{"id":19067,"date":"2023-04-12T07:23:51","date_gmt":"2023-04-12T00:23:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19067"},"modified":"2023-04-13T09:48:39","modified_gmt":"2023-04-13T02:48:39","slug":"huong-dan-chan-doan-ung-thu-da-day","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/huong-dan-chan-doan-ung-thu-da-day\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n ung th\u01b0 d\u1ea1 d\u00e0y theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p><strong>Ung th\u01b0 d\u1ea1 d\u00e0y (UTDD) l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh ung th\u01b0 (UT) ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean\u00a0 th\u1ebf gi\u1edbi. UTDD \u0111\u1ee9ng th\u1ee9 3 \u1edf c\u1ea3 hai gi\u1edbi sau ung th\u01b0 gan v\u00e0 ung th\u01b0 ph\u1ed5i v\u1edbi t\u1ef7 l\u1ec7 m\u1eafc\u00a0 chu\u1ea9n theo tu\u1ed5i l\u00e0 11,38\/100.000 d\u00e2n. Trong \u0111\u00f3, lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn chi\u1ebfm\u00a0 ch\u1ee7 y\u1ebfu (90-95%).\u00a0<\/strong><\/p>\n<h2>1. \u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n<p><span style=\"font-weight: 400;\">N\u0103m 2018, \u01b0\u1edbc t\u00ednh tr\u00ean th\u1ebf gi\u1edbi c\u00f3 1.033.700 tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 d\u1ea1 d\u00e0y m\u1eafc m\u1edbi v\u00e0 h\u01a1n 782.600 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong. T\u1ea1i Vi\u1ec7t nam theo Globocan 2018.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">UTDD c\u00f3 t\u00ednh ch\u1ea5t v\u00f9ng mi\u1ec1n r\u00f5 r\u1ec7t li\u00ean quan t\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 b\u1ea3o qu\u1ea3n th\u1ef1c\u00a0 ph\u1ea9m. Ph\u00e2n b\u1ed1 kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u theo khu v\u1ef1c \u0111\u1ecba l\u00fd v\u00e0 th\u1eddi gian. T\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh th\u01b0\u1eddng \u1edf \u0111\u1ed9 tu\u1ed5i cao, hi\u1ebfm g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh d\u01b0\u1edbi 30 tu\u1ed5i, nam gi\u1edbi chi\u1ebfm\u00a0 t\u1ef7 l\u1ec7 cao \u1edf t\u1ea5t c\u1ea3 c\u00e1c qu\u1ed1c gia tr\u00ean th\u1ebf gi\u1edbi v\u1edbi t\u1ef7 l\u1ec7 g\u1ea5p 2- 4 l\u1ea7n so v\u1edbi n\u1eef gi\u1edbi. V\u1ecb tr\u00ed hay g\u1eb7p \u1edf v\u00f9ng hang m\u00f4n v\u1ecb (chi\u1ebfm 60-70%), sau \u0111\u00f3 l\u00e0 \u1edf v\u00f9ng b\u1edd cong nh\u1ecf (18- 30%), c\u00e1c v\u00f9ng kh\u00e1c \u00edt g\u1eb7p h\u01a1n nh\u01a3 b\u1edd cong l\u1edbn kho\u1ea3ng 3%, \u0111\u00e1y v\u1ecb 12%, t\u00e2m v\u1ecb 9%, UT to\u00e0n b\u1ed9 d\u1ea1 d\u00e0y chi\u1ebfm 8-10%. Theo nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y \u1edf Nh\u1eadt B\u1ea3n v\u00e0\u00a0 Ch\u00e2u \u00c2u cho th\u1ea5y UT v\u00f9ng t\u00e2m v\u1ecb c\u00f3 chi\u1ec1u h\u01b0\u01a1ng t\u0103ng l\u00ean. T\u1ef7 l\u1ec7 UT t\u00e2m v\u1ecb t\u1eeb 25- 55%, UT th\u00e2n v\u1ecb v\u00e0 hang m\u00f4n v\u1ecb t\u1eeb 45-75%.\u00a0<\/span><\/p>\n<h2>2. Nguy\u00ean nh\u00e2n v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1<\/h2>\n<h3>2.1. Y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng v\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng<\/h3>\n<p><span style=\"font-weight: 400;\">M\u00f4i tr\u01b0\u1eddng s\u1ed1ng v\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng li\u00ean quan t\u1edbi UTDD.