So wowɔ akisikuru bi wɔ wo kɔn mu? Momma yɛnka Papillary Thyroid Cancer (PTC) ho asɛm!

So woahu akuru ketewaa bi wɔ wo kɔn mu pɛn? Anaasɛ oduruyɛfo bi aka ho asɛm akyerɛ wo bere a wɔreyɛ nhwehwɛmu no? Ɛtɔ mmere bi a, akisikuru ketewaa bi te sɛ eyi betumi ayɛ tebea bi a wɔfrɛ no Papillary Thyroid Cancer (PTC) ho sɛnkyerɛnne a edi kan. Mma ɛnhaw wo, yɛbɛka ho asɛm akɔ akyiri na yɛayɛ no tiawa.

Dɛn ne papillary thyroid carcinoma (PTC)? Dɛn ne thyroid ntini no?

Sɛ yɛbɛka no tiawa a, papillary thyroid cancer (PTC) yɛ kokoram bi a ɛba yɛn thyroid ntini mu. Efi ase wɔ thyroid ntini no mu nkwammoaa a ɛyɛ follicular no mu. Saa nkwammoaa yi yɛ protein bi a wɔfrɛ no thyroglobulin . Ade a ɛho hia sen biara a ɛsɛ sɛ wuhu ne sɛ PTC ne thyroid kokoram a abu so sen biara .

Afei ma yɛnhwɛ nea thyroid gland no yɛ. Fa no sɛ, wɔ wo kɔn anim, wo were ase, akwaa ketewaa bi a ɛte sɛ ntontom. Ɛno ne thyroid ntini no. Eyi yɛ yɛn endocrine nhyehyɛe no fã . N’adwuma titiriw ne sɛ ɛbɛyɛ nkwaadɔm a ɛhwɛ dwumadi ahorow a ɛho hia pii so wɔ yɛn nipadua mu na ayi afi mu.

Sɛ ɛba PTC so a, ɛtaa yɛ kokoram a enyin brɛoo paa . Afei nso, ɛtaa ba thyroid ntini no fã biako (lobe) nkutoo.

So `PTC` subtypes ahorow bi wɔ hɔ?

Yiw, `PTC` subtypes pii wɔ hɔ. Eyinom mu no, follicular subtype no na ɛtaa ba. Ɛtɔ da bi a wɔfrɛ no `mixed papillary-follicular variant`. Subtypes afoforo no nyɛ nea abu so saa. However, they can grow and spread a little faster . Nneɛma nketewa a ɛtete saa ne:

• `Kɔlam`
• `Nkwammoaa atenten`
• `Nsupɔw so`
• `Sclerosis a ɛtrɛw`

Ɛtɔ da bi a wɔsan frɛ `PTC` `papillary thyroid carcinoma` .

Hena na onya papillary thyroid kokoram?

Nokwarem no, PTC betumi anya nkɔso wɔ obiara mu. Nanso, ɛtaa ba mpanyimfo a wɔadi mfe mfinimfini mu kɛse . Afei nso, ɛda adi sɛ mmea benya saa tebea yi sen mmarima.

PTC yɛ tebea a ɛntaa nsi koraa wɔ mmofra mu. Nanso, ɛno ne thyroid kokoram a abu so sen biara wɔ mmofra mu.

`PTC` yi abu so dɛn?

Thyroid kokoram yɛ tebea a ɛtaa ba. Nanso, sɛnea yɛadi kan aka no, nsɛm no mu 80% kosi 85% yɛ PTC su. Ɛno kyerɛ sɛ nnipa du biara mu bɛyɛ awotwe a wonya thyroid kokoram no wɔ saa kokoram yi.

So `PTC` yɛ tebea a emu yɛ den?

Kokoram biara yɛ aniberesɛm. Ɛhia ayaresa na ebetumi atrɛw (metastasize) akɔ nipadua no afã afoforo. Nanso, nkɔmhyɛ a ɛfa PTC ho no ye yiye sɛ wɔde toto thyroid kokoram ahorow afoforo ho a.

Mpɛn pii no, wobetumi asa PTC yiye. Ɛntaa mma koraa nso sɛ ɛde owu bɛba. Enti, ɛho hia sɛ wommɔ hu na wudi aduruyɛ mu afotu a ɛfata akyi.

