Khansara ya chiberekero

Khansara ya chiberekero ndi khansa yomwe imayamba m'chibelekero. Khomo lachiberekero ndilo gawo lotsika la chiberekero (chiberekero) lomwe limatsegukira kumtunda kwa nyini.

Padziko lonse lapansi, khansa ya pachibelekero ndi mtundu wachitatu wofala kwambiri wa khansa mwa azimayi. Ndizofala kwambiri ku United States chifukwa chogwiritsa ntchito Pap smears.

Khansara ya chiberekero imayamba m'maselo omwe ali pamwamba pa khomo lachiberekero. Pamwamba pa khomo lachiberekero pali mitundu iwiri yamaselo, squamous and columnar. Khansa zambiri za khomo lachiberekero zimachokera m'maselo oopsa.

Khansa ya pachibelekero nthawi zambiri imayamba pang'onopang'ono. Imayamba ngati vuto lotha kusamba lotchedwa dysplasia. Vutoli limatha kupezeka ndi Pap smear ndipo limachiritsidwa pafupifupi 100%. Zitha kutenga zaka kuti dysplasia ipange khansa ya pachibelekero. Amayi ambiri omwe amapezeka kuti ali ndi khansa ya pachibelekero lero sanapezeke ndi Pap smear, kapena sanatsatire zotsatira zachilendo za Pap smear.

Pafupifupi khansa yonse ya khomo lachiberekero imayamba chifukwa cha papillomavirus ya anthu (HPV). HPV ndi kachilombo kofala kamene kamafalikira kudzera pakhungu pakhungu komanso kugonana. Pali mitundu yosiyanasiyana (mitundu) ya HPV. Matenda ena amatsogolera ku khansa ya pachibelekero. Matenda ena amatha kuyambitsa maliseche. Zina sizimayambitsa mavuto alionse.

Zizolowezi zogonana ndi zikhalidwe za amayi zitha kuonjezera chiopsezo chotenga khansa ya pachibelekero. Zochita zogonana zowopsa zimaphatikizapo:

• Kugonana adakali aang'ono
• Kukhala ndi zibwenzi zingapo
• Kukhala ndi bwenzi kapena okondedwa ambiri omwe amatenga nawo mbali pachiwopsezo chogonana

Zina mwaziwopsezo za khansa ya pachibelekero ndi monga:

• Osalandira katemera wa HPV
• Kukhala osauka pachuma
• Kukhala ndi mayi yemwe adamwa mankhwala a diethylstilbestrol (DES) ali ndi pakati koyambirira kwa ma 1960 kuti ateteze kupita padera
• Kukhala ndi chitetezo chamthupi chofooka

Nthawi zambiri, khansa yoyambirira ya khomo lachiberekero ilibe zisonyezo. Zizindikiro zomwe zingachitike ndi monga:

• Kutuluka kwachilendo kumaliseche pakati pa msambo, mutagonana, kapena mutatha kusamba
• Kutulutsa kumaliseche komwe sikumaima, ndipo kumatha kukhala kotuwa, madzi, pinki, bulauni, wamagazi, kapena wonunkha
• Nthawi zomwe zimakhala zolemera komanso zimakhala zazitali kuposa masiku onse

Khansara ya chiberekero imatha kufalikira kumaliseche, ma lymph node, chikhodzodzo, matumbo, mapapo, mafupa, ndi chiwindi. Nthawi zambiri, palibe zovuta mpaka khansara itakula ndikufalikira. Zizindikiro za khansa yapachibelekero ingaphatikizepo:

• Ululu wammbuyo
• Kupweteka kwa mafupa kapena mafupa
• Kutopa
• Kutuluka mkodzo kapena ndowe kuchokera kumaliseche
• Kupweteka kwa mwendo
• Kutaya njala
• Kupweteka kwa m'mimba
• Mwendo umodzi wotupa
• Kuchepetsa thupi

Kusintha kwa khomo pachibelekeropo ndi khansa ya pachibelekero sikuwoneka ndi maso. Kuyesedwa kwapadera ndi zida zofunikira kumafunikira kuti muwone izi:

