Uwufunda kanjani umbiko wakho wokuhlolwa kwe-Pap


Kuyini ukuhlolwa kwe-Pap?

Ukuhlolwa kwe-Pap ukuhlolwa kokuhlola okubheka amaseli angavamile engxenyeni yangasese yomlomo wesibeletho. Kubizwa nge-screening test ngoba yakhelwe ukuthola isifo ngaphambi kokuba umuntu ezwe noma yiziphi izimpawu. Ukuhlolwa kwaqanjwa ngoDkt. Georgios Papanicolaou owasungula ukuhlolwa noDkt. Aurel Babes ekuqaleni kwekhulu lama-20. Amanye amagama alokhu kuhlolwa yi-Pap smear kanye ne-cervical smear.

Kungani kwenziwa ukuhlolwa kwe-Pap?

Inhloso yokuhlolwa kwe-Pap ukubheka izifo ezingaphambi komdlavuza emlonyeni wesibeletho. Lezi zifo ezitholakala ngaphambi komdlavuza zingaphenduka umdlavuza ngokuhamba kwesikhathi, ngakho-ke kubalulekile ukuzithola bese welapheka kusenesikhathi. Ukuhlolwa kwe-Pap nakho kungakhomba amaseli angavamile aphuma ku-endocervical canal noma i-endometrium.

Umdlavuza ovame kakhulu emlonyeni wesibeletho yiwo i-squamous cell carcinoma. Lolu hlobo lomdlavuza lusuka esifweni esingaphambi komdlavuza esibizwa ngokuthi izinga eliphezulu le-squamous intraepithelial lesion (HSIL). Ukuhlolwa kwe-Pap kuklanyelwe ukubheka kokubili i-squamous cell carcinoma kanye ne-HSIL.

Ukuhlolwa kwe-Pap nakho kungakhomba amagciwane abangela ukutheleleka okuhlanganisa izinhlobo ze-candida, i-trichomonas vaginalis, izinhlobo ze-actinomyces, igciwane le-herpes, ne-cytomegalovirus.

Qhubeka ufunda ukuze ufunde kabanzi mayelana nokuhlolwa kwe-Pap nokuthi uyifunda kanjani imiphumela yakho yokuhlolwa kwe-Pap.

Umlomo wesibeletho

Isibeletho siyisitho sowesifazane sokuzala esimise okwepheya, esingenalutho esitholakala ethangeni elincane. Ingxenye engenhla yesibeletho ibizwa ngokuthi umzimba (uterine corpus), kanti ingxenye engezansi ibizwa ngokuthi intamo (umlomo wesibeletho). Umzimba wakhiwe imisipha eyakha imbobo ebizwa ngokuthi i-endometrium. I-endometrium ihlanganiswe ne-endometrial acorns futhi i-stroma.

Umlomo wesibeletho utholakala phezulu esithweni sangasese. Umgudu omncane odlula emlonyeni wesibeletho bese uxhuma i-endometrium kanye nesitho sangasese sowesifazane esibizwa ngokuthi i-endocervical canal. Ingxenye yomlomo wesibeletho ngaphakathi kwesitho sangasese sowesifazane imbozwe amaseli akhethekile abizwa ama-squamous cell. Lawa maseli akha umgoqo obizwa ngokuthi i i-epithelium lokho kuvikela umlomo wesibeletho. I-endocervical canal imbozwe uhlobo oluhlukile lweseli elixhuma ukwenza i-endocervical acorns. I-endometrium nayo imbozwe yizindlala ezishintshayo phakathi nomjikelezo wokuya esikhathini. Ithishu phakathi kwezindlala ibizwa ngokuthi i-stroma.

Yini ebangela umdlavuza womlomo wesibeletho?

Iningi lomdlavuza kanye nezifo ezingaphambi komdlavuza emlonyeni wesibeletho zibangelwa igciwane elibizwa i-human papillomavirus (HPV). Igciwane lithelela amaseli angaphezulu komlomo wesibeletho okubangela ukuthi aguquke ngokuhamba kwesikhathi abe amaseli omdlavuza. Lona leli gciwane lidala umdlavuza kanye nezifo ezingaphambi komdlavuza kwezinye izingxenye zomzimba okuhlanganisa umphimbo, umgudu wangemuva, ingquza, nepipi.

