Ukucacisa uLimi Lwezindlela Zakho Zokuhlolwa
Kungaba ukwesaba ukuthola imiphumela yakho ye-Pap smear kudokotela wakho. "Okuvamile" kulula ukuyiqonda. Kodwa-ke, uma une-Pap smear engavamile , kungaba nzima ukwazi ukuthi imiphumela yikho yini okudingayo ukuba ukhathazeke ngayo. Lo mhlahlandlela weziphumo ezingavamile zeP Pap smear kuzokusiza ukuthi uqonde ukuthi udokotela wakho uzama ukukutshela. Uma uqonda ngokwengeziwe, kuzoba lula ukwenza izinqumo ezinolwazi mayelana nokunakekelwa kokulandelwa.
Okujwayelekile
Umphumela ovamile wePap smear usho ukuthi wonke amaseli esampula abukeka ngendlela okufanele ayenze ngayo. Ukulandela okulandelayo akukhonjiswa. Kufanele uqhubeke ukuhlolwa ngokulandela imihlahlandlela yamanje.
ASCUS
I-ASCUS imelela ama- Atypical Squamous Cell of Value Not Determined. Ngamanye amazwi, kunama- squamous amangqamuzana angabheki ajwayelekile. Noma kunjalo, lawo maseli awavamile okwanele okubhekwa njenge- dysplasia .
I-ASCUS yiyona imiphumela evamile kakhulu yePap smear. Ngokuvamile akukho okumele ukhathazeke ngakho. Nakuba i- ASCUS ingabangelwa ukutheleleka kokuqala kwe- HPV , ukuxilongwa kwe-ASCUS kungase kube ngenxa yokucasula kusuka ocansini noma ngisho nohlelo olubi lwe-Pap smear. Ukutholakala kwe-ASCUS kuzovame ukuxazulula ngokuzenzekelayo ngokuhamba kwesikhathi ngaphandle kokungenelela noma ukwelashwa.
Ukulandelwa kwe-ASCUS kuvamise ukuphinda iP smear ezinyangeni eziyisithupha. Uma lokho kungokwemvelo, akudingeki ukulandelwa okulandelayo. Ngaleso sikhathi, isiguli singabuyela esimisweni esijwayelekile sokuhlola.
Ngaphandle kwalokho, iziguli ezitholwe nge-ASCUS zingahlolwa i-HPV. Khona-ke, noma ubani onomthelela ophezulu ozobe engcupheni angathunyelwa ukuze aqhubeke nokulandelwa, njenge- colposcopy noma i- LEEP . Imihlahlandlela yokulandelwa iyahlukahluka nobudala kanye nesimo sokukhulelwa, kepha i-ASCUS ayidingi ukulandela ukulandelela noma ukwelashwa okunonya.
I-SIL
I-SIL ingenye enye imiphumela evamile yeP Pap smear. Isichazamazwi sisho lesi sifo se-squamous intraepithelial. Izilonda ze-intraepithelial ezincane ziyizingqamuzana ezishintshiwe ngendlela ebonisa ukuthi ekugcineni bangaba nomdlavuza. Lokhu, Nokho, akusho ukuthi bazoba nomdlavuza. Ngisho nangaphandle kokwelashwa, amacala amaningi e-SIL azozixazulula eyedwa.
Ukuxilongwa kwe-lesion ye-intraepithelial lesi sifo kungenziwa ngezigaba ezimbili: ibanga eliphezulu nebanga eliphansi. Lezi zixhumanisi ku- CIN 1 no-CIN 2 noma 3 ukuxilongwa, ngokulandelana.
I-LSIL / I-CIN 1: Izilonda ezincane ze-intraepithelial squamous (LSIL) cishe ziyisibonakaliso sokuthi owesifazane usulele nge-HPV. Lokhu ukuxilongwa kusho ukuthi udokotela ofunda i -Pap smear noma i- biopsy uye wabona izibonakaliso ezibukeka sengathi ziqala ngaphambi komdlavuza.
Ukuxilongwa kwe-LSIL akuvamile. Bavame ukuzixazulula ngokwabo ngaphandle kokwelashwa. Kubesifazane abancane kakhulu, ukulandelela ngokuvamile kuvame ukuphinda u-Pap smear ezinyangeni eziyisithupha noma ezingu-12. Kwabesifazane asebekhulile, abesifazane abaneminyaka yokuzala, i-American College of Obstetrics kanye ne-Gynecology (ACOG) imihlahlandlela iphakamisa i- colposcopy ukuthola inani lomonakalo. AYIKHO ukuthi batusa ukwelashwa. Kulaba besifazane abakwa-post-menopausal, ukulandelela kungase kube iPs smear ephindaphindiwe, i- HPV test , noma i-colposcopy.