Ɛhe na `PTC` di kan trɛw?

Sɛ PTC trɛw a, ɛda adi kɛse sɛ edi kan trɛw kɔ ntini a ɛwɔ kɔn no mu no mu . Saa ntini ahorow yi yɛ nneɛma nketenkete a ɛte sɛ bankye a ɛyɛ yɛn nipadua no ntini a ɛma mogya tu ne nipadua no mu tumi a ɛko tia nyarewa no fã.

`PTC` trɛw kɔ he?

Ɛwom sɛ PTC nyin nkakrankakra de, nanso ɛtaa tumi trɛw kɔ ntini a ɛwɔ kɔn no mu no mu. Sɛ yɛbɛka no tiawa a, nnipa a wɔwɔ PTC no mu bɛyɛ 30% bɛtrɛw akɔ mmeae afoforo (metastatic papillary thyroid cancer) bere a wɔahu sɛ wɔwɔ bi no .

Dɛn ne `PTC` ho sɛnkyerɛnne?

Mpɛn pii no, PTC ho sɛnkyerɛnne titiriw ne sɛ ntini bi a ɛnyɛ yaw bɛda adi wɔ thyroid ntini no mu . Ebia sɛnkyerɛnne afoforo nso nni hɔ.

Nanso, ɛntaa mma sɛ nnipa binom bɛte yaw wɔ wɔn kɔn, wɔn anom, anaa wɔn aso mu . Sɛ akuru no yɛ kɛse araa ma ɛtumi mia yɛn mframa nhama anaa yɛn aduan mu a, ebetumi ama ayɛ den sɛ yɛbɛhome anaasɛ yɛbɛmene .

Nea ɛho hia: Sɛ wuhu sɛ akuru foforo bi wɔ wo kɔn mu, sɛ ɛnyɛ yaw mpo a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn. Dodow a wuhu no ntɛm no, dodow no ara na ayaresa no di yiye.

Dɛn ne nneɛma a ɛde `PTC` ba?

Nyansahufo da so ara nnim nea ɛde PTC ba ankasa , nanso wɔahu asiane ahorow pii a ɛma asiane a ɛwɔ hɔ sɛ obi benya tebea no yɛ kɛse, a nea ɛka ho ne mframa a ɛbɔ ne awosu mu tebea horow bi .

Radiation a wɔde da wɔn ho adi ne `PTC`

Nnipa a wɔanya mframa a ɛma ionizing dodow a ɛho hia wɔ wɔn abakɔsɛm mu no taa nya PTC. Akwan a wobetumi afa so ada saa mframa yi adi ne:

• Wɔde abɔnten so mframa a ano yɛ den sa kɔn no de sa kokoram anaa tebea afoforo a ɛnyɛ kokoram, titiriw wɔ mmofraase.
• Mframa a efi nuklea ahoɔden adwumayɛbea akwanhyia mu ba . Sɛ nhwɛso no, wɔ Chernobyl nuklea akwanhyia a esii wɔ 1986 mu akyi no, PTC ayarefo dodow a wɔwɔ mmeae a atwa ho ahyia no kɔɔ soro fi mmɔho 3 koduu mmɔho 75.

Awosu mu tebea horow ne `PTC`

Awosu mu tebea horow pii (a wonya fi awo mu) a ɛbata PTC ho:

