Umhlaza wesibeleko ngowona luhlobo olulona lubi kakhulu lwenkqubo yokuzala isetyhini emhlabeni wonke; Ungowesibini oqhelekileyo kubasetyhini emva komhlaza wesifuba. Ngokuqhelekileyo kufumaneka kubasetyhini abaneminyaka engama-45 ukuya kuma-50, kodwa inokuthi iyenzeka nokuba yinto esemncinci. Iziganeko ziphezulu kumazwe asathuthukayo. Ngokomzekelo, eIndiya, umdlavuza wesibeleko ngowona nto ibangela ukufa kubantu besetyhini abaneminyaka engama-35 ukuya kwe-45. E-Rashiya, izinga lezenzalo limalunga nama-11 angama-100 000 abantu. Ukuxilongwa komhlaza wesibeleko - umxholo wale nqaku.
Ulwakhiwo lobuthathaka
Kukho iintlukwano kwiziganeko zomhlaza wesibeleko kumaqela ahlukeneyo kwintlalo-qoqosho kwilizwe elinye. Ngokomzekelo, e-US, amabhinqa amnyama aphindwa kabini ukuba ahlupheke ngumhlaza wesibeleko kunabamhlophe abamhlophe, kodwa oku kubonakalisa izinga lokuphila eliphantsi kunye nokufikelela ngokungeneli kwiinkonzo zempilo kunokuba kubekho ubuhlanga. Kuphando oluqhutyelwe eScotland, kukho iziphumo ezifanayo: phakathi kwabasetyhini abaneemali eziphantsi, umngcipheko wesibeleko somlomo wesibeleko ukwanda kathathu xa kuthelekiswa nabasetyhini abaninzi.
Iintlobo zesifo somhlaza wesibeleko
I-Squamous cell carcinoma yindlela eqhelekileyo yomhlaza womlomo wesibeleko, obala ngaphezu kwama-90% amacala. Ichaphazela iiseli ze-epithelium eplatile ebandakanya umlomo wesibeleko. Nangona kunjalo, okwangoku, i-adenocarcinoma (i-tumor evela kwi-epithelium eyimfihlo) iyaba yinto eqhelekileyo. Yilona nqanaba lesifo, kwaye akukhona ukubunjwa kwamaselula e-tumor, esenza isigqibo sesi sifo kwisigulane.
Ixabiso lokuhlola
Kwamazwe athuthukileyo, iziganeko ze-squamous cell carcinoma yomlomo wesibeleko ziye zancipha kwiminyaka yamuva, ngenxa yokufumanisa kwangaphambili ngexesha lokuhlola kunye nokunyanga ngempumelelo kweemeko ezinqabileyo. Ukuhlola i-screening akusebenzi kakuhle ekufumaneni i-adenocarcinoma; mhlawumbi esinye sesinye sezizathu zokunyuka kwenyani kwinani lamatyala esi sifo. Ukukhubazeka kwe-cervix kunokufunyanwa ngexesha lokuhlolwa kwe-gynecological. Ekuqaleni umhlaza ufunyaniswa, umlinganiselo ophezulu wokusinda kwesigulane. Izizathu zokuphuhliswa komhlaza wesibeleko azizange zichazwe ngokupheleleyo, nangona kunjalo, ulwalamano lwawo kunye nepapillomavirus yabantu (HPV) luye lwafakazelwa ngokuqinisekileyo. Kukho iintlobo ezingaphezu kwezingama-70 ezaziwayo kule ntsholongwane. Iintlobo 16,18, 31 kunye ne-33 zi-oncogenic (ezinokubangela ukuchithwa kwesalathisi esibi) kwaye zidibene nokuphuhliswa komhlaza wesibeleko.
Umsebenzi wesondo
Ukuqalisa kokuqala ngokwesondo, kwaye utshintsho oluqhelekileyo kumaqabane olwabelana ngesondo lukhulisa umngcipheko wokuba nomhlaza wesibeleko kwikamva. Kwi-electron microscopy i-virus yamagciwane e-papilloma inempawu ezibonakalayo. Ezinye zeentlobo zawo zidibene nomhlaza wesibeleko. Ukongezelela, ubuncwane bakhe buphezulu xa iqabane lomguli linalo ubudlelwane obuninzi bezesondo nabanye abafazi. Kukholelwa ukuba ukutshaya kudibaniswa nomngcipheko wokwanda komhlaza wesibeleko.
Ukunyuswa kwamagciwane
Abasetyhini abane-immunity encinci banomngcipheko ophezulu wokuhlakulela i-cervical carcinoma (inzala ye-intraepithelial neoplasia-CIN). Izigulane ezifumana ukunyuswa kwe-immunosuppression, okuyiyo, ukuguqulwa kweengso, ziyingozi. Usuleleko lwe-HIV, oluhamba kunye nokuxothwa kwe-immune system, lwandisa amathuba okuphuhlisa eso sifo. Kuyaziwa ukuba umdlavuza wesibeletho ulandelelwe ngokubonakalayo kwangaphambili (inqabileyo) utshintsho kwi-mucosa. Kule nqanaba, i-pathological foci kwi-epithelium engenasiphelo yomlomo wesibeleko inendawo ethile kwindawo yeshintsho ye-ectocervix (ibhande le-vaginal of the cervix) kwi-canal yomlomo. Ezi zinguqu zinokuguqulwa zibe ngumdlavuza ekungabikho unyango.
