiriyay kansarka papillary thyroid (1.3 ilaa 35.1 xaaladood / 10,000 qof-sano). Daraasad kooxeed oo baadhay 13,127 carruur ah oo da'doodu ka yar tahay 18 sano oo ku nool Ukraine ka dib shilkii nukliyeerka Chernobyl ee 1986 ee kansarka tayroodhka ayaa helay wadar ahaan 45 xaaladood oo kansarka tayroodh ah oo leh khatar xad dhaaf ah oo ah 5.25 / Gy kansarka tayroodhka. Waxa kale oo jira xidhiidh ka jawaab celin ah oo u dhexeeya shucaaca ionizing iyo kansarka tayroodh. Da'da da'da yar ee la helay shucaaca ionizing, waa ay sareeysaa khatarta ah inuu ku dhaco kansarka qanjirka tayroodhka ee shucaaca, khatartani waxay sii socotay ku dhawaad ​​​​30 sano ka dib soo-gaadhista.

Inta badan arrimaha khatarta ah ee kansarka tayroodh waa kuwo aan isbeddelin: da'da, jinsiga, jinsiga ama qowmiyadda, iyo taariikhda qoyska ee kansarka tayroodh ayaa ah kuwa ugu muhiimsan ee saadaaliya khatarta. Mar kasta oo da'du ay sii weynaato, waa ay sii korodhaa dhacdooyinka oo hoos u dhaca heerka badbaadada. Kansarka qanjirka thyroid-ka ayaa saddex jeer ku badan dumarka marka loo eego ragga, waana heer qiyaas ahaan joogto adduunka oo dhan. Kala duwanaanshaha hidda-socodka ee xariiqda jeermiska ee 25% bukaannada qaba kansarka qanjirka 'medullary thyroid cancer' waxay la xiriirtaa hiddo-wadayaasha burooyinka endocrine oo badan oo la iska dhaxlo nooca 2A iyo 2B. 3% ilaa 9% bukaanada qaba kansarka qanjirka tayroodh si fiican u kala duwan ayaa leh dhaxal.

Dabagal ay sameeyeen in ka badan 8 milyan oo degane Danmark ah ayaa muujisay in goiter-ka aan suntu ahayn ee qanjidhada thyroid-ka uu la xidhiidho khatarta korodhka ah ee kansarka tayroodhka. Daraasad kooxeed dib-u-eegis ah oo lagu sameeyay bukaannada 843 ee lagu sameeyay qalliinka tayroodhka ee qanjirka tayroodh ee hal dhinac ama laba-geesoodka ah, goiter, ama autoimmune thyroid disease, heerarka sare ee serum thyrotropin (TSH) ee hore ayaa lala xiriiriyay kansarka qanjirka tayroodhka: 16% bukaannada qaba heerarka TSH ee ka hooseeya 0.06 mIU / L ayaa horumariyay kansarka tayroodhka 5% kansarka.

Dadka qaba kansarka tayroodh inta badan ma laha calaamado. Daraasad dib-u-eegis ah oo lagu sameeyay 1328 bukaan oo qaba kansarka tayroodh ee 16 xarumood oo ku yaal 4 waddan ayaa muujisay in kaliya 30% (183/613) ay calaamado u leeyihiin cudurka. Bukaanka qaba cufnaanta qoorta, dysphagia, dareenka jidhka ajnabiga ah iyo xabeeb ayaa caadi ahaan aad u xanuunsan.

Kansarka qanjirka 'thyroid' wuxuu dhaqan ahaan u soo bandhigaa sida qanjirka tayroodh la taaban karo. Dhacdooyinka kansarka qanjirka tayroodh ee qanjidhada la taaban karo ayaa lagu soo waramayaa inay yihiin ilaa 5% iyo 1%, siday u kala horreeyaan, dumarka iyo ragga ee meelaha ku filan iodine ee adduunka. Waqtigan xaadirka ah, qiyaastii 30% ilaa 40% kansarka qanjirka tayroodhka waxaa laga helaa garaacid. Hababka kale ee ogaanshaha caadiga ah waxaa ka mid ah sawir-qaadista aan la xiriirin tayroodh (tusaale, karootid ultrasound, qoorta, laf-dhabarka, iyo sawirka laabta); Bukaanka qaba hyperthyroidism ama hypothyroidism ee aan taaban qanjidhada ayaa helaya ultrasonography thyroid; Bukaanka qaba qanjidhada qanjirka 'thyroid nodules' ayaa lagu soo celiyay ultrasound; Helitaanka lama filaanka ah ee kansarka tayroodh sixir ayaa la sameeyay intii lagu jiray baaritaanka pathologic qalliinka kadib.

