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Kimanin kashi 1.2 cikin 100 na mutane za a bincikar su da ciwon daji na thyroid a lokacin rayuwarsu. A cikin shekaru 40 da suka gabata, saboda yaɗuwar amfani da hoto da kuma ƙaddamar da ƙwayar cuta mai kyau ta allura, yawan gano ciwon daji na thyroid ya karu sosai, kuma yawan ciwon daji na thyroid ya karu sau uku. Maganin ciwon daji na thyroid ya ci gaba da sauri a cikin shekaru 5 zuwa 10 da suka gabata, tare da sababbin ka'idoji daban-daban suna samun amincewar tsari.

Bayyanawa ga ionizing radiation a lokacin ƙuruciya an fi danganta shi da ciwon daji na papillary thyroid (1.3 zuwa 35.1 lokuta / 10,000 mutum-shekaru). Wani bincike na ƙungiyar da ya bincika yara 13,127 a ƙarƙashin shekaru 18 da ke zaune a Ukraine bayan 1986 Chernobyl hadarin nukiliya don ciwon daji na thyroid ya sami adadin 45 na ciwon daji na thyroid tare da haɗarin dangi na 5.25 / Gy don ciwon daji na thyroid. Hakanan akwai alaƙar amsa kashi tsakanin ionizing radiation da ciwon daji na thyroid. Ƙananan shekarun da aka karɓi radiation ionizing, mafi girma haɗarin kamuwa da ciwon daji na thyroid mai alaka da radiation, kuma wannan hadarin ya ci gaba da kusan shekaru 30 bayan bayyanar.

Yawancin abubuwan haɗari ga ciwon daji na thyroid ba su iya canzawa: shekaru, jima'i, kabilanci ko kabilanci, da tarihin iyali na ciwon daji na thyroid shine mafi mahimmancin haɗarin haɗari. Tsofaffin shekaru, mafi girman abin da ke faruwa kuma rage yawan rayuwa. Ciwon daji na thyroid sau uku ya zama ruwan dare a cikin mata fiye da na maza, adadin da ke dawwama a duniya. Bambancin kwayoyin halitta a cikin layin ƙwayoyin cuta na 25% na marasa lafiya tare da ciwon daji na medullary thyroid yana da alaƙa da gaji da yawa na ciwon daji na ciwon daji na nau'in 2A da 2B. 3% zuwa 9% na marasa lafiya da ke da bambancin ciwon daji na thyroid suna da gado.

Bibiyar fiye da mazaunan 8 miliyan a Denmark ya nuna cewa goiter mara guba mara guba yana da alaƙa da haɗarin ciwon daji na thyroid. A cikin binciken da aka yi nazari na baya-bayan nan na marasa lafiya na 843 da ke yin aikin tiyata na thyroid don unilateral ko bilateral thyroid nodule, goiter, ko autoimmune thyroid cuta, mafi girma preoperative serum thyrotropin (TSH) matakan da aka hade da thyroid ciwon daji: 16% na marasa lafiya tare da matakan TSH da ke ƙasa 0.06 mIU / L sun ci gaba da ciwon thyroid na 2%, yayin da 5 mU / L ya ci gaba da ciwon daji na 2.5. ciwon daji.

Mutanen da ke da ciwon thyroid sau da yawa ba su da alamun bayyanar. Wani bincike na baya-bayan nan na marasa lafiya 1328 da ciwon daji na thyroid a cibiyoyi 16 a cikin kasashe 4 ya nuna cewa kawai 30% (183/613) yana da alamun bayyanar cututtuka. Marasa lafiya tare da wuyan wuyansa, dysphagia, jin jiki na waje da jin zafi yawanci sun fi rashin lafiya.

Ciwon daji na thyroid a al'ada yana gabatar da shi azaman nodule na thyroid. Abubuwan da ke faruwa na ciwon daji na thyroid a cikin nodules mai laushi an ba da rahoton kusan kashi 5% da 1%, bi da bi, a cikin mata da maza a cikin isassun yankunan iodine na duniya. A halin yanzu, kusan kashi 30 zuwa 40% na ciwon daji na thyroid ana samun su ta hanyar palpation. Sauran hanyoyin bincike na yau da kullun sun haɗa da hoton da ba na thyroid ba (misali, carotid duban dan tayi, wuyansa, kashin baya, da hoton kirji); Marasa lafiya tare da hyperthyroidism ko hypothyroidism waɗanda ba su taɓa nodules ba suna karɓar thyroid ultrasonography; An sake maimaita marasa lafiya tare da nodules na thyroid tare da duban dan tayi; An gano ba zato ba tsammani game da ciwon daji na thyroid na asiri a lokacin gwajin cututtuka na bayan tiyata.

Ultrasound shine hanyar da aka fi so don kimanta nodules na thyroid ko wasu binciken binciken nodules na thyroid. Duban dan tayi yana da matukar damuwa wajen tantance lamba da halaye na nodules na thyroid da kuma manyan abubuwan haɗari masu alaƙa da haɗarin malignancy, kamar rashin daidaituwa na gefe, punctate mai ƙarfi echoic mayar da hankali, da ƙarin mamayewar thyroid.

A halin yanzu, yin bincike fiye da kima da kuma magance ciwon daji na thyroid, matsala ce da likitoci da marasa lafiya da yawa ke ba da kulawa ta musamman, kuma ya kamata likitocin su yi ƙoƙari su guje wa bayyanar cututtuka. Amma wannan ma'auni yana da wuyar cimmawa saboda ba duk marasa lafiya da ke da ci gaba ba, ciwon daji na thyroid na metastatic zai iya jin nodules na thyroid, kuma ba duk ƙananan hadarin ciwon daji na thyroid ba za a iya kauce masa. Alal misali, wani microcarcinoma na thyroid na lokaci-lokaci wanda bazai taba haifar da bayyanar cututtuka ko mutuwa ba za a iya gano shi ta hanyar tarihi bayan tiyata don cututtukan thyroid.

