Masifunde ngoMhlaza weParathyroid. Musa ukoyika, masithethe!

Sonke sifumana utshintsho oluncinci kunye nokungonwabi emizimbeni yethu ngamanye amaxesha, akunjalo? Mhlawumbi liqhuma elincinci entanyeni, okanye linokuba yinto efana nokuziva udiniwe ngaphandle kwesizathu, okanye ukuziva unxaniwe ngalo lonke ixesha. Nangona uninzi lwezi zinto zingeyonto yokuxhalaba, kwiimeko ezingaqhelekanga, zinokuba ziimpawu eziphambili zesifo. Namhlanje siza kuthetha ngohlobo lomhlaza olungaqhelekanga, kodwa kubaluleke kakhulu ukuba sonke siluqaphele. Lo ngumhlaza okhula kwiindlala ze-parathyroid, ngokwezonyango obizwa ngokuba ngumhlaza we-parathyroid , okanye `(Parathyroid Carcinoma)`.

Yintoni umhlaza weParathyroid?

Ngamafutshane, umhlaza we-parathyroid luhlobo lomhlaza olungaqhelekanga oluvela kwizicubu ze-parathyroid glands yakho. Ii-parathyroid glands zakho zihlala zifumaneka ngasemva kwe-thyroid gland efana nebhabhathane ngaphambili entanyeni yakho.

Umhlaza we-parathyroid awuhlulwahlulwanga ngokwamanqanaba amane ("inkqubo yokubiza amagama enezigaba ezine") njengezinye iintlobo zomhlaza. Endaweni yoko, oogqirha bahlulahlula umhlaza ube ziintlobo ezintathu eziphambili:

• Indawo: Oku kuthetha ukuba umhlaza ukwi-parathyroid gland yakho kuphela. Ngamanye amaxesha usenokuba usasazeke kancinci kwizicwili ezingqongileyo. Oku kuthetha ukuba umhlaza usaphelele kwindawo enye.
• I-Metastatic: Oku kwenzeka xa umhlaza usasazeke kwezinye iindawo zomzimba wakho, ezinje ngee-lymph nodes, isibindi, imiphunga, amathambo, okanye i-pancreas. Phakathi kwe-10% kunye ne-30% yabantu abanomhlaza we-parathyroid basasazeke ngumhlaza ngexesha lokuxilongwa. Iindawo ezixhaphakileyo yimiphunga, amathambo, okanye isibindi.
• Iphinda-phinda: Kulapho umhlaza ubuya khona emva konyango lokuqala – ngesiqhelo emva kokuba idlala lomhlaza lisusiwe ngotyando. Ngaphezulu kwesiqingatha sabantu abanomhlaza we-parathyroid baya kuba nolu hlobo lomhlaza. Umhlaza udla ngokubuya kwiminyaka emibini ukuya kwemihlanu emva kotyando lokuqala. Nangona kunjalo, ngamanye amaxesha unokubuya emva kweminyaka engama-20.

Zithini ezi glands ze-parathyroid?

Uninzi lwethu lunee-parathyroid glands ezine ezinobukhulu beepitshi. Njengoko bekutshiwo ngaphambili, ezi zifumaneka ngasemva kwe-thyroid gland. Njenge-thyroid gland, ii-parathyroid glands ziyinxalenye yenkqubo yakho ye-endocrine. Ngamanye amaxesha, ezi parathyroid glands zinokufumaneka ecaleni komphunga wakho okanye esifubeni sakho. Oku kubizwa ngokuba yi -ectopic.Ii-parathyroid glands zibizwa ngokuba zii-parathyroid glands, oko kuthetha ukuba azikho kwindawo ezifanele ukuba kuyo ngokuqhelekileyo.

Umsebenzi ophambili wee-parathyroid glands zakho kukulawula ubungakanani be-calcium egazini lakho ngokuvelisa i-parathyroid hormone (PTH) . Ngamanye amaxesha, enye okanye ngaphezulu kwee-parathyroid glands zakho ziqala ukuvelisa i-parathyroid hormone eninzi kakhulu (PTH). Le meko ibizwa ngokuba yiPrimary Hyperparathyroidism (pHPT) . Xa i-PTH ininzi kakhulu iveliswa, inqanaba le-calcium egazini lakho liyakhula. Le meko ibizwa ngokuba yi -hypercalcemia .