• Abusua mu Adenomatous Polyposis (FAP / Gardner syndrome): Eyi yɛ tebea a ɛntaa nsi, a wonya fi awo mu. Ɛma obi nya polyps pii wɔ ne dwensɔtwaa ne ne dwensɔtwaa mu, na ebetumi abɛyɛ kokoram. Nnipa a wɔwɔ FAP nso wɔ asiane kɛse mu sɛ wobenya akisikuru wɔ nipadua no afã afoforo, a thyroid ntini ka ho. Tebea no fi nkwaadɔm mu nsakrae a wonya fi awo mu wɔ APC awosu mu abɔde mu.
• Werner syndrome : Eyi nso yɛ tebea a ɛntaa nsi. Ɛda onyin ntɛmntɛm a ɛnyɛ ne kwan so (progeria) ho sɛnkyerɛnne adi. Nnipa a wɔwɔ Werner syndrome no wɔ asiane kɛse mu sɛ wobenya kokoram. Nea abu so sen biara ne thyroid kokoram. Wɔahu nkwaadɔm mu nsakrae ahorow bɛboro 80 wɔ WRN awosu mu abɔde mu wɔ nnipa a wɔwɔ saa tebea yi mu.
• Carney complex type 1 : Saa tebea yi nso ma asiane a ɛwɔ hɔ sɛ obi benya akisikuru ahorow, a thyroid akisikuru ka ho no yɛ kɛse. Mpɛn pii no, nsakrae a ɛba PRKAR1A awosu mu abɔde mu na ɛde ba.

Nanso, ɛsɛ sɛ yɛkae sɛ PTC ayarefo nyinaa mu 5% pɛ na wɔne awosu mu tebea horow a ɛte saa wɔ abusuabɔ.

Ɔkwan bɛn so na wobehu `PTC`?

Mpɛn pii no, PTC da adi sɛ akuru wɔ thyroid ntini no mu. Ebia w’ankasa woate nka, anaasɛ ebia oduruyɛfo bi behu bere a wɔreyɛ kɔn mu nhwehwɛmu a wɔyɛ no daa no. Ɛtɔ mmere bi a, wohu akuru no wɔ akwanhyia mu bere a wɔreyɛ scan de ahu tebea foforo bi no.

Wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu a edidi so yi na ama wɔahu PTC:

• Mfoniniyɛ mu nhwehwɛmu : Saa nhwehwɛmu ahorow yi betumi aboa ma wɔahu thyroid nodule bi. Sɛ nhwɛso no, wobetumi ayɛ thyroid ultrasound , CT scan , ne/anaa MRI scan .
• Fine needle aspiration (needle biopsy ): Mpɛn pii no, oduruyɛfo de ade a ɛyɛ tratraa yiye bɛfa ntini ketewaa bi (biopsy) afi wo thyroid nodule no mu. Ɔyare ho ɔbenfo bɛhwɛ ntini no wɔ afiri a wɔde hwɛ nneɛma nketenkete mu ahwɛ sɛ kokoram nkwammoaa bi wɔ hɔ anaa, na sɛ ɛte saa a, thyroid kokoram ko a ɛyɛ.

Ɛtɔ da bi a, wo duruyɛfoɔ bɛtumi de wo akɔ awosuo ho afotuo mu akɔhwɛ sɛ wowɔ awosuo mu yareɛ bi a ɛde PTC ba, ne akisikuru ahodoɔ foforɔ nso.

Ɔkwan bɛn so na wɔsa PTC?

PTC ayaresa gyina akisikuru no kɛse ne sɛ ebia kokoram no atrɛw anaa.

Oprehyɛn ne aduru titiriw a wɔtaa de sa PTC.Ɛdenam sɛnea akisikuru no kɛse ne baabi a ɛwɔ so no, ebia oduruyɛfo a ɔyɛ oprehyɛn no beyi thyroid gland no fã bi (lobectomy) anaa gland no nyinaa (thyroidectomy). Sɛ kokoram no wɔ thyroid ntini mu a, oduruyɛfo a ɔyɛ oprehyɛn no betumi ayi ntini a ayɛ no bere koro no ara a wɔreyɛ thyroid oprehyɛn no anaasɛ wɔ oprehyɛn a ɛto so abien mu.

Nea ɛho hia: Sɛ woyi wo thyroid gland nyinaa (total thyroidectomy) a, ɛho behia sɛ wonom thyroid hormone nnuru wo nkwa nna nyinaa .