Mafi ƙarancin magungunan shiga tsakani kamar su zubar da mitar rediyo mai jagorar duban dan tayi, ablation na microwave da ablation na laser suna ba da madaidaicin madaidaicin tiyata lokacin da ƙananan ciwon kanjin thyroid ke buƙatar magani. Kodayake hanyoyin aiwatar da hanyoyin cirewa guda uku sun ɗan bambanta, suna da kama da ma'auni na zaɓin ƙwayar cuta, amsawar ƙari, da rikitarwa bayan aiki. A halin yanzu, yawancin likitocin sun yarda cewa madaidaicin fasalin ƙwayar ƙwayar cuta don ƙananan ƙwayar cuta shine ciwon daji na papillary na thyroid na ciki <10 mm a diamita da> 5 mm daga sifofi masu zafi irin su trachea, esophagus, da jijiyar laryngeal mai maimaita. Mafi yawan rikice-rikicen bayan jiyya ya kasance raunin zafi na rashin hankali ga jijiyar laryngeal mai maimaitawa a kusa, yana haifar da kururuwa na ɗan lokaci. Don rage lalacewa ga gine-ginen da ke kewaye, ana ba da shawarar barin tazara mai aminci daga raunin da aka yi niyya.

Yawancin karatu sun nuna cewa ƙaramar shiga tsakani a cikin maganin thyroid papillary microcarcinoma yana da inganci da aminci. Ko da yake ƙananan sauye-sauye don ƙananan ciwon daji na papillary thyroid sun haifar da sakamako mai ban sha'awa, yawancin nazarin sun kasance sun koma baya kuma sun mayar da hankali ga China, Italiya, da Koriya ta Kudu. Bugu da kari, babu kwatancen kai tsaye tsakanin amfani da mafi karancin shiga tsakani da sa ido mai aiki. Sabili da haka, ƙaddamar da zafin jiki na duban dan tayi ya dace kawai ga marasa lafiya da ƙananan ciwon daji na thyroid wadanda ba 'yan takarar neman magani ba ko kuma waɗanda suka fi son wannan zaɓi na magani.

A nan gaba, ga marasa lafiya da ke fama da ciwon daji na thyroid na asibiti, ƙananan maganin shiga tsakani na iya zama wani zaɓi na magani tare da ƙananan haɗarin rikitarwa fiye da tiyata. Tun daga 2021, an yi amfani da dabarun haɓakar thermal don magance marasa lafiya da ciwon thyroid a ƙasa da 38 mm (T1b ~ T2) tare da halayen haɗari. Duk da haka, waɗannan nazarin na baya-bayan nan sun haɗa da ƙananan ƙungiyoyi na marasa lafiya (daga 12 zuwa 172) da kuma ɗan gajeren lokaci (yana nufin 19.8 zuwa 25.0 watanni). Sabili da haka, ana buƙatar ƙarin bincike don fahimtar ƙimar haɓakar thermal a cikin kula da marasa lafiya da ciwon daji mai mahimmanci na asibiti.

Tiyata ita ce hanya ta farko ta jiyya don abin da ake zargi ko cytologically an tabbatar da bambancin cutar sankarar thyroid. An sami sabani game da mafi dacewa iyakar thyroidectomy (lobectomy da jimlar thyroidectomy). Marasa lafiya da ke jurewa jimillar thyroidectomy suna cikin haɗarin tiyata fiye da waɗanda ke fuskantar lobectomy. Hadarin tiyatar thyroid sun haɗa da lalacewar jijiya na laryngeal akai-akai, hypoparathyroidism, rikice-rikicen rauni, da buƙatar ƙarin ƙarin hormone thyroid. A baya, jimillar thyroidectomy shine mafi kyawun magani ga kowane nau'in ciwon daji na thyroid> 10 mm. Koyaya, binciken 2014 na Adam et al. ya nuna cewa babu wani bambanci mai mahimmanci a cikin rayuwa da sake dawowa tsakanin marasa lafiya da ke fama da lobectomy da jimillar thyroidectomy na 10 mm zuwa 40 mm papillary thyroid ciwon daji ba tare da siffofi masu haɗari na asibiti ba.

Sabili da haka, a halin yanzu, lobectomy yawanci ana fifita don ciwon daji na thyroid mai ban sha'awa <40 mm. An ba da shawarar jimlar thyroidectomy gabaɗaya don bambance-bambancen kansar thyroid na 40 mm ko mafi girma da kansar thyroid na biyu. Idan ciwon daji ya yada zuwa ƙananan ƙwayoyin lymph na yanki, ya kamata a yi rarrabuwa na tsakiya da na gefe na wuyansa. Sai kawai marasa lafiya da ciwon daji na medullary thyroid da wasu nau'in ciwon daji masu girma masu girma, da kuma marasa lafiya tare da zalunci na thyroid na waje, suna buƙatar prophylactic tsakiya na kumburin kumburi. Za a iya yin la'akari da rarraba ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ga marasa lafiya da ciwon daji na medullary thyroid. A cikin marasa lafiya da ake zargin medullary thyroid carcinoma na gado, ya kamata a kimanta matakan plasma na norepinephrine, calcium, da parathyroid hormone (PTH) kafin a yi aiki don gano ciwon MEN2A kuma kauce wa ɓacewar pheochromocytoma da hyperparathyroidism.

An fi amfani da shigar da jijiya don haɗawa tare da na'urar duba jijiya mai dacewa don samar da hanyar iska mara hankali da kuma lura da tsokar ciki da ayyukan jijiya a cikin makogwaro.

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