Umdlavuza womlomo wesibeletho yiyona eyakheke kabi kakhulu ohlelweni lwezokuzala emhlabeni jikelele; ungowesibili evamile kubesifazane emva komdlavuza webele. Kuvame ukutholakala kulabo besifazane abaneminyaka engama-45 kuya kwengu-50, kodwa kungenzeka futhi ngesikhathi esincane. Isibalo siphezulu emazweni asathuthuka. Ngokwesibonelo, eNdiya, umdlavuza womlomo wesibeletho uyimbangela evamile yokufa phakathi kwabesifazane abaneminyaka engama-35 kuya ku-45. ERussia, isilinganiso senani labantu abalinganiselwa ku-11 ngamaphesenti angu-100 000. Ukuxilongwa komdlavuza womlomo wesibeletho - isihloko sendaba.
Ukwakhiwa kokukhubazeka
Kukhona umehluko esihlakalweni somdlavuza womlomo wesibeletho emaqenjini ahlukahlukene ezomphakathi nezomnotho ngaphakathi kombuso owodwa. Ngokwesibonelo, e-US, abesifazane abamnyama cishe cishe kabili bahlushwa umdlavuza wesibeletho kunabesifazane abamhlophe, kodwa lokhu kubonisa indlela yokuphila engezansi kanye nokufinyelela okungenele kwezinsizakalo zezempilo kunezizwe ezithintekayo. Ezifundweni ezenziwa eScotland, kwavela imiphumela efanayo: phakathi kwabesifazane abanemali ephansi, ingozi yomdlavuza wesibeletho yanda kathathu uma iqhathaniswa nabesifazane abacebile kakhulu.
Izinhlobo zomdlavuza wesibeletho
I-Squamous cell carcinoma yindlela ejwayelekile kunazo zonke zomdlavuza womlomo wesibeletho, okubalwa ngamacala angu-90%. Ithinta amangqamuzana epithelium flat efaka umlomo wesibeletho. Nokho, njengamanje, i-adenocarcinoma (i-tumor evela epithelium eyimfihlo) iyaba yinto evamile kakhulu. Yisiteji sesifo, hhayi ukubunjwa kwamaselula kwesisu, esinquma isifo sesiguli.
I-Valueing Screening
Emazweni athuthukile, isifo se-squamous cell carcinoma yomlomo wesibeletho sinqabile eminyakeni yamuva, ngenxa yokutholakala kokuqala ngesikhathi sokuhlolwa nokuphathwa ngempumelelo kwemibandela eqondile. Ukuhlola akusebenzi ngendlela efanele ekutholeni i-adenocarcinoma; mhlawumbe lokhu kungenye yezizathu zokwanda kwenani lezinkinga zalesi sifo. I-pathology ye-cervix ingatholakala ngesikhathi sokuhlolwa komzimba. Ngaphambili umdlavuza utholakala, izinga eliphezulu lokusinda kwesiguli. Izizathu zokuthuthukiswa komdlavuza womlomo wesibeletho azange zichazwe ngokugcwele, noma kunjalo, ubuhlobo bayo ne-papillomavirus yomuntu (HPV) buye kwafakazelwa ngokuthembeka. Kunezinhlobo ezingaziwa ezingu-70 zalesi sifo. Izinhlobo 16,18, 31 no-33 ziyi-oncogenic (ezikwazi ukudala ukuguqulwa kweseli okulimazayo) futhi zihlobene nokuthuthukiswa komdlavuza wesibeletho.
Umsebenzi wocansi
Ukuqala kokuqala kocansi, futhi izinguquko ezivamile kubalingani bobulili zandisa ingozi yokuthuthukisa umdlavuza wesibeletho esikhathini esizayo. E-electron microscopy igciwane lomuntu le-papilloma linokubukeka okuphawulekayo. Ezinye zezinhlobo zawo zihlotshaniswa nomdlavuza wesibeletho. Ngaphezu kwalokho, amathuba akhe aphakeme uma umlingani wegciwane anezicansi eziningi zobulili nabanye besifazane. Kucatshangwa ukuthi ukubhema kuhlotshaniswa nengozi enkulu yokwenza umdlavuza wesibeletho.
I-Immunosuppression
Abesifazane abanesandulela-ngculazi banciphekile kakhulu ukuba babe ne-cervical carcinoma engavamile (i-cervical intraepithelial neoplasia - CIN). Iziguli ezithola imithi yokugonywa kwezidakamizwa, isibonelo, ukufakelwa kwesifo sezinso, ziyingozi kakhulu. Ukutheleleka ngegciwane lesandulela ngculazi, kuhambisane nokucindezelwa kwesimiso somzimba, futhi kwandisa amathuba okuthuthukisa lesi sifo. Kuyaziwa ukuthi umdlavuza womlomo wesibeletho ulandelwa izinguquko zangaphambi kokuhlasela (precancerous) ezibonakalayo ku-mucosa. Ngalesi sigaba, i-foci ye-pathological epithelium engenasifo yomlomo wesibeletho inendawo ethile esendaweni yokuguqulwa kwe-ectocervix (i-lining of the vaginal part of the cervix) engxenyeni yomlomo wesibeletho. Lezi zinguquko zingashintshwa zibe ngumdlavuza lapho kungekho khona ukwelashwa.