Ultrasound waa habka la doorbido ee qiimeynta qanjidhada tayroodh ee la taaban karo ama natiijooyinka sawirada kale ee qanjidhada thyroid. Ultrasound waa mid aad xasaasi u ah marka la go'aamiyo tirada iyo sifooyinka qanjidhada qanjidhada thyroid iyo sidoo kale sifooyinka khatarta sare leh ee la xidhiidha khatarta malignantiga, sida cilladaha marginal, punctate echoic focus xoog, iyo duulaanka dheeraadka ah ee tayroodh.

Waqtigan xaadirka ah, ogaanshaha xad-dhaafka ah iyo daaweynta kansarka qanjirka thyroid waa dhibaato ay dhakhaatiir badan iyo bukaanno badan si gaar ah u siiyaan, dhakhaatiirta caafimaadkuna waa inay isku dayaan inay iska ilaaliyaan ogaanshaha dheeraadka ah. Laakiin dheelitirkaani waa ay adagtahay in la gaaro sababtoo ah ma aha dhammaan bukaanada qaba kansarka tayroodhka ee metastatic ma dareemi karaan qanjidhada tayroodh, mana aha dhammaan khatarta hoose ee kansarka qanjirka thyroid waa laga fogaan karaa. Tusaale ahaan, microcarcinoma tayroodh marmar ah oo aan waligiis keenin calaamado ama dhimasho ayaa lagu ogaan karaa taariikh ahaan ka dib qaliinka cudurka tayroodhka benign.

Daawaynta dhexgalka ugu yar sida ablation radiofrequency-ultrasound-hagaya, ablation microwave iyo ablation laser waxay bixiyaan beddelka rajo ee qalliinka marka kansarka qanjirka tayroodh uu u baahan yahay daaweyn. Inkasta oo hababka ficilka ee saddexda hab ee ablation-ka ay wax yar ka duwan yihiin, waxay asal ahaan la mid yihiin marka la eego shuruudaha xulashada burooyinka, jawaabta buro, iyo dhibaatooyinka qalliinka kadib. Waqtigan xaadirka ah, dhakhaatiirta intooda badani waxay ku heshiiyaan in qaabka ugu habboon ee faragelinta ugu yar ay tahay kansarka qanjirka thyroid papillary gudaha <10 mm dhexroorka iyo> 5 mm oo ka soo jeeda qaababka kulaylka leh sida trachea, hunguriga, iyo dareemayaasha laryngeal ee soo noqnoqda. Dhibaatada ugu badan ee daaweynta ka dib ayaa weli ah dhaawac kuleyl ah oo aan loo baahnayn oo soo noqnoqda dareemaha laryngeal ee u dhow, taasoo keentay xabeeb ku meel gaar ah. Si loo yareeyo burburka dhismayaasha ku hareeraysan, waxaa lagu talinayaa in laga tago masaafo badbaado leh oo ka fog dhaawaca bartilmaameedka.

Tiro daraasado ah ayaa muujiyay in faragelinta ugu yar ee daaweynta tayroodh papillary microcarcinoma ay leedahay waxtar iyo badbaado wanaagsan. Inkasta oo wax ka qabadyada ugu yar ee loogu talagalay kansarka qanjirka thyroid-ka ee papillary ay keeneen natiijooyin rajo leh, cilmi-baarisyada intooda badani waxay noqdeen kuwo dib-u-eegis ah oo diiradda saaray Shiinaha, Talyaaniga, iyo Koonfurta Kuuriya. Intaa waxaa dheer, ma jirin isbarbar toos ah oo u dhexeeya isticmaalka faragelinta ugu yar iyo ilaalinta firfircoon. Sidaa darteed, ka-saarista kulaylka ee ay hagato ultrasound-ku waxay ku habboon tahay oo keliya bukaannada qaba kansarka qanjirka thyroid-ka ee khatarta yar ee aan u sharaxin daaweynta qalliinka ama doorbidaya doorashadan daaweynta.