Ayaresa foforo a wɔde sa PTC ne:

• Radioiodine ayaresa : Thyroid nkwammoaa ne PTC nkwammoaa twetwe mineral iodine (a wohu wɔ nnuan bi mu). Esiane eyi nti, ɛtɔ mmere bi a nnuruyɛfo de iodine bi a ɛyɛ radioactive di dwuma de sɛe thyroid ntini biara a ɛteɛ a aka bere a wɔayi thyroid gland no akyi, ne thyroid ntini biara a kokoram wom a ebia ɛbɛka no.
• Mframa a wɔde sa yare : Mframa kunkum kokoram nkwammoaa na ɛmma wontumi nnyin. Wɔ abɔnten so mframa a wɔde sa yare mu no, afiri bi de ahoɔden a ano yɛ den kyerɛ akisikuru no so tẽẽ. Wɔ mframa a wɔde sa yare a ɛwɔ nipadua no mu mu no, wɔde aba a ɛma mframa bɔne gu akisikuru no mu anaa ne ho hyia.
• Nnuru a wɔde sa yare : Nnuru a wɔde fa ntini mu (IV) anaa wɔnom (ano) kunkum kokoram nkwammoaa na ɛma kokoram no nnyin. Nanso, nnipa a wɔwɔ thyroid kokoram no mu kakraa bi pɛ na wohia nnuru a wɔde sa yare.

Dɛn ne nsunsuanso bɔne ne nsɛnnennen a ɛwɔ `PTC` ayaresa mu?

Ade bɔne a ebetumi afi thyroidectomy ne radioiodine ayaresa mu aba ne hypothyroidism a ɛtra hɔ daa. Enti, sɛ wowɔ saa ayaresa yi mu biako anaa abien no nyinaa a, ebehia sɛ wonom thyroid hormone nnuru wo nkwa nna nyinaa.

Nsɛnnennen pii wɔ hɔ a ebetumi aba bere a wɔreyɛ thyroid oprehyɛn no:

• Nsaneɛ.
• Parathyroid ntini , a ɛhwɛ calcium dodow a ɛwɔ wo mogya mu so no a woyi fi hɔ wɔ akwanhyia mu anaasɛ ɛsɛe no.
• Ahurututu mu ntini a ɛsan ba bio a ɛnam thyroid ntini no akyi no sɛe. Eyi betumi ama ɛnne no ayɛ den na ayɛ mmerɛw.

Nneɛma bɔne a ebetumi afi radioactive iodine a wɔde sa yare mu aba:

• Akisikuru ne ɔfe.
• Sialadenitis - a ɛho ahonhon wɔ nnompe mu.
• Thyrotoxicosis a ɛba bere tiaa bi.
• Pulmonary fibrosis yɛ yare a ɛma akuru ba ahurututu mu ntini mu.
• Bere tiaa mu anaa daa awo a wontumi nwo.
• Leukemia a ɛma mogya tuAsiane ketewaa bi a ɛwɔ hɔ sɛ obenya mogya mu kokoram, nufu mu kokoram, anaa akisikuru.

So wobetumi asiw `PTC` ano?

Nnipa pii a wonya thyroid kokoram no nni asiane pɔtee biara. Enti, wontumi nsiw PTC nsɛm dodow no ara ano.

Mframa a wɔde ma, titiriw wɔ mmofraase, yɛ asiane a wonim sɛ ɛde PTC ba. Esiane eyi nti, nnuruyɛfo mfa mframa a ano yɛ den nni dwuma bio mma tebea horow a emu nyɛ den pii. Mmofra nso nya mframa a efi mfoniniyɛ mu nhwehwɛmu te sɛ X-ray ne CT scan mu, nanso ɛba fam koraa. Ɛnyɛ nea ɛda adi pefee kodu baabi a wɔma asiane a ɛwɔ hɔ sɛ wobenya PTC no yɛ kɛse kodu.

Sɛ obi a ɔwɔ w’abusua mu anya thyroid kokoram a, ebia wobɛpɛ sɛ wunya awosu mu afotu . Eyi bɛboa ma woahu sɛ ebia wowɔ awosu mu tebea bi a ɛde wo to asiane kɛse mu sɛ wubenya PTC anaa. Sɛ woyɛ saa a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn a wɔde siw wo thyroid ntini no fi hɔ ansa na kokoram aba.

Dɛn ne PTC ho nkɔmhyɛ?

Mpɛn pii no, PTC ho nkɔmhyɛ ye yiye , titiriw sɛ wunnii mfe 40 na akisikuru no sua a. Mpɛn pii no, wobetumi asa PTC yiye. Sɛ atrɛw akɔ ntini a ɛwɔ kɔn mu no mu mpo a, ɛntaa nkum.