Kwenziwa kanjani ukuhlolwa kwe-Pap?

Ukuhlolwa kwe-Pap ngokuvamile kwenziwa ehhovisi likadokotela ngudokotela womndeni, udokotela wezifo zabesifazane, noma umhlengikazi oqeqeshiwe. Uzocelwa ukuthi ulale ngomhlane etafuleni lokuhlola amadolo akho egobile. Udokotela uzosebenzisa idivayisi yezokwelapha ebizwa ngokuthi i-speculum ukuze abone umlomo wesibeletho sakho. Amasampula amancane ezithishu azothathwa emlonyeni wakho wesibeletho kusetshenziswa ibhulashi elithambile kanye nomshini wokukhuhla okuthiwa i-spatula. Ezigulini eziningi, inqubo ithatha imizuzu embalwa kuphela.

Ubani okufanele ahlolwe?

Ukuhlolwa nge-Pap test kufanele kuqale eminyakeni engu-21 kwabesifazane abaya ocansini. Kwabesifazane abangakaze baye ocansini, ukuhlolwa kufanele kumiswe kuze kube yilapho sebeya ocansini. Imisebenzi yocansi ihlanganisa ukuya ocansini, kanye nemisebenzi yocansi yedijithali noma yomlomo ehlanganisa indawo yangasese nozakwethu wanoma yibuphi ubulili. Uma engekho amaseli angavamile atholakele, ukuhlolwa kufanele kuphindwe njalo eminyakeni emi-3. Owesifazane angase akhethe ukuyeka ukuhlola eneminyaka engu-70 uma zonke izivivinyo zakhe eminyakeni eyi-10 edlule zazingenayo.

Ukuhlolwa kwe-Pap kuphephile futhi kuyasebenza ngisho noma ukhulelwe. Abesifazane abakhulelwe kufanele bahlolwe ngokulandela iziqondiso ezifanayo nabangakhulelwe. Abesifazane abakhishwe isibeletho futhi abesilisa abashintsha ubulili abasenomlomo wesibeletho kufanele bahlolwe ngokulandela iziqondiso ezifanayo. Abesifazane abangenaso isimiso somzimba sokuzivikela ezifweni (i-HIV+, ukwelashwa kwe-immunosuppressant, isifo sokuzivikela komzimba) kufanele kwenziwe ukuhlolwa kwe-Pap minyaka yonke.

Kwezinye izimo, ukuhlolwa kwe-Pap kungase kusetshenziselwe ukuthola isampula esithweni sangasese sowesifazane, njengoba izindonga zesitho sangasese sowesifazane zifakwe umugqa wohlobo olufanayo lwamaseli njengezithako zangasese zomlomo wesibeletho. Izimo ezifanayo zangaphambi komdlavuza zingatholwa esithweni sangasese.

*Lezi zincomo zisekelwe I-Ontario Cervical Screening Guidelines. Ezinye izifundazwe zingaba nemihlahlandlela ehluke kancane.

Iyini imiphumela yokuhlolwa kwe-Pap engenzeka?

E-Canada nase-United States, imiphumela yokuhlolwa kwe-Pap ihlukaniswe izigaba ezintathu:

  • Normal
  • Okungajwayelekile
  • Ayenele
Normal

Uma i-pap smear yakho ijwayelekile, umphumela wakho uzothi unegethivu ye-intraepithelial ukulimala or ukulimala. Amaseli avamile adinga ukubonwa ukuze kwenziwe lokhu kuxilongwa. Udokotela wakho uzohlela ukuhlolwa kwe-Pap okulandelayo ngokweziqondiso zendawo.

Okungajwayelekile

Kunezinhlobo ezintathu ezingenzeka zemiphumela engajwayelekile kuye ngokuthi udokotela wezifo ubonani lapho ehlola ukuhlolwa kwakho kwe-Pap ngesibonakhulu.

