- 1. Umthwalo weHlabathi jikelele woMhlaza wesibeleko kunye nemingeni yokuhlolwa
Umhlaza womlomo wesibeleko usengumngeni omkhulu wezempilo yoluntu kwihlabathi liphela, nangona unokuthintelwa kakhulu ngokuhlolwa ngokufanelekileyo kunye nokungenelela kwangoko. Ngokutsho kwe-World Health Organisation (WHO), kuqikelelwa ukuba kukho amatyala amatsha angama-662,000 kunye nokufa okungama-349,000 okwenzeka kwihlabathi liphela ngo-2022, nto leyo ebeka umhlaza wesine oqhelekileyo kunye nonobangela wesine ophambili wokufa okunxulumene nomhlaza phakathi kwabasetyhini. Umthwalo wesifo ugxile kakhulu kumazwe anengeniso ephantsi nephakathi (ii-LMIC), apho amazinga okuxhaphaka nokufa aphezulu kakhulu kunakwiindawo ezinengeniso ephezulu. Ngokuyintloko kungenxa yokunqongophala kweenkqubo zokuhlola ezisemgangathweni ophezulu kunye nokuchonga kunye nonyango olufanelekileyo lwezilonda ezingaphambi komhlaza, okwenziwa ngcono yi:
-Iziseko zovavanyo ezingekhoyo okanye ezibuthathaka: Ukungabikho kweenkonzo zokuhlola ezifikelelekayo neziqinisekisiweyo ngomgangatho.
-Imida yezixhobo: Iziseko zelebhu ezinqongopheleyo, uthungelwano lwezixhobo ezibandayo, kunye nombane othembekileyo.
-Ukunqongophala kwabasebenzi: Ukunqongophala kwabasebenzi abaqeqeshiweyo belebhu kunye nabasebenzi beklinikhi.
-Ukulibaziseka kunye nokulahlekelwa kulandelelwano: Ixesha elilibazisekileyo phakathi kokuqokelelwa kweesampuli kunye nokufumaneka kweziphumo, nto leyo ekhokelela ekulibazisekeni kolawulo lwezonyango okanye ekulahlekelweni zizigulane kulandelelwano [1].
2. I-Etiology kunye neMolecular Basis ye-Cervical Carcinogenesis
Usulelo oluqhubekayo olune-human papillomavirus (HR-HPV) olunobungozi obuphezulu luyimbangela ebalulekileyo yomhlaza womlomo wesibeleko. Phakathi kweentlobo ze-HPV ezingaphezu kwama-200 ezichongiweyo, ubuncinciIintlobo ezili-12zihlelwe njengezibangela umhlaza (iQela 1) yi-International Agency for Research on Cancer (IARC).
Kwinqanaba leemolekyuli, i-carcinogenesis ebangelwa yi-HPV iqhutywa ikakhulu zii-viral oncoproteins E6 kunye ne-E7. I-E6 ikhuthaza ukuwohloka kweproteni ye-tumor suppressor p53, ngelixa i-E7 ingasebenzi kakuhle iproteni ye-retinoblastoma (Rb), nto leyo ebangela ukuphazamiseka komjikelo weseli kunye notshintsho olubi.
3.Amaqhinga Okuhlola Acetyiswa yi-WHO
I-World Health Organization icebisa uvavanyo lwe-HPV nucleic acid (NAT) njengendlela yokuvavanya eyintloko ekhethwayo yokuthintela umhlaza wesibeleko.
Uluntu ngokubanzi:Ii-NAT ezisekelwe kwi-HPV DNA okanye kwi-mRNA
Abafazi abaphila ne-HIV:Ii-NAT ezisekelwe kwi-HPV DNA
Amaxesha okuvavanya:
Abafazi abaneminyaka engama-30-65 ubudala: Rhoqo emva kweminyaka emi-5-10
Abafazi abaphila ne-HIV: Rhoqo emva kweminyaka emi-3 ukuya kwemi-5
Xa kuthelekiswa neendlela ezisekelwe kwi-cytology, uvavanyo lwe-HPV lubonisauvakalelo oluphezulukwaye ibonelelaixabiso eliphezulu elibi lokuqikelela, okuvumela ukuba kubekho amaxesha okuvavanya athatha ixesha elide kwaye angabizi kakhulu.