Ukutholakala kokuqala
Izinguquko zangaphambi kweqanda ku-epithelium yomlomo wesibeletho kanye nezinyathelo zokuqala zomdlavuza, ezenzeka ngokungafani, zivezwe ngesikhathi kuhlolwa isifo somlomo esibelethweni. Amaseli e-epithelial avela kumlomo wesibeletho athunyelwa kwisifundo se-cytological (ukuhlaziywa kwezakhi zesisindo). Kulesi silungiselelo sakhe, amaqembu amangqamuzana e-epithelium yomlomo wesibeletho abonakalayo. Ngesikhathi sokuhlola, wonke amaseli ahlolwe ukuguqulwa kwamathambo. Lapho imiphumela ye-pathological yokuhlolwa kwe-cytological ye-smear itholakala, isiguli sithunyelwa nge-colposcopy.
I-Colposcopy
I-colposcopy ihlolwe ukubonwa komlomo wesibeletho nomugqa ophezulu ngedivayisi endoscopic. Izindlela zobuchwepheshe ze-colposcopy zikuvumela ukuba uhlole umlomo wesibeletho ngaphansi kwenyuka futhi ungafaki ukutholakala kwama-neoplasms ebonakalayo, izidakamizwa noma izilonda ebusweni. Phakathi naleso sifundo, kungenzeka ukukhiqiza ama-biopsies amathishu ukuze ahlaziywe. Ngosizo lwe-colposcope, ungakwazi ukukhanyisa umlomo wesibeletho futhi ubuke ngaphansi kokukhuliswa ukuze uthole izinguquko zomdlavuza ekuqaleni. Ukuze kunqume ukusabalalisa kwenqubo ye-tumor, ukuhlolwa kwe-vaginal (amabili) kwesinye isisu noma ukuhlolwa kwamagciwane kwenziwa. Kwezinye izimo, ukuhlola usayizi nokusabalalisa kwenqubo yezinkinga, ukuhlolwa kwenziwa ngaphansi kwe-anesthesia. Ukuhlukaniswa komdlavuza womlomo wesibeletho kubonisa ukusabalalisa kwenqubo ye-tumor. Ukunquma isigaba somdlavuza kubalulekile ekukhetheni indlela yokwelashwa nokubikezela. Kunezigaba ezine (i-MV), ngayinye ehlukaniswe ibe yizigaba ezincane a no-b. Izitebhisi a ne b zihlukaniswe ngo-1 no-2. Ngokwezigaba ze-FIGO (International Federation of Obstetricians and Gynecologists), isigaba sesi-0 sifana nezinguquko ezingenakuqhathaniswa, kanti i-IVb isiteji esikhulu kakhulu. Izinga lokubandakanya i-pelvic ne-para-aortic (ezungezile i-aorta) lymph nodes landa ngokukhula kwesiteji.
I-carinoma engaphambi kokuqala
Umdlavuza omangalisa, onomkhawulo wesibeletho. Umdlavuza omangele, owenziwe kuphela nge-microscopy. I-Cancer ihluma i-stroma yomlomo wesibeletho ngobukhulu obungaphezu kuka-5 mm nobubanzi obungaphezu kuka-7 mm. I-Cancer ihluma i-stroma ibe ngaphezu kwama-3 mm nobubanzi obungaphezu kwama-7 mm. Ukujula kokuhluma ku-stroma kusuka ku-3 ukuya ku-5 mm nobubanzi obungaphezulu kwama-7 mm. Amakhansela ebonakalayo emitholampilo ngaphakathi komlomo wesibeletho noma i-lesion ezincane kakhulu ezitholakalayo kunezigaba. Isilonda esibonakalayo emitholampilo akusilo ngaphezu kwe-4 cm. Isilonda esibonakalayo emitholampilo esingaphezu kuka-4 cm. I-Cancer isakazwa ngaphesheya komlomo wesibeletho kuya kwesiswini noma izicubu ezizungezile. I-Cancer eyasakazwa ngaphesheya komlomo wesibeletho kuya ezingxenyeni ezingaphezu kwezintathu zesiswini. I-Cancer isakaze ngaphesheya komlomo wesibeletho kuya kwezicubu ezixhumene nazo. I-Cancer isakazekele ezindongeni eziseceleni zesifuba noma kwisithathu esingaphansi kwesiguli. Lesi sifo sithinta isithathu esingaphansi kwesiguli, kepha asifinyeleli ezindongeni eziseceleni zesifuba. I-Cancer enokusabalalisa ezindongeni eziseceleni zesikhumba noma ama-ureters. I-Cancer isakaze ngaphesheya kwesikhumba noma ukubandakanya kwesinye nesisu noma / noma i-rectum. I-Cancer isakazwe ezitho ezingomakhelwane
Umlomo wesibeletho
I-carinoma yomlomo wesibeletho esandulele ihambisana nesigaba esinzima se-neoplasia ye-intraepithelial ne-copical (CIN). I-CIN ihlukaniswa ngokusho kokusakazeka kokusabalalisa kwenqubo ye-tumor epithelium, futhi nangesilinganiso sokuhlukaniswa kwamangqamuzana omzimba:
• I-CIN I - izinguquko azithathi ngaphezu kwe-1/3 yobukhulu besendlalelo se-epithelial;
• I-CIN II - izinguquko zithatha 1/2 ubukhulu besendlalelo se-epithelial;
• I-CIN III - ithinta lonke ubukhulu be-epithelium.
Lapho amangqamuzana angavamile ehluma isitho senyakatho se-epithelium, khuluma ngokuguqulwa kwe-precancer kumdlavuza wokuhlasela. Ku-20% kuzo zonke iziguli ezine-CIN III, ngokungabikho kokwelashwa eminyakeni eyishumi elandelayo, umdlavuza womlomo wesibeletho uqala.