Izinhlobo ezintathu zokungajwayelekile zihlukaniswe ngamaqembu alandelayo:

  • Amanqamu
  • Izifo zangaphambi komdlavuza
  • Imiphumela yokuqala

Uhlobo ngalunye lomphumela ongajwayelekile luchazwe kabanzi ezigabeni ezingezansi.

Amanqamu

Leli qembu lihlanganisa kokubili umdlavuza womlomo wesibeletho kanye nomdlavuza we-endometrial. Akuvamile ukuthi kube nolunye uhlobo lomdlavuza olubonakala ku-Pap smear.

Imiphumela elandelayo izinhlobo zomdlavuza:

Umphumela womdlavuza udinga ukwelashwa ngokushesha. Xhumana nodokotela wakho uma unikezwa umphumela womdlavuza futhi ungatholi ulwazi mayelana nezinyathelo ezilandelayo ngesikhathi.

Izifo zangaphambi komdlavuza

Isifo sangaphambi komdlavuza yisimo lapho, ngaphandle kokwelashwa, singaphenduka umdlavuza ngokuhamba kwesikhathi. Ukuhlolwa kwe-Pap yakhelwe ukuthola izifo ezimbili zangaphambi komdlavuza zomlomo wesibeletho. Zombili lezi zifo zibangelwa i-papillomavirus yesintu (HPV).

Amathuba okuba nomdlavuza aphakeme ezigulini ezine-HSIL. Uma uthola umphumela we-HSIL, udokotela wakho uzoxoxa nawe ngezinketho zokwelashwa ezingase zibe khona. Amathuba okuba nomdlavuza aphansi ezigulini ezine-LSIL nakuba udokotela wakho ezokhuluma nawe mayelana nokuhlolwa kwe-Pap kwesibili.

Umphumela wokuqala

Umphumela wokuqala usho ukuthi amaseli angavamile abonakale ekuhlolweni kwakho kwe-Pap kodwa izinguquko azanele ukwenza ukuxilongwa kokugcina. Umphumela wokuqala awusho umdlavuza kodwa eminye imiphumela yokuqala iphakamisa ukuthi kungenzeka ukuthi isifo sangaphambi komdlavuza noma umdlavuza kungenzeka kube khona emlonyeni wakho wesibeletho.

Kufanele ukhulume nodokotela wakho mayelana nanoma yimiphi imiphumela engajwayelekile engenhla. Ezimweni eziningi, ukuhlolwa okwengeziwe okufana ne-colposcopy noma ukuhlolwa kwe-Pap okuphindayo kuzotuswa.

Ayenele

Ezimweni ezingavamile, imiphumela yokuhlolwa kwe-Pap ingase ichazwe njengenganele. Lokhu kusho ukuthi udokotela wakho wezifo akakwazanga ukufinyelela ekuxilongweni okusekelwe esicutshini esitholwe ukuze sihlolwe. Izizathu ezivamile zalokhu zihlanganisa inani elincane lamaseli, ukulondolozwa kabi kwamaseli, izakhi ezivimbelayo njengegazi, namaphutha okucubungula izicubu. Ukuhlolwa kwe-Pap okuphindayo kuvame ukwenziwa lapho umphumela unganele.

Amaseli we-Endometrial

Amaseli angaphakathi kwe-endometrial cavity (i-endometrium) angase abonakale kusampula yakho yethishu. Lo mphumela uthathwa njengojwayelekile kwabesifazane abaneminyaka engaphansi kuka-45. Nokho, kwabesifazane abaneminyaka engaphezu kwengama-45, lawa maseli kungenzeka abe okungavamile.

Uma ungaphezu kweminyaka engama-45 ubudala futhi amaseli e-endometrial abonakala ku-Pap smear yakho, udokotela wakho angase atuse ukuhlolwa okwengeziwe. Ukuhlola kungase kuhlanganise ukuthatha isampula elincane lethishu ngaphakathi kwesibeletho sakho ngenqubo ebizwa ngokuthi i-endometrial biopsy.

ngu-Adnan Karavelic, MD FRCPC (kubuyekezwe ngoJanuwari 17, 2022)
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