Ake sifunde ngomdlavuza we-Parathyroid. Ungesabi, ake sixoxe!

Sonke sibhekana nezinguquko ezincane kanye nokungakhululeki emizimbeni yethu ngezikhathi ezithile, akunjalo? Mhlawumbe kuyiqhubu elincane entanyeni, noma kungaba yinto efana nokuzizwa ukhathele ngaphandle kwesizathu, noma ukuzizwa womile njalo. Nakuba iningi lalezi zinto lingeyona into okufanele ukhathazeke ngayo, ezimweni ezingavamile, zingaba izimpawu eziyinhloko zesimo sezokwelapha. Namuhla sizokhuluma ngohlobo lomdlavuza olungavamile kancane, kodwa kubaluleke kakhulu kithi sonke ukuba siluqaphele. Lona umdlavuza okhula ezindlaleni ze-parathyroid, ngokwezokwelapha obizwa ngokuthi umdlavuza we-parathyroid , noma `(Parathyroid Carcinoma)`.

Uyini umdlavuza we-Parathyroid?

Kalula nje, umdlavuza we-parathyroid uhlobo lomdlavuza olungavamile kakhulu oluvela ezicutshini zezindlala zakho ze-parathyroid. Izindlala zakho ze-parathyroid zivame ukutholakala ngemuva kwendlala ye-thyroid efana novemvane ngaphambili kwentamo yakho.

Umdlavuza we-parathyroid awuhlukaniswa ngezigaba ezine ("uhlelo lokuqamba amagama lwezigaba ezine") njengezinye izinhlobo zomdlavuza. Esikhundleni salokho, odokotela bahlukanisa umdlavuza ngezinhlobo ezintathu eziyinhloko:

• Okutholakala endaweni ethile: Lokhu kusho ukuthi umdlavuza usesigabeni sakho se-parathyroid kuphela. Ngezinye izikhathi kungenzeka ukuthi usakazeke kancane ezicutshini ezizungezile. Lokhu kusho ukuthi umdlavuza usagcinwe endaweni eyodwa kuphela.
• I-Metastatic: Lokhu kwenzeka lapho umdlavuza ususakazekele kwezinye izingxenye zomzimba wakho, njenge-lymph nodes, isibindi, amaphaphu, amathambo, noma i-pancreas. Phakathi kuka-10% no-30% wabantu abanomdlavuza we-parathyroid basakazeka umdlavuza (metastatic) ngesikhathi sokuxilongwa. Izindawo ezivame kakhulu amaphaphu, amathambo, noma isibindi.
• Okuphindaphindayo: Yilapho umdlavuza ubuya khona ngemva kokwelashwa kokuqala – ngokuvamile ngemva kokuba indlala yomdlavuza isisusiwe ngokuhlinzwa. Abantu abangaphezu kwengxenye abanomdlavuza we-parathyroid bazoba nalolu hlobo lomdlavuza. Umdlavuza uvame ukubuya phakathi neminyaka emibili kuya kwemihlanu yokuhlinzwa kokuqala. Kodwa-ke, ngezinye izikhathi ungabuya sekwephuzile eminyakeni engama-20.

Ziyini lezi zindlala ze-parathyroid?

Iningi lethu linezindlala ezine ze-parathyroid ezinobukhulu be-pea. Njengoba kushiwo ngaphambili, lezi zitholakala ngemuva kwendlala ye-thyroid. Njengendlala ye-thyroid, izindlala ze-parathyroid ziyingxenye yesistimu yakho ye-endocrine. Ngezinye izikhathi, lezi zindlala ze-parathyroid zingatholakala eduze komphimbo wakho noma ngisho nasesifubeni sakho. Lokhu kubizwa ngokuthi i-ectopic.Izindlala ze-parathyroid zibizwa ngokuthi izindlala ze-parathyroid, okusho ukuthi azikho lapho kufanele zibe khona ngokuvamile.

Umsebenzi oyinhloko wezindlala zakho ze-parathyroid ukulawula inani le-calcium egazini lakho ngokukhiqiza i-parathyroid hormone (PTH) . Ngezinye izikhathi, eyodwa noma ngaphezulu kwezindlala zakho ze-parathyroid ziqala ukukhiqiza kakhulu le hormone ye-parathyroid (PTH). Lesi simo sibizwa ngokuthi i-Primary Hyperparathyroidism (pHPT) . Uma kukhiqizwa i-PTH eningi kakhulu, izinga le-calcium egazini lakho liyakhuphuka. Lesi simo sibizwa ngokuthi i-hypercalcemia .