Yintoni umahluko phakathi komhlaza we-parathyroid kunye ne-parathyroid adenoma?

I-parathyroid adenoma kukukhula okungenabungozi, okungekho mhlaza kwi-parathyroid gland. Nangona kunjalo, umhlaza we-parathyroid kukukhula kweeseli ezinobungozi, ezingengomhlaza kwizicubu zakho ze-parathyroid. Kwizifo ezinxulumene ne-parathyroid glands, i-parathyroid adenoma ixhaphake kakhulu kunomhlaza we-parathyroid.

Kodwa nantsi into ebalulekileyo: Kuzo zombini ezi meko, umhlaza we-parathyroid kunye ne-parathyroid adenoma, i-parathyroid gland yakho inokuba nokusebenza kakhulu kwaye ivelise i-parathyroid hormone (PTH) eninzi kakhulu. Emva koko, njengoko bekutshiwo ngaphambili, i-hypercalcemia iyenzeka. Le hypercalcemia inokuba yingozi emzimbeni nakwimpilo yakho. Ke ngoko, unyango oluqhelekileyo lomhlaza we-parathyroid, kunye ne-parathyroid adenomas, kukususa ngotyando i-parathyroid gland esebenza kakhulu.

Kwanoogqirha, kunokuba nzima ukufumanisa ngoko nangoko ukuba yi-parathyroid adenoma okanye yi-parathyroid carcinoma. Ngenxa yokuba iiseli zazo zombini zinokubonakala zifana, emva kokuba i-parathyroid gland esebenzayo kakhulu isusiwe ngotyando, kufuneka uvavanyo olongezelelekileyo ukuqinisekisa ukuba yi-adenoma okanye yi-carcinoma.

Yintoni i-hypercalcemia? Inxulumene njani nomhlaza we-parathyroid?

I-Hypercalcemia kuxa amanqanaba e-calcium egazini lakho ephezulu kunesiqhelo. Abantu abanomhlaza we-parathyroid badla ngokuba ne-hypercalcemia. Oku kungenxa yokuba umhlaza ubangela ukuba i-parathyroid gland yakho isebenze kakhulu kwaye ivelise i-parathyroid hormone (PTH) eninzi kakhulu. I-Parathyroid hormone (PTH) ilawula ubungakanani be-calcium egazini lakho. Ngoko ke, ukuba une-parathyroid hormone eninzi kakhulu (PTH), amanqanaba e-calcium egazini lakho aya kwanda.

I-Hypercalcemia inokuba yingozi kwimpilo yakho nasemzimbeni wakho. Ngoko ke, kubaluleke kakhulu ukunyanga i-hypercalcemia ebangelwa ngumhlaza we-parathyroid kunye nomhlaza ngokwawo.

Ngaba kukho iintlobo ezahlukeneyo zomhlaza we-parathyroid?

Ewe, kukho iintlobo ezimbini eziphambili zomhlaza we-parathyroid.

1. Uhlobo oluqhelekileyo: Kule meko, iiseli zomhlaza zibangela ukuba i-parathyroid gland yakho ivelise i-parathyroid hormone (PTH) eninzi kakhulu ize iyikhuphe egazini. Oku kubangela ukuba amanqanaba e-calcium egazini lakho anyuke.

2. I-parathyroid carcinoma engasebenziyo: Le ikwabizwa ngokuba yi-"non-secreting parathyroid carcinoma". Le yahlukile kwezinye iintlobo. Kuba, abantu abanolu hlobo lomhlaza abanamazinga aphezulu e-parathyroid hormone (PTH) okanye i-calcium egazini labo. Olu hlobo aluqhelekanga kakhulu, luvela ngaphantsi kwe-10% yezigulane ezinomhlaza we-parathyroid.

Nje ukuba umhlaza we-parathyroid ufunyaniswe, kwenziwa olunye uvavanyo ukuze kuqinisekiswe ukuba ungaphakathi , usasazeka okanye awuphindeki . Njengoko bekutshiwo ngaphambili, udidi olunezigaba ezine olusetyenziswa kwezinye iintlobo zomhlaza alusetyenziswa koku.