Ukufumanisa kwangaphambili
Utshintsho lwangaphambili kwi-epithelium yomlomo wesibeleko kunye nezigaba zokuqala zomhlaza, ezenzeka ngokungaqhelekanga, zityhilwa ngexesha loviwo lwe-smear ukusuka kwisibeleko ngexesha lokuhlola. Iiseli ze-epithelial ezivela kumlomo zithunyelwa kwisifundo se-cytological (uhlalutyo lwesakhiwo seeseli). Kulolu lungiselelo lwe-hertological, amaqela eeseli ze-epithelium yesibeleko abonakalayo. Ngethuba lokuhlola, zonke iiseli zihlolwe ukutshintsha kweentsholongwane. Xa iziphumo zesifo se-cytological of smear zifunyenwe, isigulane sithunyelwa kwi-colposcopy.
Colposcopy
I-Colposcopy iyimviwo ebonakalayo yomlomo wesibeleko kunye ne-upper femin nge-endoscopic device. Ubungakanani bezobugcisa bekholposcopy kukuvumela ukuba uhlolisise umlomo wesibeleko ngaphantsi kwenyuka kwaye ungabandakanyi ubukho bezinto ezingabonakaliyo, izidumbu okanye izilonda ebusweni. Ngethuba lokufunda, kunokwenzeka ukuvelisa ii-biopsies zamathambo ukuhlalutya. Ngoxa uncediswa yi-colposcope, unokwazi ukukhanyisa umlomo wesibeleko uze ukhangele phantsi kokuphakanyiswa ukuze ufumane utshintsho lomhlaza kwinqanaba eliqala. Ukuqaphela ukusabalalisa kwenkqubo yokutya, inxalenye ye-bimanual (yesibini isandla) i-vaginal examination or rectal examination. Kwezinye iimeko, ukujonga ubungakanani kunye nokuxhaphaka kwenkqubo yokugula, uviwo luqhutywa phantsi kwe-anesthesia. Ukuhlonywa komhlaza wesibeleko kubonisa ukusabalalisa kwenkqubo yokutya. Ukuqaphela isigaba somhlaza kubalulekile ekukhetheni indlela yokonyango kunye nokuxela. Kukho amanyathelo amane (MV), nganye ekwahlula kwiinqanaba eziphantsi kunye kwaye b. Amagatya a kwaye b ahlukaniswe ngo-1 no-2. Ngokwezihlomelo ze-FIGO (i-International Federation of Ostrijians and Gynecologists), isigaba 0 sihambelana nokutshintsha kwangaphambili, kwaye i-IVb isigaba esona sikhulu. Iqondo lokubandakanyeka kwe-pelvic kunye ne-para-aortic (ejikelezayo i-aorta) i-lymph node yanda ngokunyuka kwinqanaba.
Preinvasive carcinoma
Umhlaza osasazekayo, umda wesibeleko. Umdlavuza othakazelisayo, owenziwe kuphela nge-microscopy. I-Cancer ihluma i-stroma ye-cervix ngobukhulu obungaphezu kwama-5 mm kunye nobubanzi obungaphezulu kwama-7 mm. I-cancer ihluma i-stroma ukuya kwi-3 mm engaphezulu kunye nobubanzi obungaphezu kwama-7 mm. Ubunzulu bokuhluma kwi-stroma ukusuka kwi-3 ukuya kwi-5 mm kunye nobubanzi obungaphezulu kwama-7 mm. Amanqamane ebonakalayo ekliniki ngaphakathi komlomo wesibeleko okanye i-lesion microscopically ebonakalayo inkulu ngaphezu kwesigaba. Isilonda esibonakalayo esikliniki asikho ngaphaya kwe-4 cm. Isilonda esibonakalayo se-Clinic esingaphezu kwe-4 cm. I-cancer iyasasazeka ngaphaya komlomo wesibeleko ukuya kumfazi okanye kwiisisombululo ezijikelezayo. I-Cancer isasazeka ngaphaya komlomo wesibeleko ukuya kumacala amabini aphezulu kwisondo. I-Cancer isasazeka ngaphaya komlomo wesibeleko kwiisisombululo ezijikelezayo. I-Cancer isasazeka kwiindonga zecala le-pelvis okanye kwisithathu esezantsi kwisini. I-tumor iyathintela kwisithathu esezantsi kwesigxina, kodwa ayithethi kwiindonga zecala. I-Cancer isasazeka kwiindonga zecala le-pelvis okanye i-ureters. I-Cancer isasaze ngaphaya kwesikhumba sekhanda okanye ukubandakanyeka kwesigxina kunye / okanye i-rectum. I-Cancer isasazeka kwizitho ezingummelwane
Umlomo wesibeleko
I-preinvasive cervical carcinoma ihambelana nesigaba esinzima se-intraepithelial neoplasia (CIN). I-CIN ihlelwe ngokuxhomekeka kokusasazeka kwenkqubo ye-tumor kwi-epithelium, kunye neqondo lokwahlukana kweeseli zesisu:
• I-CIN I - utshintsho aluthathi ngaphezu kwe-1/3 yobunzima bomgca we-epithelial;
• ICIN II - utshintsho kuthatha i-1/2 ubukhulu bomgca we-epithelial;
• ICIN III - ithintela ubungqina be-epithelium.
Xa iiseli ezingaqhelekanga zihluma i-membrane ye-epithelium, thetha malunga nokuguqulwa kwe-precancer kumdlavuza otshabalalayo. Kwi-20% yazo zonke izigulane ezine-CIN III, ekungabikho unyango kwiminyaka eyi-10 ezayo, umhlaza wesibeleko ukhula.