Ngenxa yokuthi i-LSIL ihlala iphulukisa yedwa, odokotela abaningi bakhuthaza indlela engavamile yokulandelela esikhundleni sokwelapha. Eqinisweni, imihlahlandlela ye-ACOG ithi i-CIN 1 / LSIL akufanele iphathwe ngaphandle uma iqhubeka iminyaka engaphezu kwengu-2, iqhubekela phambili ku-CIN 2 noma i-CIN 3, noma ezinye izici zezokwelapha zihilelekile. Kodwa-ke, ukwelapha ngokweqile, kusekujwayelekile. Ngesinye isikhathi lapho abantu bezwa inkulumo ethi "amangqamuzana angaphambi komdlavuza" banquma ukuthi bangathanda ukuphepheka kunokudabuka, ngisho nalapho ukwelashwa kungaba nemiphumela emibi kakhulu.
I-HSIL / i-CIN 2-3: Izilonda eziphezulu ze-intraepithelial (HSIL) zezinga eliphezulu ziba nomdlavuza wesibeletho kuneLSIL.
Kodwa-ke, eziningi zalezi zilonda zilokhu zizibuyisa zodwa. I-carcinoma in situ, noma i-CIS, ifomu elibi kunazo zonke le-HSIL futhi okungenzeka ukuthi lizoqhubeka nomdlavuza. I-CIS ingatholakala futhi njengeCIN 3.
Imihlahlandlela ithi wonke owesifazane otholakala ene-HSIL nge-Pap smear kufanele alandelwe yi-colposcopy. Ngenkambinkimbi ye - colposcopy , izilonda zingase zibe ne-biopsied, noma zingase ziphathwe yi- LEEP , conization , congress (cryotherapy), noma i-laser therapy. Ngezilonda ezincane ezanele, i-punch biopsy ingase isetshenziswe njengokwelashwa.
ASC-H
Lesi sichazamazwi esibucayi sibhekene nokuxilongwa "amangqamuzana e-squashous atypical, angeke akhiphe i-HSIL." Ngokuyisisekelo kusho ukuthi odokotela banenkinga yokuthola ukuxilongwa. Ungase ube ne-HSIL, kungenzeka ukuthi awukho. Odokotela abakwazi ukutshela ngaphandle kokuhlolwa okunye. Kunconywa ukulandelwa nge- colposcopy .
AGC
Amaseli we-atypical glandular (AGC) abhekisela ekuguqulweni komlomo wesibeletho okwenzeki okwenziwe nge- epithelium e- squamous . Esikhundleni salokho, amangqamuzana angavamile amangqamuzana abonakala esampheni. Lo mphumela ubonisa ukuthi kungaba nomdlavuza ezingxenyeni ezingaphezulu zomlomo wesibeletho noma kwesibeletho.
Ukulandelwa kwe-AGC kungafaka ikholpocopy, ukuhlolwa kwe-HPV, kanye nesampula kwendwangu yomlomo wesibeletho (i-endocervix) nesisu (i-endometrium). Ukukhethwa kokulandela okulandelako kuncike ekutheni izinhlobo ezinjani zamaseli angavamile abonakala ku-smear. Ukwelashwa kwe-AGC, uma kunesidingo, kuyingozi kakhulu kunokwelashwa kwezilonda ze-squamous cell.
I-Cancer
Uma uthola ukuthi unesifo somdlavuza womlomo wesibeletho , kusho ukuthi umonakalo wesibeletho sakho awusekho nje. Mhlawumbe uzothunyelwa ku- oncologist ukuze ulandele phambili nokulandela ukwelashwa. Izinga lokwelapha lizohluka ngobukhulu bomdlavuza wakho.
Imithombo:
> IKomiti ye-ACOG ye-Practice Bulletins - iGynecology. I-ACOG Yokufundisa Bulletin no. 109: Ukuhlolwa kwe-cervical cytology. I-Obstet Gynecol. 2009 Dec; 114 (6): 1409-20. doi: 10.1097 / AOG.0b013e3181c6f8a4.
> Corbelli J, Borrero S, Bonnema R, McNamara M, Kraemer K, Rubio D, Karpov I, McNeil M. Umehluko phakathi kokunakekelwa kwabahlengikazi odokotela bokuqala ukunakekelwa kuka-2009 I-ACOG iziqondiso zokuhlolwa komdlavuza wesibeletho. J Womens Health (Larchmt). May Meyi 2014; 23 (5): 397-403. doi: 10.1089 / jwh.2013.4475.
> Munk AC, Kruse AJ, van Diermen B, Janssen EA, Skaland I, Gudlaugsson E, Nilsen ST, Baak JP. Izilonda ze-3 ze-neoplasia ze-neervlasia ze-cervical zingaphenduka. I-APMIS. 2007 Dec; 115 (12): 1409-14. i-doi: 10.1111 / j.1600-0463.2007.00769.x.