Uyini umehluko phakathi komdlavuza we-parathyroid kanye ne-parathyroid adenoma?

I-parathyroid adenoma iwukukhula okungenabungozi, okungenamdlavuza endlaleni ye-parathyroid. Kodwa-ke, umdlavuza we-parathyroid uwukukhula kwamangqamuzana amabi, angenamdlavuza ezicutshini zakho ze-parathyroid. Ezifweni ezihambisana nezindlala ze-parathyroid, i-parathyroid adenoma ivame kakhulu kunomdlavuza we-parathyroid.

Kodwa nansi into ebalulekile: Kuzo zombili lezi zimo, umdlavuza we-parathyroid kanye ne-parathyroid adenoma, i-parathyroid gland yakho ingaba matasa kakhulu futhi ikhiqize i-parathyroid hormone (PTH) eningi kakhulu. Bese kuthi, njengoba kushiwo ngaphambili, kube ne-hypercalcemia. Le hypercalcemia ingaba yingozi emzimbeni wakho nasempilweni yakho. Ngakho-ke, ukwelashwa okuvame kakhulu komdlavuza we-parathyroid, kanye ne-parathyroid adenomas, ukususa ngokuhlinzwa i-parathyroid gland esebenza kakhulu.

Ngisho nakodokotela, kungaba nzima ukusho ngokushesha ukuthi ngabe i-parathyroid adenoma noma i-parathyroid carcinoma. Ngenxa yokuthi amaseli azo zombili angabonakala efana, ngemva kokususwa kwe-parathyroid gland esebenza ngokweqile, kudingeka ukuhlolwa okwengeziwe ukuqinisekisa ukuthi ngabe i-adenoma noma i-carcinoma.

Kuyini i-hypercalcemia? Ihlobene kanjani nomdlavuza we-parathyroid?

I-Hypercalcemia yilapho amazinga e-calcium egazini lakho ephakeme kunokujwayelekile. Abantu abanomdlavuza we-parathyroid bavame ukuba ne-hypercalcemia. Lokhu kungenxa yokuthi umdlavuza ubangela ukuthi i-parathyroid gland yakho isebenze ngokweqile futhi ikhiqize i-parathyroid hormone (PTH) eningi kakhulu. I-Parathyroid hormone (PTH) ilawula inani le-calcium egazini lakho. Ngakho-ke, uma une-parathyroid hormone (PTH) eningi kakhulu, amazinga e-calcium egazini lakho azokhula.

I-Hypercalcemia ingaba yingozi empilweni yakho nasemzimbeni wakho. Ngakho-ke, kubaluleke kakhulu ukwelapha i-hypercalcemia ebangelwa umdlavuza we-parathyroid kanye nomdlavuza uqobo.

Ingabe kunezinhlobo ezahlukene zomdlavuza we-parathyroid?

Yebo, kunezinhlobo ezimbili eziyinhloko zomdlavuza we-parathyroid.

1. Uhlobo oluvame kakhulu: Kulesi simo, amangqamuzana omdlavuza abangela ukuthi i-parathyroid gland yakho ikhiqize i-parathyroid hormone (PTH) eningi kakhulu bese iyidedela egazini. Lokhu kubangela ukuthi izinga le-calcium egazini lakho likhuphuke.

2. I-carcinoma ye-parathyroid engasebenzi: Lokhu kubizwa nangokuthi "i-carcinoma ye-parathyroid engakhiqizi lutho". Lokhu kuhlukile kwezinye izinhlobo. Ngoba, abantu abanalolu hlobo lomdlavuza abanamazinga aphezulu e-hormone ye-parathyroid (PTH) noma i-calcium egazini labo. Lolu hlobo aluvamile kakhulu, luvela ngaphansi kwe-10% yeziguli ezinomdlavuza we-parathyroid.

Uma umdlavuza we-parathyroid usutholakele, kwenziwa ezinye izivivinyo ukuze kutholakale ukuthi usendaweni ethile , usakazeke kakhulu , noma uphindaphindeka . Njengoba kushiwo ngaphambili, ukuhlukaniswa kwezigaba ezine okusetshenziselwa eminye imidlavuza akusetshenziselwa lokhu.