Mustaqbalka, bukaanada qaba kansarka qanjirka tayroodh ee kiliinikada ah, daawaynta dhexdhexaadka ah ee ugu yar waxay noqon kartaa doorasho kale oo daweyn ah oo leh khatar ka yar qalliinka. Laga soo bilaabo 2021, farsamooyinka baabi'inta kulaylka ayaa loo isticmaalay in lagu daweeyo bukaannada qaba kansarka qanjirka tayroodh ee ka hooseeya 38 mm (T1b ~ T2) oo leh astaamo halis sare leh. Si kastaba ha noqotee, daraasaddan dib-u-eegista ah waxaa ku jiray koox yar oo bukaanno ah (laga bilaabo 12 ilaa 172) iyo muddo gaaban oo dabagal ah (macnaha 19.8 ilaa 25.0 bilood). Sidaa darteed, cilmi baaris dheeraad ah ayaa loo baahan yahay si loo fahmo qiimaha kuleylka kuleylka ee daaweynta bukaanada qaba kansarka qanjirka thyroid ee muhiimka ah.

Qalliinka ayaa weli ah habka aasaasiga ah ee daawaynta looga shakisan yahay ama cytological ahaan la xaqiijiyay kansarka qanjirka tayroodhka. Waxaa jiray muran ku saabsan baaxadda ugu habboon ee thyroidectomy (lobectomy iyo total thyroidectomy). Bukaanka lagu sameeyo wadarta qanjirka tayroodhku waxay halis ugu jiraan qalliin ka weyn kuwa lagu sameeyo lobectomy. Khatarta qalliinka tayroodh waxaa ka mid ah dhaawaca dareemaha dhuunta ee soo noqnoqda, hypoparathyroidism, dhibaatooyinka nabarrada, iyo baahida loo qabo kabidda hoormoonka tayroodhka. Waagii hore, wadarta qanjirka 'thyroidectomy' ayaa ahaa daawaynta la doorbiday ee dhammaan kansarrada tayroodh ee kala duwan> 10 mm. Si kastaba ha ahaatee, daraasad 2014 ah oo uu sameeyay Adam et al. waxay muujisay in aysan jirin farqi weyn oo u dhexeeya badbaadada iyo khatarta soo noqoshada ee u dhaxaysa bukaanada ku jira lobectomy iyo wadarta thyroidectomy ee 10 mm ilaa 40 mm papillary thyroid kansarka iyada oo aan lahayn astaamo caafimaad oo halis sare leh.

Sidaa darteed, hadda, lobectomy ayaa inta badan loo door bidaa kansarka qanjirka 'thyroid' oo si wanaagsan u kala duwan <40 mm. Wadarta guud ee tayroodhectomy ayaa guud ahaan lagula talinayaa kansarka tayroodhka tayroodh ee 40 mm ka weyn iyo laba geesoodba. Haddii buradu ku faafto qanjidhada gobolka, kala goynta qanjidhada dhexe iyo lateral ee qoorta waa in la sameeyaa. Kaliya bukaanada qaba kansarka qanjirka tayroodhka ee medullary iyo qaar ka mid ah kansarka qanjirka tayroodhka ee mugga weyn ee si fiican u kala duwan, iyo sidoo kale bukaanada qaba gardarada tayroodh ee dibadeed, waxay u baahan yihiin kala goynta qanjidhada dhexe ee prophylactic. Kala-baxa qanjidhada dhuunta ilmagaleenka ee lateral prophylactic ayaa laga yaabaa in loo tixgeliyo bukaanada qaba kansarka tayroodh medullary. Bukaanka qaba kansarka qanjirka tayroodh ee medullary ee la iska dhaxlo, heerarka plasma ee norepinephrine, calcium, iyo parathyroid hormone (PTH) waa in la qiimeeyaa ka hor qaliinka si loo aqoonsado MEN2A syndrome iyo in laga fogaado pheochromocytoma maqan iyo hyperparathyroidism.

Gelitaanka neerfaha waxaa inta badan loo isticmaalaa in lagu xidho kormeeraha dareemaha ee ku habboon si loo bixiyo marin hawo-mareeneed oo aan la daboolin iyo in lala socdo muruqa qalliinka gudaha iyo dhaqdhaqaaqa dareenka ee larynx.

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