Ngubani onokuba nomhlaza we-parathyroid?

Lo mhlaza uchaphazela abafazi namadoda ngokulinganayo. Udla ngokubonakala kubantu abangaphezu kweminyaka engama-30 ubudala .

Ixhaphake kangakanani le sifo?

Umhlaza we-parathyroid sisifo esingaqhelekanga kakhulu. Khawucinge nje, singu- 0.005% kuphela yazo zonke iintlobo zomhlaza. Kwakhona, umhlaza we-parathyroid uphakathi kwe -0.5% kunye ne-1% yazo zonke izifo ezinxulumene ne-parathyroid gland. Ngoko ke, oku kunqabile kakhulu.

Zithini izizathu zomhlaza we-Parathyroid?

Enyanisweni, akukho sizathu sithile somhlaza we-parathyroid esifunyenweyo okwangoku.

Nangona kunjalo, ezi meko zilandelayo zemfuza ezingaqhelekanga (oko kukuthi, ezizuzwe njengelifa kusapho) zithathwa njengezinto ezibangela umhlaza:

• Uhlobo lwe-neoplasia ye-endocrine ezininzi (MEN1)
• I-Familial isolated hyperparathyroidism (FIHP)
• I-Hyperparathyroidism-isifo se-jaw tumor

Ukongeza, ukuba ukhe wanyangwa nge-radiation entlokweni okanye entanyeni yakho ngaphambili, inokunyusa umngcipheko wokuba nomhlaza we-parathyroid.

Zithini iimpawu zomhlaza we-Parathyroid?

Amaxesha amaninzi, iimpawu zomhlaza we-parathyroid ziimpawu ze-hypercalcemia ezibangelwa yiyo. Iimpawu kunye neempawu ze-hypercalcemia zingabandakanya:

• Ukufuna ukuchama rhoqo kunesiqhelo (ukuchama rhoqo)
• Ndiziva ndinxaniwe ngaphezu kwesiqhelo
• Isicaphucaphu nokuhlanza
• NjengesiqheloAndiziva ndilambile
• Ukuqhinwa
• Ndiziva ndidiniwe kakhulu
• Uziva ngathi uxinezelekile
• Ukulibala okanye ukulahleka kwenkumbulo
• Intlungu yemisipha, ubuthathaka, kunye/okanye ukuqhwalela

Ezinye iimpawu ezinokubakho zomhlaza we-parathyroid:

• Ukuba neqhubu entanyeni
• Utshintsho lwelizwi okanye ukurhawuzelela
• Ubunzima bokuginya ukutya

Ukuba unenye okanye ngaphezulu kwezi mpawu, ungoyiki ukucinga ukuba ngokuqinisekileyo ngumhlaza we-parathyroid. Ezi mpawu zinokubonakala nakwezinye iimeko ezininzi. Nangona kunjalo, ukuba into efana nale iyaqhubeka, kungcono ukubona ugqirha ukuze akunike ingcebiso.

Ufunyaniswa njani umhlaza we-Parathyroid?

Ukufumanisa umhlaza we-parathyroid ngamanye amaxesha kunokuba nzima kancinci. Esinye isizathu kukuba iiseli ze-parathyroid adenoma engengomhlaza kunye nezo zomhlaza we-parathyroid zinokufana.

Umhlaza we-parathyroid udla ngokufunyaniswa emva kokuba i-parathyroid gland yakho engaqhelekanga, esebenza kakhulu isusiwe ngotyando (i-'parathyroidectomy'), kwaye izicubu zihlolwe ngakumbi. Ngamanye amaxesha, ugqirha wotyando unokufumanisa umhlaza we-parathyroid ngexesha lotyando.

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe isifo?

Njengoko bekutshiwo ngaphambili, umhlaza we-parathyroid udla ngokufunyaniswa emva kokuba ufunyaniswe une- primary hyperparathyroidism , kwaye i-parathyroid gland engaqhelekanga, esebenza kakhulu, isuswa ngotyando. Ngamanye amaxesha, ugqirha wotyando unokufumanisa umhlaza we-parathyroid ngexesha lotyando.