Ubani onamathuba amaningi okuthola umdlavuza we-parathyroid?

Lo mdlavuza uthinta abesifazane nabesilisa ngokulinganayo. Ngokuvamile ubonakala kubantu abaneminyaka engaphezu kwengu-30 .

Sivame kangakanani lesi sifo?

Umdlavuza we-parathyroid uyisifo esingavamile kakhulu. Cabanga nje, ubanga u -0.005% kuphela wabo bonke umdlavuza. Futhi, umdlavuza we-parathyroid ubanga phakathi kuka -0.5% no-1% wazo zonke izifo ezihlobene ne-parathyroid gland. Ngakho-ke, lokhu akuvamile ngempela.

Yiziphi izimbangela zomdlavuza we-Parathyroid?

Eqinisweni, akukho imbangela ethile yomdlavuza we-parathyroid etholakele okwamanje.

Kodwa-ke, izimo ezilandelayo ezingavamile zofuzo (okungukuthi, ezizuzwe njengefa emndenini) zibhekwa njengezici eziyingozi zalo mdlavuza:

• I-neoplasia ye-endocrine eminingi yohlobo I (MEN1)
• I-Familial isolated hyperparathyroidism (FIHP)
• I-Hyperparathyroidism-isifo somhlathi

Ngaphezu kwalokho, uma wake welashwa ngemisebe ekhanda noma entanyeni yakho esikhathini esidlule, kungandisa nengozi yakho yokuba nomdlavuza we-parathyroid.

Ziyini izimpawu zomdlavuza we-Parathyroid?

Ngokuvamile, izimpawu zomdlavuza we-parathyroid ziyizimpawu ze-hypercalcemia eziba khona. Izimpawu nezimpawu ze-hypercalcemia zingafaka:

• Ukudinga ukuchama kaningi kunokujwayelekile (ukuchama njalo)
• Ukuzizwa womile kakhulu kunokujwayelekile
• Isicanucanu nokuhlanza
• NjengenjwayeloAngizizwa ngilambile
• Ukuqunjelwa
• Ukuzizwa ukhathele kakhulu
• Ukuzizwa sengathi ucindezelekile
• Ukukhohlwa noma ukulahlekelwa inkumbulo
• Ubuhlungu bemisipha, ubuthakathaka, kanye/noma ukuxhuga

Ezinye izimpawu ezingaba khona zomdlavuza we-parathyroid:

• Ukuba neqhubu entanyeni
• Izinguquko zezwi noma ukuhosha
• Ubunzima bokugwinya ukudla

Uma unesinye noma ngaphezulu salezi zimpawu, ungesabi ukucabanga ukuthi ngokuqinisekile umdlavuza we-parathyroid. Lezi zimpawu zingabonakala nakwezinye izimo eziningi. Kodwa-ke, uma into efana nale iqhubeka, kungcono ukubona udokotela ukuze akunike iseluleko.

Umdlavuza we-Parathyroid utholakala kanjani?

Ukuxilonga umdlavuza we-parathyroid ngezinye izikhathi kungaba nzima kancane. Esinye isizathu ukuthi amangqamuzana e-parathyroid adenoma engeyona umdlavuza kanye nalawo omdlavuza we-parathyroid angafana.

Umdlavuza we-parathyroid uvame ukutholakala ngemva kokuba i-parathyroid gland yakho engavamile, esebenza ngokweqile isusiwe ngokuhlinzwa (i-'parathyroidectomy'), bese izicubu zihlolwa kabanzi. Ngezinye izikhathi, udokotela ohlinzayo angathola umdlavuza we-parathyroid ngesikhathi sokuhlinzwa.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale ukuthi unesifo?

Njengoba kushiwo ngaphambili, umdlavuza we-parathyroid uvame ukutholakala ngemva kokuba utholakale une- primary hyperparathyroidism , futhi i-parathyroid gland engavamile, esebenza ngokweqile isuswa ngokuhlinzwa. Ngezinye izikhathi, udokotela ohlinzayo angaxilonga umdlavuza we-parathyroid ngesikhathi sokuhlinzwa.