• Pap smear imawunikira ma precancers ndi khansa, koma siyimaliza matenda.
• Kutengera msinkhu wanu, kuyesa kwa DNA ya papillomavirus (HPV) kumatha kuchitidwa limodzi ndi mayeso a Pap. Kapenanso atha kugwiritsidwa ntchito mayi atalandira zotsatira zachilendo za mayeso a Pap. Itha kugwiritsidwanso ntchito ngati mayeso oyamba. Lankhulani ndi omwe amakuthandizani pa zaumoyo kuti ndi mayeso ati omwe angakuyenerereni.
• Ngati zosintha zachilendo zimapezeka, khomo lachiberekero limayesedwa ndikukulitsa. Njirayi imatchedwa colposcopy. Zidutswa za minofu zimatha kuchotsedwa (biopsied) panthawiyi. Minofu imeneyi imatumizidwa ku labu kuti ikaunikidwe.
• Njira yotchedwa cone biopsy itha kuchitidwanso. Iyi ndi njira yomwe imachotsa mphete yooneka ngati kondomu kutsogolo kwa khomo lachiberekero.

Ngati khansa yachiberekero ikupezeka, woperekayo adzaitanitsa mayeso ena. Izi zimathandiza kudziwa momwe khansara yafalikira. Izi zimatchedwa staging. Mayeso atha kuphatikiza:

• X-ray pachifuwa
• Kujambula kwa CT m'chiuno
• Zojambulajambula
• Mitsempha yotchedwa pyelogram (IVP)
• MRI ya mafupa a chiuno
• Kujambula PET

Chithandizo cha khansa ya pachibelekero chimadalira:

• Gawo la khansa
• Kukula ndi mawonekedwe a chotupacho
• Zaka za mkaziyo ndi thanzi lake lonse
• Kufunitsitsa kwake kudzakhala ndi ana mtsogolo

Khansara yoyambirira ya khomo lachiberekero imatha kuchiritsidwa pochotsa kapena kuwononga minyewa yomwe ili ndi khansa kapena khansa. Ichi ndichifukwa chake ma smear amachitidwe nthawi zonse amakhala ofunikira kwambiri kupewa khansa ya pachibelekero, kapena kuigwira idakali msanga. Pali njira zochitira opaleshoni izi osachotsa chiberekero kapena kuwononga khomo lachiberekero, kuti mayi adzakhale ndi ana mtsogolo.

Mitundu ya opaleshoni ya khomo lachiberekero, ndipo nthawi zina, khansa ya pachibelekero yaying'ono kwambiri imaphatikizapo:

• Njira ya Loop electrosurgical excision (LEEP) - imagwiritsa ntchito magetsi kuti ichotse minofu yachilendo.
• Cryotherapy - amaunditsa maselo osadziwika.
• Laser therapy - amagwiritsa ntchito kuwala kuti awotche minofu yachilendo.
• Hysterectomy imafunikira kwa azimayi omwe ali ndi zotsogola omwe adachitapo njira zingapo za LEEP.
  

Chithandizo cha khansara yapachiyambi kwambiri chingaphatikizepo:

• Radical hysterectomy, yomwe imachotsa chiberekero ndi ziwalo zambiri zozungulira, kuphatikiza ma lymph node ndi kumtunda kwa nyini. Izi zimachitika nthawi zambiri kwa azimayi achichepere, athanzi ali ndi zotupa zazing'ono.
• Thandizo la radiation, limodzi ndi chemotherapy wotsika kwambiri, limagwiritsidwa ntchito nthawi zambiri kwa azimayi omwe ali ndi zotupa zazikulu kwambiri chifukwa cha hysterectomy kapena azimayi omwe siabwino ofuna opaleshoni.
  
• Kukwiya kwa m'mimba, mtundu wochita opareshoni kwambiri momwe ziwalo zonse zamchiuno, kuphatikiza chikhodzodzo ndi rectum, zimachotsedwa.

Magetsi amathanso kugwiritsidwa ntchito pochiza khansa yomwe yabwerera.