Ngaphambi kotyando lwakho lokususa i-hyperactive parathyroid gland yakho, ungenza uvavanyo olufana nolu:

• Uvavanyo lwe-calcium egazini
• Uvavanyo lwe-PTH yegazi
• Iskeni ye-Parathyroid - Esi siskeni se-radioactive sestamibi kunye/okanye i-CT scan.

Ukuba ufunyaniswe ukuba unomhlaza we-parathyroid, ugqirha wakho unokuyalela iimvavanyo zomfanekiso ezifana nezi ukuze abone ukuba umhlaza usasazeke na kwamanye amalungu omzimba wakho:

• I-CT scan (i-computerized tomography scan): I-CT scan isebenzisa i-X-ray kunye nekhompyutha ukwenza imifanekiso emininzi yomzimba wakho enamacala amathathu (3D).
• Iskeni se-MRI (i-MRI - i-magnetic resonance imaging):I-MRI scan isebenzisa imagnethi enkulu, amaza erediyo, kunye nekhompyutha ukwenza imifanekiso eneenkcukacha zomzimba wakho. Ayisebenzisi ii-X-ray (radiation).

Ziziphi iindlela zonyango zomhlaza we-parathyroid?

Eyona ndlela iphambili yonyango lomhlaza we-parathyroid kukususwa ngotyando kwe-parathyroid gland enomhlaza (`en bloc resection`). Ukuba umhlaza we-parathyroid usasazekile (usulwe), ugqirha wakho unokufuna ukususa izicwili ezijikeleze i-parathyroid gland yakho okanye izicwili ezinomhlaza kwezinye iindawo zomzimba wakho.

Ezi ndlela zilandelayo zotyando zingasetyenziselwa umhlaza we-parathyroid:

• Ukususwa kwe-En bloc: Kule nkqubo, ugqirha ususa yonke i-parathyroid gland yakho kunye ne-capsule eyijikelezileyo. Ngamanye amaxesha, banokususa nesiqingatha se-thyroid gland kwicala elifanayo ne-parathyroid gland enesifo somhlaza, kunye nezicubu ezijikelezileyo, izihlunu kunye nemithambo-luvo.
• Ukususa ithumba: Kule nkqubo, ugqirha ususa ithumba elininzi kangangoko kunokwenzeka. Amanye amathumba asenokungasuswa ngokupheleleyo.
• Ukususwa kwezicubu: Kule meko, ugqirha otyandayo ususa naluphi na umhlaza osasazeke (owasasazeke) kwezinye izicwili kunye/okanye amalungu omzimba wakho, umzekelo, imiphunga.

Ngaba ndiza kufumana unyango lwe-chemotherapy okanye i-radiation?

Unyango lwe-chemotherapy kunye nonyango lwe-radiation azisetyenziswa rhoqo ukunyanga umhlaza we-parathyroid. Ugqirha wakho uya kugqiba ukuba unyango lwe-chemotherapy kunye/okanye unyango lwe-radiation lukhetho olufanelekileyo kuwe.

Ngaba ikho indlela yokunyanga umhlaza we-parathyroid?

Okwangoku, akukho mayeza athile omhlaza we-parathyroid. Abantu abaninzi abanomhlaza we-parathyroid baba neempawu ze-hypercalcemia. Ngenxa yokuba i-hypercalcemia inokuba yingozi, ugqirha wakho unokukunika elinye okanye ngaphezulu la mayeza alandelayo e-hypercalcemia:

• ICinacalcet (Cinacalcet - Sensipar®)
• IiBisphosphonates
• I-Denosumab (i-Denosumab - XGEVA®)

Ukuba uneempawu eziqatha ze-hypercalcemia, ugqirha wakho unokucebisa ukuba ulaliswe esibhedlele ngoko nangoko kwaye uqale ulwelo olufakwa kwimithambo yegazi (IV) kunye nolunye unyango.

Ngaba umhlaza wam we-parathyroid ungabuya?