Ngaphambi kokuhlinzwa kwakho ukuze kususwe i-hyperactive parathyroid gland yakho, ungase ube nokuhlolwa okufana nalokhu:

• Ukuhlolwa kwe-calcium egazini
• Ukuhlolwa kwe-PTH yegazi
• Ukuskena kwe-Parathyroid - Lokhu kuvame ukuba ukuskena kwe-radioactive sestamibi kanye/noma ukuskena kwe-CT.

Uma kutholakale ukuthi unomdlavuza we-parathyroid, udokotela wakho angase akucele ukuthi uhlolwe izithombe ezifana nalezi ukuze abone ukuthi umdlavuza ususakazeke yini kwezinye izingxenye zomzimba wakho:

• I-CT scan (i-computerized tomography scan): I-CT scan isebenzisa i-X-ray kanye nekhompyutha ukudala izithombe eziningi zomzimba wakho ezinezinhlangothi ezintathu (3D).
• Ukuskena kwe-MRI (i-MRI - ukuthwebula izithombe ze-magnetic resonance):I-MRI scan isebenzisa i-magnet enkulu, amaza omsakazo, kanye nekhompyutha ukwenza izithombe ezinemininingwane yomzimba wakho. Ayisebenzisi i-X-ray (imisebe).

Yiziphi izindlela zokwelapha umdlavuza we-parathyroid?

Inketho eyinhloko yokwelapha umdlavuza we-parathyroid ukususwa ngokuhlinzwa kwe-parathyroid gland enomdlavuza (`en bloc resection`). Uma umdlavuza we-parathyroid ususakazeke (usuhlukaniswe), udokotela wakho ohlinzayo angadinga futhi ukususa izicubu ezizungeze i-parathyroid gland yakho noma izicubu ezinomdlavuza kwezinye izingxenye zomzimba wakho.

Izindlela ezilandelayo zokuhlinzwa zingasetshenziswa kumdlavuza we-parathyroid:

• Ukususwa kwe-E bloc: Kule nqubo, udokotela ohlinzayo ususa yonke i-parathyroid gland yakho kanye ne-capsule eyizungezile. Ngezinye izikhathi, bangase basuse nengxenye ye-thyroid gland ohlangothini olufanayo ne-parathyroid gland enomdlavuza, kanye nezicubu ezizungezile, imisipha, kanye nemizwa.
• Ukususa isimila: Kule nqubo, udokotela ohlinzayo ususa isimila esiningi ngangokunokwenzeka. Amanye amathumba angase angasuswa ngokuphelele.
• Ukususwa kwezicubu: Kulokhu, udokotela ohlinzayo ususa noma yimuphi umdlavuza osakazeke (osuvele usakazeke) kwezinye izicubu kanye/noma izitho zomzimba wakho, isibonelo, amaphaphu.

Ingabe ngizokwelashwa nge-chemotherapy noma nge-radiation?

Ukwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe akuvamile ukusetshenziswa ekwelapheni umdlavuza we-parathyroid. Udokotela wakho uzonquma ukuthi ukwelashwa ngamakhemikhali kanye/noma ukwelashwa ngemisebe kuyindlela efanelekile yini kuwe.

Ingabe ikhona ikhambi lomdlavuza we-parathyroid?

Okwamanje, ayikho imithi ethile yomdlavuza we-parathyroid. Abantu abaningi abanomdlavuza we-parathyroid baba nezimpawu ze-hypercalcemia. Ngenxa yokuthi i-hypercalcemia ingaba yingozi, udokotela wakho angase akunike umuthi owodwa noma ngaphezulu kwemithi elandelayo ye-hypercalcemia:

• I-Cinacalcet (Cinacalcet - Sensipar®)
• Ama-bisphosphonates
• I-Denosumab (i-Denosumab - XGEVA®)

Uma unezimpawu ezibucayi ze-hypercalcemia, udokotela wakho angase akuncome ukuthi ulaliswe esibhedlela ngokushesha bese uqala uketshezi olufakwa emthanjeni (IV) kanye nezinye izindlela zokwelapha.

Ingabe umdlavuza wami we-parathyroid ungabuya?

Yebo, abantu abangaphezu kwengxenye abatholakale benomdlavuza we-parathyroid bangaphinde babuye umdlavuza.Umdlavuza uvame ukubuya phakathi neminyaka embalwa - ngokuvamile phakathi kweminyaka emibili kuya kwemihlanu. Kodwa kwezinye izimo, kungenzeka amashumi eminyaka (iminyaka engama-20 noma ngaphezulu) ngemva kokuxilongwa kokuqala kanye nokwelashwa.