4.Iprofayili yeMveliso ejolise kwi-WHO kwiimvavanyo zoHlolo lwe-HPV
I-WHO iphuhlise inkquboIprofayili yeMveliso ekujoliswe kuyo (i-TPP)kwiimvavanyo zovavanyo lwe-HPV ezenzelwe ukusetyenziswa kwiindawo ezilawulwa ngokweemfuno zabantu kunye neendawo ezinqongopheleyo.[1]
Iimpawu eziphambili ziquka:
- Ukuhambelana neesampuli eziziqokeleleyo
- Ukufunyanwa kweentlobo ezininzi ze-HPV ezinobungozi obuphezulu (≥iintlobo ezili-12)
- Ukusebenza ngabasebenzi abangaqeqeshwanga kwilebhu
- Iziphumo ziyafumaneka ngaphakathi kovavanyo olunye lweklinikhi
Ezi ndlela zixhasa uvavanyo lwendawo yokhathalelo kunye namaqhinga "okuhlola nokunyanga".
5.Iqonga Lokufumanisa I-HPV Elinomngcipheko Ophezulu Elizenzekelayo Ngokupheleleyo
Inkqubo ye-AIO800 yeMacro kunye neMicro-Test ibonelelaindlela yokusebenza yeSampuli yokuya kwimpendulo ezenzekelayo ngokupheleleyoukudibanisa ukukhutshwa kwe-nucleic acid, ukwandiswa, kunye nokufunyanwa ngokuhambelana namaqhinga okuhlola acetyiswa yi-WHO.
5.1 Uhambo lomsebenzi oluzenzekelayo lweSampuli ukuya kwiimpendulo
Eli qonga lidibanisa ukukhutshwa kwe-nucleic acid, ukwandiswa, kunye nokufunyanwa kwenkqubo enye, evaliweyo, efuna ukungenelela okuncinci komqhubi. Olu luyilo:
- -Yehlisa ukuxhomekeka kubasebenzi abakhethekileyo belabhoratri
- -Inciphisa ukuguquguquka kwenkqubo kunye nomngcipheko wongcoliseko
- -Ivumela ukusasazwa kwiindawo zonyango ezisasazwa kwiindawo ezahlukeneyo
Kwangaxeshanye, amandla ayo okuvelisa axhasa ukusetyenziswa kwiilabhoratri ezikwindawo enye, nto leyo eququzelela iinkqubo zokuhlola ezinkulu.
5.2 Ugutyungelwe ngokubanzi kweGenotyping
Le nkqubo ibona iintlobo ezili-14 ze-HPV ezinobungozi obukhulu, kuquka zonke iintlobo ezili-12 ezibangela umhlaza ezihlelwe yi-IARC (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, kunye ne-59), kunye ne-HPV66 kunye ne-HPV68.
Okubalulekileyo, ibonelelauhlobo oluthile lwe-genotypingiziphumo, ezivumela ukwahlulwahlulwa komngcipheko kunye nolawulo lweklinikhi oluchanekileyo.
5.3 Uvakalelo lohlalutyo kunye neziphumo zeklinikhi
Ngomda wokufunyanwa kweekopi ezingama-300/mL, inkqubo iyakwazi ukuchonga usulelo lwe-HPV oluphantsi olunegalelo koku:
- -Ukufunyaniswa kwangethuba kwezifo ezinxulumene nonyango
- -Ixabiso elingcono lokuqikelela elingalunganga
- -Inkxaso yexesha elide lokuvavanya
5.4 Inkxaso yokuZivavanya
Iqonga liyahambelana nazo zombiniiisampulu ze-cervical swab kunye neesampulu zomchamo oziqokeleleyoukuhambelana neengcebiso ze-WHO ukuze kujongwane nemiqobo ephambili ekuthathweni kweenkonzo zokuhlola, kuquka:
- -Ukufikelela okuncinci kwiindawo zempilo
- -Imida yentlalo-ntle
Ixesha leposi: Matshi-27-2026