nguCatherine Forse MD FRCPC
December 13, 2023
I-high grade squamous intraepithelial lesion (HSIL) isifo esiyingozi esibangelwa i-human papillomavirus (HPV). Yakhiwe ngokungajwayelekile ama-squamous cell ezithelelekile futhi zaguqulwa igciwane. Amaseli e-squamous atholakala ongqimbeni oluncane lwezicubu ezibizwa ngokuthi i-epithelium elimboza ingaphakathi lendunu kanye nomsele wendunu. Ziningi izinhlobo ze-HPV kodwa izimo eziningi ze-HSIL zidalwa izinhlobo ezinobungozi kakhulu 6, 11, 16, 18, kanye no-51. Elinye igama le-HSIL ye-anal canal lithi I-anal intraepithelial neoplasia (AIN).
I-HSIL akuwona umdlavuza nakuba iziguli ezine-HSIL zisengozini enkulu yokuba nohlobo lomdlavuza wezindunu olubizwa i-squamous cell carcinoma. Ngalesi sizathu, iziguli eziningi ezine-HSIL zinikezwa ukwelashwa ukuze zisuse indawo yezicubu ezingavamile. I-low-grade squamous intraepithelial lesion (LSIL) yisimo esihlobene naso esidalwa HPV. Nokho, uma kuqhathaniswa ne-HSIL, ingozi yokuba nomdlavuza ovela ku-LSIL iphansi kakhulu.
Cha. Ngoba i-HSIL iyisimo esingahlaseli, esingavamile ama-squamous cell azikwazi ukusabalala ezicutshini ezingaphandle komsele wangemuva noma kwezinye izingxenye zomzimba ezifana ama-lymph node.
Uma udokotela wakho ekhathazekile ngokuthi ungase ube nokungajwayelekile komsele wakho wangemuva, uzokwenza inqubo ebizwa ngokuthi i-anoscopy. Phakathi ne-anoscopy, udokotela wakho uzofaka ithuluzi elibizwa ngokuthi i-anoscope emseleni wakho wangemuva. I-anoscope inomthombo wokukhanya ovumela udokotela wakho ukuthi abone yonke indawo engaphakathi yomsele wangemuva. Uma kunendawo yethishu engavamile, udokotela wakho angase athathe isampula elincane lesicubu esibizwa ngokuthi a i-biopsy. Kwezinye izibhedlela, odokotela bangase bafake i-swab ekhethekile emseleni wangemuva esikhundleni sokwenza i-biopsy. I-swab iqoqa amangqamuzana ezicubu ukusuka phezulu komsele wangemuva. Isifanekiso esiqoqiwe sibizwa nge-cytology specimen. Ngemva kokuqoqwa kwamasampula ezicubu ezivela kumsele wangemuva, ahlolwa ngesibonakhulu ngudokotela wezifo.
Ngaphansi kokuhlolwa kwe-microscope, okungavamile ama-squamous cell zivalelwe ku i-epithelium ebusweni bezicubu. Amaseli e-squamous angavamile ngokuvamile amakhulu futhi amnyama kunamaseli azungezile avamile we-squamous. Amaseli enza inqubo ebizwa ngokuthi i-mitosis (ukuhlukanisa ukudala amaseli amasha) nakho kuvame ukubonwa. Izazi ze-pathologists zivame ukuqinisekisa ukuxilongwa ngokwenza ukuhlolwa okubizwa ngokuthi i-immunohistochemistry (IHC) okwephrotheni okuthiwa p16. Amaseli angajwayelekile ku-HSIL azoba positive ku-p16 kanti ezinye izimo ezingabukeka njenge-HSIL zizoba zimbi.
Zonke iziguli ezine-HSIL kufanele zilandelwe eduze noma zinikezwe ukwelashwa ukususa lesi sifo.
Kunezinketho zokwelashwa ezimbalwa ezitholakalayo ze-HSIL:
Sicela ukhulume nodokotela wakho mayelana nezinketho ezikufanele kakhulu.
Lesi sihloko sabhalwa odokotela ukuze bakusize ufunde futhi uqonde umbiko wakho we-pathology. Xhumana nathi uma unemibuzo mayelana nalesi sihloko noma umbiko wakho we-pathology. Ukuze uthole isingeniso esiphelele sombiko wakho we-pathology, funda lesi sihloko.