Ingabe lo mdlavuza ungasakazeka (usakazeke) kwezinye izingxenye zomzimba?

Yebo, umdlavuza we-parathyroid ungasakazeka (usakazeke) kwezinye izingxenye zomzimba wakho. Phakathi kuka-10% no-30% wabantu abanomdlavuza we-parathyroid banomdlavuza osuvele usakazeke (usakazeke) ngesikhathi sokuxilongwa. Kulezi zimo, umdlavuza uvame ukusakazeka emaphashini akho, emathanjeni, noma esibindini. Kodwa-ke, ungasakazeka nakuma-lymph node akho noma kuma-pancreas.

Iyini i-prognosis yomdlavuza we-parathyroid?

Ukubikezela komdlavuza we-parathyroid kuncike ekutheni ukuhlinzwa kokususa i-parathyroid gland kuphelele kangakanani lapho utholakala okokuqala, njengoba izinketho zokwelapha zesibili ezifana nokwelashwa ngemisebe kanye ne-chemotherapy zilinganiselwe.

Kubantu abanomdlavuza we-parathyroid abaye bahlinzwa ngokuhlinzwa futhi abanezinkinga ezingezinhle, izinga lokusinda liphezulu ngamaphesenti angama-90% eminyakeni emihlanu ngemva kokuhlinzwa kokuqala. Izinga lokusinda liphezulu ngamaphesenti angama-67% eminyakeni eyishumi ngemva kokuhlinzwa kokuqala.

Abantu abangaphezu kwengxenye abatholakale benomdlavuza we-parathyroid futhi abahlinzwa ukuze kususwe indlala bazophinde babhekane nomdlavuza. Kulezi zimo, umdlavuza uvame ukubuya phakathi neminyaka emibili kuya kwemihlanu kusukela ohlinzweni lokuqala. Kodwa-ke, ungabuya emashumini eminyaka kamuva.

Ingabe umdlavuza we-Parathyroid ungavinjelwa?

Ngeshwa, ayikho indlela eyaziwayo yokuvimbela umdlavuza we-parathyroid. Futhi, ayikho indlela yokunciphisa ingozi yokuthola lesi sifo. Uma kukhona emndenini wakho oke waba nezinkinga ze-parathyroid gland, kuwumqondo omuhle ukukhuluma nodokotela wakho.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma unomdlavuza we-parathyroid, ungase ufune ukubuza udokotela wakho imibuzo efana nale:

• Ingabe umdlavuza ususakazeke ngale kwendlala yami ye-parathyroid?
• Yikuphi ukwelashwa okungcono kakhulu komdlavuza we-parathyroid?
• Ziyini izingozi nemiphumela emibi yokwelashwa?
• Ingabe umndeni wami usengozini yokuthola umdlavuza we-parathyroid?
• Ngingaphinde ngibe nomdlavuza we-parathyroid?
• Ingabe ngisengozini yokuthola ezinye izinhlobo zomdlavuza?
• Ngizodinga ukunakekelwa okulandelayo okunjani ngemva kokwelashwa?
• Ingabe kufanele ngiqaphele izimpawu zezinkinga?

Okokugcina, izinto okufanele uzikhumbule

Ukutholwa unomdlavuza kungaba yinto eyesabekayo. Kodwa khumbula,Ithimba lakho lezokwelapha lilapha ukuzokusiza futhi likubonise indlela engcono kakhulu yokwelapha. Nakuba ukuhlinzwa okwamanje kuyindlela yokwelapha kuphela umdlavuza we-parathyroid, ucwaningo kanye nokwelashwa komdlavuza kuyaqhubeka kuthuthuka. Kungase kube nokuhlolwa kwezokwelapha ongahlanganyela kukho. Ngakho-ke, ungesabi ukubuza udokotela wakho imibuzo mayelana nomdlavuza wakho we-parathyroid. Qiniseka ukuthi konke kuchazwa ngendlela oyiqondayo.

Umdlavuza we - Parathyroid, Izindlala ze-Parathyroid, i-Hypercalcemia, i-Parathyroid Hormone, i-PTH, Izimpawu Zomdlavuza, Ukwelashwa Komdlavuza, Ukuhlinzwa