Kt qu chng vim c t cung t nhng thay i bt thng trong t bo c t

cung (c t cung). Thay i sm, gi l tn thng mc thp ca cc bc s, c

th tn ti v tr thnh thng tn cao cp, trong c th ln lt pht trin thnh
ung th c t cung. Hi t bo c t cung bt thng bin mt ca mnh trong hu
ht cc trng hp. C phng php iu tr hiu qu i vi chng Vim c t
cung. Mt virus ly truyn qua ng tnh dc c gi l HPV (Human
Papilloma Virus) gy ra phn ln cc trng hp vim c t cung v ca tt c cc
bnh ung th c t cung. vim c t cung rt ph bin ph n sng chung vi
HIV. Tuy nhin, ung th c t cung l khng ph bin ph n nhim HIV cc
nc giu c l i tng gim st thng xuyn v chm sc ph khoa.
C t cung l phn di ca t cung m ra vo trong m o. Bn c th chm vo
c t cung bng cch chn cc u ngn tay vo m o.
Trong trng hp vim c t cung, t bo bt thng xut hin trn b mt ca c
t cung. Chng ti gi l cc t bo tn thng c t cung bt thng. Cc tn
thng c th thoi lon sn (thu hp hoc thm ch bin mt), vn tn ti (n
nh) hoc di chuyn (forward) cc tn thng cao cp hoc ung th.
Ung th c t cung hin khi cc t bo c t cung bt u pht trin mt cch bt
thng. Tn thng c t cung bt thng c th dn dn bin thnh ung th theo
mt khong thi gian vi nm.
iu g gy ra chng vim c t cung v ung th c t cung?
Chng ti thnh lp mt lin h nhn qu gia chng vim c t cung v ung th
c t cung v mt virus rt ph bin c gi l u nh ngi (HPV). C hn 100
loi HPV, trong bn mi ly truyn qua ng tnh dc. Mt s trong s h
gy ra mn cc sinh, bao gm c mn cc sinh dc (tng trng bt thng trn
da), nhng ngi khc c kh nng gy ung th ca cc b phn sinh dc, hu
mn, rut, phi, hng hoc ming, v mt s loi khng c hiu lc c bit.
H thng min dch gip bo v ph n chng li chng vim c t cung v ung
th c t cung. Nguy c ly nhim HPV, vim c t cung v ung th c t cung
cao hn ph n c h min dch b suy yu bi HIV hoc cc loi thuc, c bit

l nhng ngi s dng ngn chn t chi cc b phn cy ghp. Nhng ri ro

cao hn i vi ph n c HIV dng tnh v chng xut hin tng dn khi cc
t bo CD4 + ca chng cng gim.
HPV phi c mt cho mt bnh ung th c t cung xy ra, nhng cng c nhng
yu t khc c li cho s pht trin ca chng vim c t cung hoc ung th, bao
gm ht thuc. Ha cht c trong khi thuc l c th tch t trong cht dch ca c
v gy tn hi cho sc khe ca cc t bo no, do nguy c d tt tng ln. Mt
lch s ca bnh ly truyn qua ng tnh dc (STIs), nhiu ln mang thai trc
v mt ch n ung ngho cng c th lm tng nguy c vim c t cung v
ung th c t cung. Bi v HPV ly truyn qua quan h tnh dc, mt ngi ph n
c nhiu i tc tnh dc nhiu kh nng c tip xc vi vi rt ny. iu ni
rng, cn lu rng ngay c nhng ph n c vi i tc tnh dc rt d b nhim
HPV.
>>>Xem thm:Nguy him khng ng ti khi b mc vim c t cung
Thc hnh tnh dc an ton, trong c s dng bao cao su v vic s dng cc h
tnh dc khng thm nhp, c th gip gim nguy c hp ng HPV. Tuy nhin cn
lu rng bao cao su khng th hon ton ngn chn ly truyn HPV v virus
thng xut hin trn da m khng c bao ph bi m. S dng bao cao su vn
c khuyn co nh l iu ny lm gim nguy c mc cc bnh LTQTD khc
c th ng gp vo s pht trin ca chng vim c t cung hoc ung th. N
cng c th lm gim nguy c vim c t cung v ung th bng cch ngn chn
ht thuc.
Ti Canada, hai loi vc-xin c sn ngn chn kiu gen HPV ph bin. Gardasil
c ph duyt ti Canada cho mi ngi c hai gii trong tui t 9-26 nm.
N cung cp bo v chng li cc chng 16 v 18 ca HPV, trong gy ra khong
70% cc ca ung th c t cung, cng nh chng li cc chng 6 v 11. Nhng iu
ny khng gy ra ung th, nhng nguyn nhn ca khong 90 % mn cc xut
hin trn b phn sinh dc v hu mn. Cervarix c chp thun cho tr em gi
v ph n tr tui t 10-25 nm. N cung cp bo v chng li cc kiu gen ca
HPV 16 v ch c 18.