Nneɛma a ebetumi atew sɛnea wɔn ho bɛtɔ wɔn no bi ne:

• Sɛ́ wadi boro mfe 55 bere a wohui sɛ ɔwɔ yare no.
• Akisikuru no reyɛ kɛse .
• Kokoram no atrɛw akɔ nipadua no afã horow a ɛwɔ akyirikyiri .
• Sɛ wowɔ `PTC` subtype a ɛntaa nsi, a ɛyɛ basabasa (e.g. `nkwaboaa tenten soronko`, `diffuse sclerosis variant`, `solid variant`).

So wubetumi anya nkwa wɔ `PTC` mu?

Nnipa dodow a wonya nkwa wɔ PTC mu no dɔɔso yiye . Mpanyimfo a wɔwɔ PTC bɛboro 90% tra ase anyɛ yiye koraa no mfe 10 kosi 20 wɔ ayaresa akyi.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn fa `PTC` ho?

Sɛ wohu sɛ wowɔ PTC a, ɛho behia sɛ wo ne w’aduruyɛfo kuw no hyia daa hwɛ sɛnea w’ayaresa no rekɔ so. Ɛho behia nso sɛ wobɛkɔ akɔhwɛ wo bere tenten asram 6 kosi 12 biara anyɛ yiye koraa no mfe anum de ahwɛ sɛ ebia ɛsan ba bio anaa.

Sɛ woyii wo thyroid ntini no na/anaasɛ wɔde radioactive iodine ayaresa mae sɛ w’ayaresa no fã a, ebehia sɛ wonom thyroid hormone nnuru wo nkwa nna nyinaa . Oduruyɛfo bɛhwɛ wo thyroid hormone dodow so wɔ w’asetra nyinaa mu ahwɛ ahu sɛ nnuru dodow a wode di dwuma no fata wo.

Sɛ wohu sɛ wowɔ kokoram a, ɛmfa ho sɛnea ɛte biara no, ebetumi ayɛ ahodwiriw. Nanso, asɛmpa no ne sɛ mpɛn pii no, nkɔmhyɛ a ɛfa PTC ho no ye yiye. Wo nnuruyɛfo kuw no ne wo bɛyɛ adwuma de ahu ayaresa nhyehyɛe a eye sen biara ama wo.

## Nneɛma a ɛho hia a ɛsɛ sɛ wokae (Take-Home Message)

Okay, enti, sɛnea yɛaka ho asɛm no, eyinom ne nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae:

• Papillary thyroid cancer (PTC) ne thyroid kokoram a abu so sen biara na ɛwɔ nkɔmhyɛ a eye sen biara.
• Nsɛnkyerɛnne titiriw ne akisikuru a ɛnyɛ yaw wɔ kɔn mu. Sɛ wuhu biribi a ɛte saa a, akyinnye biara nni ho sɛ kɔ oduruyɛfo nkyɛn.
• Oprehyɛn ne ayaresa titiriw. Ebia ɛho behia sɛ wɔde radioactive iodine a wɔde sa yare nso.
• Sɛ woyi thyroid ntini no koraa a, ɛsɛ sɛ wonom thyroid hormone wo nkwa nna nyinaa .
• Dodow a wohu tebea yi ntɛm no, dodow no ara na ayaresa no di yiye. Enti, aduruyɛ mu nhwehwɛmu a wɔyɛ no daa ne afotu a wobedi akyi ho hia yiye.
• Nsuro. Ɛnyɛ wo nko ara. Nnuruyɛfo, abusuafo, ne nnamfo wɔ hɔ a wɔbɛboa wo.

Mewɔ anidaso sɛ saa nsɛm yi bɛboa wo. Sɛ wowɔ nsɛmmisa bi a, ntwentwɛn wo nan ase sɛ wubebisa wo duruyɛfo. Kɔ so nya apɔwmuden!

` Thyroid kokoram, papillary thyroid kokoram, PTC, kɔn mu ntini, thyroid oprehyɛn, mframa a wɔde sa yare, hormone ayaresa