I-squamous intraepithelial lesion yezinga eliphezulu wendunu kanye nomsele womthonjana

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.

Ingabe amaseli e-squamous esezingeni eliphezulu angasakazekela kwezinye izingxenye zomzimba?

Cha. Ngoba i-HSIL iyisimo esingahlaseli, esingavamile ama-squamous cell azikwazi ukusabalala ezicutshini ezingaphandle komsele wangemuva noma kwezinye izingxenye zomzimba ezifana ama-lymph node.

Kwenziwa kanjani lokhu kuxilongwa? 

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.

Ingabe i-high grade squamous intraepithelial lesion ibukeka kanjani ngaphansi kwe-microscope?

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.

I-squamous intraepithelial lesion yezinga eliphezulu

Kwenzekani ngemva kokutholakala kwezilonda ze-squamous intraepithelial zebanga eliphezulu?

Zonke iziguli ezine-HSIL kufanele zilandelwe eduze noma zinikezwe ukwelashwa ukususa lesi sifo.

Kunezinketho zokwelashwa ezimbalwa ezitholakalayo ze-HSIL:

  • Ukwelashwa kwe-ablative kwasendaweni – I-Radiofrequency ablation noma i-electrocautery ingasetshenziswa ukususa izicubu ze-atypical emseleni wangemuva.
  • Ukwelashwa kwezihloko – Umuthi (isb i-trichloroacetic acid, imiquimod, 5-fluorouracil) ungasetshenziswa ezilonda ezithile noma kuwo wonke umsele wokukhipha indunu.
  • Ukuhlinzwa – Ukususwa kwezicubu ezingajwayelekile ngokuhlinzwa kungase kunconywe udokotela wakho uma kunokukhathazeka ngokuthi kungase kube ne-squamous cell carcinoma. 

Sicela ukhulume nodokotela wakho mayelana nezinketho ezikufanele kakhulu.

Mayelana nalesi sihloko

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.

Ezinye izinsiza eziwusizo

ICanada Cancer Society
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