Trong cc th nghim lm sng lin quan n tr em gi v ph n tr, vc xin

tng mt bo v rt quan trng, hn 90% so vi cc bin chng ca cc kiu gen
HPV mc tiu, bao gm chng vim c t cung, ung th c t cung v mn cc
sinh dc. Trong mt s xt nghim, cc ch s v hiu qu bo v c duy tr
trong t nht 10 nm sau khi tim. c hiu qu, vc xin cn phi c qun l
trong ba liu trong mt khong thi gian su thng.
Vc-xin l v dng i vi kiu gen HPV mt ngi b nhim, nhng h
cung cp bo v tuyt vi chng li cc kiu gen ca virus m n cha bao gi
c tip xc. Ngoi ra, loi vc-xin khng c chng minh iu tr nhim
HPV thnh lp v khng c chp thun cho mc ch ny ti Canada. Gardasil
v Cervarix khng nn dng cho ph n mang thai. Gardasil c th c s dng
mt cch an ton khi cho con b, nhng Cervarix nn trnh, tr khi li ch nhiu
hn nguy c c th.
iu quan trng l phi nh rng nhng ngi c tim vaccine hoc c bo
v ch chng li hai chng gy ung th ca HPV. H l HIV dng tnh hay khng,
tt c ph n phi bt u tri qua mt cuc kim tra y t bao gm khm vng chu
v mt Papinacolaou Pap (xt nghim Pap tm sot ung th c t cung) hai
mi tui, v mt Viral th nghim t tui ba mi, v vy cc bc s ca h c th
xc nh cc du hiu c th cnh bo sm ca chng vim c t cung hoc ung
th.
TRIU CHNG
Ni chung, vim c t cung khng gy triu chng th cht. S hin din ca mn
cc sinh dc, tuy nhin, ch ra rng mt tip xc HPV xy ra. iu tr mn cc loi
tr thng tn, nhng s ly nhim ca virus vn cn. Cng lu rng n c th
c vn chuyn HPV m khng thy mn cc sinh dc v khng phn bit gii
tnh ca mnh.
Nh chng vim c t cung, ung th c t cung khng gy ra bt k triu chng
vt l trong nhiu trng hp, c bit l trong giai on u ca bnh. Tuy nhin,
vi ung th c t cung c th gy au bng v lng di, tit dch m o bt
thng, chy mu gia k kinh nguyt v au hoc chy mu trong khi quan h

tnh dc.
Xt nghim chn on v Pap soi c t cung
Vic chn on v gim st cc nhim trng HPV, vim c t cung v ung th c
t cung l thng qua khm ph khoa nh k, kim tra Pap v kim tra HPV.
thc hin mt th nghim Pap, mt bn chi nh v mt que g nh c a vo
m o v c xt vo c t cung xc nh t bo v thu thp chng. Cc t bo
ny sau c lan truyn trn mt ming knh v phn tch trong phng th
nghim. Phng php ny c th pht hin cc t bo bt thng. Ni chung, mt
xt nghim Pap c thc hin hai ln trong nm u tin sau mt chn on HIV,
v mt ln mt nm sau nu hai kt qu u tin l bnh thng. Tuy nhin,
nhiu bc s khuyn bnh nhn HIV dng tnh ca h phi tri qua mt th
nghim Pap mi su thng.
Mc d hu ch, cc th nghim Pap c th cho mt kt qu "m tnh gi", cng
cho bit mt "m tnh gi". Ni cch khc, n c th l mt kt qu c phn loi
l "bnh thng" nh anh thc s l t bo bt thng c t cung. l l do ti
sao chng ta ngy cng s dng xt nghim HPV cng vi xt nghim Pap. Sng
lc HPV lin quan n vic ly mt mu nh dch t c t cung v phn tch
xc nh xem HPV l hin ti.
Nhiu bc s khuyn ph n mi c chn on HIV dng tnh c mt soi c t
cung. Cc soi c t cung l mt knh hin vi cho php cc bc s nhn vo bn
trong m o v c t cung. Trc khi chn soi c t cung nh nhng ra c t
cung bng mt gii php dm. Gii php ny lm cho n d dng hn phn bit
cc t bo bt thng ca cc m xung quanh.
Soi c t cung c i km bi mt sinh thit c t cung (mt mu m nh t c
t cung) v i khi no tuyn c (bc s co c t cung ly mt mu m).
Nhng bin php ny c th gy au hoc gy ra chut rt, nhng rt hu ch bi
v chng cho php k thut vin kim tra tnh trng ca m c t cung.
Xt nghim Pap l mt phn ca vic theo di thng xuyn bi cc bc s gia
nh v bc s ph khoa. Soi c t cung v sinh thit c hu nh ch luyn tp

vi bng bc s ph khoa.
Bt k ngi ph n nhim HIV c biu hin bt thng ca c t cung, m h
hoc m o cng cn tri qua anoscopy. y l mt thm d th gic ca hu mn
v hu mn rch c thc hin bng cch s dng mt knh hin vi tng t nh
mt soi c t cung. Th nghim ny l quan trng bi v nhng thay i t bo gy
ra bi HPV cng c th xy ra hu mn v pht trin thnh ung th hu mn.
Kt qu qut
C mt lot cc thut ng y hc m t cc kt qu phn tch cho vic chn on
ca chng vim c t cung.
C th bn quan tm: Vim niu o v cch phng trnh hiu qu