Ewe, abantu abangaphezu kwesiqingatha abafunyaniswe benomhlaza we-parathyroid banokuphinda babe nawo lo mhlaza.Umhlaza udla ngokubuya emva kweminyaka embalwa – ngesiqhelo phakathi kweminyaka emibini ukuya kwemihlanu. Kodwa kwezinye iimeko, ungenzeka amashumi eminyaka (iminyaka engama-20 nangaphezulu) emva kokuba uxilongiwe kwaye ufumane unyango.

Ngaba lo mhlaza ungasasazeka (ukukhula kwe-metastasize) uye kwezinye iindawo zomzimba?

Ewe, umhlaza we-parathyroid ungasasazeka (usasazeka) uye kwezinye iindawo zomzimba wakho. Phakathi kwe-10% kunye ne-30% yabantu abanomhlaza we-parathyroid banomhlaza osele usasazeka (usasazeka) ngexesha lokuxilongwa. Kwezi meko, umhlaza uhlala usasazeka uye emiphungeni yakho, emathanjeni, okanye esibindini. Nangona kunjalo, unokusasazeka uye kwi-lymph nodes okanye kwi-pancreas yakho.

Ithini ingqikelelo yomhlaza we-parathyroid?

Uqikelelo lomhlaza we-parathyroid luxhomekeke ekubeni utyando lokususa i-parathyroid gland luphelele kangakanani xa uxilongwa okokuqala, njengoko iindlela zonyango lwesibini ezifana nonyango lwe-radiation kunye ne-chemotherapy zinqongophele.

Kubantu abanomhlaza we-parathyroid abaye banqunyulwa i-en bloc kwaye banemida engalunganga, izinga lokusinda liphezulu ukuya kuthi ga kwi-90% kwiminyaka emihlanu emva kotyando lokuqala. Izinga lokusinda liphezulu ukuya kuthi ga kwi-67% kwiminyaka elishumi emva kotyando lokuqala.

Abantu abangaphezu kwesiqingatha abafunyaniswe benomhlaza we-parathyroid baze batyandwe ukususa i-gland baya kuphinda babuye. Kwezi meko, umhlaza uhlala ubuyela emva kweminyaka emibini ukuya kwemihlanu emva kotyando lokuqala. Nangona kunjalo, unokubuya emva kwamashumi eminyaka.

Ngaba umhlaza weParathyroid ungathintelwa?

Ngelishwa, akukho ndlela eyaziwayo yokuthintela umhlaza we-parathyroid. Kwakhona, akukho ndlela yokunciphisa umngcipheko wokufumana esi sifo. Ukuba kukho nabani na kusapho lwakho oye waba neengxaki ze-parathyroid gland, kulungile ukuthetha nogqirha wakho.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ukuba unomhlaza we-parathyroid, ungabuza ugqirha wakho imibuzo efana nale:

• Ingaba umhlaza usasazeke ngaphaya kwe-parathyroid gland yam?
• Yeyiphi eyona ndlela ilungileyo yonyango lomhlaza we-parathyroid?
• Zithini iingozi kunye neziphumo ebezingalindelekanga zonyango?
• Ingaba usapho lwam lusengozini yokuba nomhlaza we-parathyroid?
• Ndingaphinda ndibe nomhlaza we-parathyroid kwakhona?
• Ngaba ndisengozini yokufumana ezinye iintlobo zomhlaza?
• Luluphi unyango oluza kundinceda emva konyango?
• Ngaba kufuneka ndiqaphele iimpawu zeengxaki?

Okokugqibela, izinto ekufuneka uzikhumbule

Ukufunyanwa unomhlaza kunokuba yinto eyoyikisayo. Kodwa khumbula,Iqela lakho lezonyango lilapha ukukunceda nokukubonisa eyona ndlela ilungileyo yonyango. Nangona utyando okwangoku lolona kuphela unyango lomhlaza we-parathyroid, uphando kunye nonyango lomhlaza zihlala ziphucuka. Kusenokubakho novavanyo lweklinikhi onokuthi uthabathe inxaxheba kulo. Ngoko ke, ungoyiki ukubuza ugqirha wakho imibuzo malunga nomhlaza wakho we-parathyroid. Qinisekisa ukuba yonke into ichazwa ngendlela oyiqondayo.

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