Chemotherapy amagwiritsa ntchito mankhwala kupha khansa. Itha kuperekedwa yokha kapena ndi opaleshoni kapena ma radiation.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Momwe munthuyo amachitira bwino zimadalira zinthu zambiri, kuphatikizapo:

• Mtundu wa khansa ya pachibelekero
• Gawo la khansa (momwe lafalikira)
• Zaka ndi thanzi labwino
• Khansayo ikabweranso mutalandira chithandizo

Matenda a khansa amatha kuchiritsidwa kwathunthu akatsatiridwa ndikuchiritsidwa bwino. Amayi ambiri amakhala amoyo m'zaka zisanu (zaka zisanu zapulumuka) za khansa yomwe yafalikira mkatikati mwa khomo lachiberekero koma osati kunja kwa khomo lachiberekero. Kupulumuka kwa zaka 5 kumagwa pamene khansa imafalikira kunja kwa khoma la khomo lachiberekero kupita kumadera ena.

Zovuta zitha kukhala:

• Kuopsa kwa khansa kubwerera mwa amayi omwe ali ndi chithandizo chopulumutsa chiberekero
• Mavuto azakugonana, matumbo, ndi chikhodzodzo pambuyo pa opaleshoni kapena radiation

Itanani omwe akukuthandizani ngati:

• Sindinakhalepo ndi ma pap smear wamba
• Khalani ndi magazi osatuluka kumaliseche kapena kumaliseche

Khansa ya pachibelekero imatha kupewedwa pochita izi:

• Pezani katemera wa HPV. Katemerayu amateteza mitundu yambiri yamatenda a HPV omwe amayambitsa khansa ya pachibelekero. Wopezayo angakuuzeni ngati katemerayu ali woyenera kwa inu.
• Chitani zogonana motetezeka. Kugwiritsa ntchito kondomu pogonana kumachepetsa chiopsezo cha HPV ndi matenda ena opatsirana pogonana.
• Chepetsani kuchuluka kwa omwe mumagonana nawo. Pewani anzanu omwe ali ndi chiwerewere choopsa.
• Pezani ma pap smear pafupipafupi momwe woperekayo amalangizira. Pap smears itha kuthandiza kuzindikira kusintha koyambirira, komwe kumatha kuchiritsidwa asanasanduke khansa ya pachibelekero.
• Pezani mayeso a HPV ngati akufunsidwa ndi omwe amakupatsani. Itha kugwiritsidwa ntchito limodzi ndi mayeso a Pap kuyesa khansa ya pachibelekero mwa azimayi azaka 30 kapena kupitilira apo.
• Mukasuta, siyani. Kusuta kumawonjezera mwayi wanu wodwala khansa ya pachibelekero.

Khansa - khomo pachibelekeropo; Khansa ya pachibelekero - HPV; Khansara ya chiberekero - dysplasia

• Hysterectomy - m'mimba - kutulutsa
• Hysterectomy - laparoscopic - kutulutsa
• Hysterectomy - ukazi - kutulutsa
• Kutulutsa kwapakati - kutulutsa

• Khansara ya chiberekero
• Chiberekero cha neoplasia
• Pap kupaka
• Chiberekero cha chiberekero
• Kuzizira kozizira kozizira
• Khansara ya chiberekero
• Pap smears ndi khansa ya pachibelekero

American College of Obstetricians and Gynecologists, Committee on Adolescent Health Care, Katemera Katswiri Wogwira Ntchito. Nambala Yamalingaliro a Komiti 704, June 2017. www.acog.org/Resource-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Human-Papillomavirus-Vaccination. Idapezeka pa Januware 23, 2020.

Malo Othandizira Kuteteza ndi Kuteteza tsamba lawebusayiti. Vuto la papillomavirus (HPV). Zolemba pachipatala ndi chitsogozo. www.cdc.gov/hpv/hcp/schedule-recommendations.html. Idasinthidwa pa Ogasiti 15, 2019. Idapezeka pa Januware 23, 2020.

Wolowa mokuba NF. Cervical dysplasia ndi khansa. Mu: Wolowa mokuba NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynaecology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2016: chap 38.

Salcedo MP, Baker ES, Schmeler KM. Intraepithelial neoplasia ya m'munsi maliseche (chiberekero, nyini, maliseche): etiology, kuwunika, kuzindikira, kuwongolera. Mu: Lobo RA, Gershenson DM, Lentz GM, Valea FA, olemba. Gynecology Yambiri. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 28.

Tsamba la US Preventive Services Task Force. Khansa ya pachibelekero: kuwunika. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Adatulutsidwa pa Ogasiti 21, 2018. Idapezeka pa Januware 23, 2020.