\u00a0 C\u00e1c y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc UTDD g\u1ed3m:\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; S\u1eed d\u1ee5ng h\u00e0m l\u01b0\u1ee3ng mu\u1ed1i cao trong th\u1ee9c \u0103n\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Th\u1ee9c \u0103n c\u00f3 ch\u1ee9a h\u00e0m l\u01b0\u1ee3ng nitrat cao\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Ch\u1ebf \u0111\u1ed9 \u0103n \u00edt vitamin A, C\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Nh\u1eefng th\u1ee9c \u0103n kh\u00f4, th\u1ee9c \u0103n hun kh\u00f3i\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Thi\u1ebfu ph\u01b0\u01a1ng ti\u1ec7n b\u1ea3o qu\u1ea3n l\u1ea1nh th\u1ee9c \u0103n\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; R\u01b0\u1ee3u, thu\u1ed1c l\u00e1\u2026\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c th\u1ee9c \u0103n t\u01b0\u01a1i, hoa qu\u1ea3 t\u01b0\u01a1i nh\u01b0 cam, chanh, nhi\u1ec1u ch\u1ea5t x\u01a1, th\u1ee9c \u0103n gi\u00e0u vitamin A, C, c\u00e1c y\u1ebfu t\u1ed1 vi l\u01b0\u1ee3ng nh\u01b0 k\u1ebdm, \u0111\u1ed3ng, s\u1eaft, magi\u00ea, \u2026 c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m nguy\u00a0 c\u01a1 m\u1eafc b\u1ec7nh.\u00a0<\/span><\/p>\n<h3>2.2. Vai tr\u00f2 Helicobacter Pylori (HP)<\/h3>\n<p><span style=\"font-weight: 400;\">Nhi\u1ec5m H.pylori g\u00e2y vi\u00eam ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y d\u1eabn t\u1edbi teo ni\u00eam m\u1ea1c v\u00e0 d\u1ecb s\u1ea3n ru\u1ed9t, lo\u1ea1n\u00a0 s\u1ea3n v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 ung th\u01b0. Nhi\u1ec5m H.pylori l\u00e0m t\u0103ng nguy c\u01a1 UTDD l\u00ean g\u1ea5p 6 l\u1ea7n.<\/span><\/p>\n<h3><b>2.3. Y\u1ebfu t\u1ed1 di truy\u1ec1n\u00a0<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">\u01af\u1edbc t\u00ednh UTDD c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh chi\u1ebfm t\u1ef7 l\u1ec7 1-15% trong s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh m\u1eafc\u00a0 UTDD. M\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd di truy\u1ec1n c\u0169ng t\u0103ng nguy c\u01a1.\u00a0<\/span><\/p>\n<h3><b>2.4. C\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c\u00a0<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">C\u00e1c b\u1ec7nh l\u00fd t\u1ea1i d\u1ea1 d\u00e0y c\u0169ng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y UTDD. Nhi\u1ec5m x\u1ea1 c\u0169ng \u0111\u01b0\u1ee3c coi l\u00e0\u00a0 m\u1ed9t y\u1ebfu t\u1ed1 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc UTDD.<\/span><\/p>\n<h2><b>3. CH\u1ea8N \u0110O\u00c1N\u00a0<\/b><\/h2>\n<h3><b>3.1. L\u00e2m s\u00e0ng\u00a0<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">\u1ede giai \u0111o\u1ea1n s\u1edbm th\u01b0\u1eddng t\u00ecnh c\u1edd kh\u00e1m ph\u00e1t hi\u1ec7n b\u1ec7nh. Giai \u0111o\u1ea1n n\u00e0y c\u00e1c tri\u1ec7u\u00a0 ch\u1ee9ng th\u01b0\u1eddng r\u1ea5t ngh\u00e8o n\u00e0n v\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n \u1eadm \u1ea1ch, \u0111\u1ea7y h\u01a1i\u00a0 v\u00f9ng th\u01b0\u1ee3ng v\u1ecb, \u0111au th\u01b0\u1eddng v\u1ecb kh\u00f4ng c\u00f3 chu k\u1ef3, nu\u1ed1t ngh\u1eb9n, m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n. C\u00f3\u00a0 th\u1ec3 g\u1ea7y s\u00fat c\u00e2n g\u1eb7p \u1edf tr\u00ean 80% c\u00e1c tr\u01b0\u1eddng h\u1ee3p, khi s\u00fat c\u00e2n tr\u00ean 10% tr\u1ecdng l\u01b0\u1ee3ng c\u01a1\u00a0 th\u1ec3 l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u ti\u00ean l\u01b0\u01a1ng x\u1ea5u.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u1ede giai \u0111o\u1ea1n mu\u1ed9n, tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh r\u00f5 r\u00e0ng h\u01a1n, xu\u1ea5t hi\u1ec7n th\u01b0\u1eddng xuy\u00ean v\u00e0\u00a0 li\u00ean t\u1ee5c: s\u1ee5t c\u00e2n kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, \u0111au b\u1ee5ng v\u00f9ng th\u01b0\u1ee3ng v\u1ecb, \u0111\u1ea7y b\u1ee5ng, ch\u00e1n\u00a0 \u0103n\u2026 Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c tri\u1ec7u ch\u1ee9ng thi\u1ebfu m\u00e1u, s\u1edd th\u1ea5y kh\u1ed1i u b\u1ee5ng\u00a0 th\u01b0\u1eddng khi b\u1ec7nh \u0111\u00e3 ti\u1ebfn tri\u1ec3n t\u1ea1i v\u00f9ng.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c d\u1ea5u hi\u1ec7u b\u1ec7nh lan tr\u00e0n \u0111\u00f4i khi l\u1ea1i l\u00e0 bi\u1ec3u hi\u1ec7n \u0111\u1ea7u ti\u00ean nh\u01b0 h\u1ea1ch di c\u0103n, t\u1ed5n\u00a0 th\u01b0\u01a1ng lan tr\u00e0n ph\u00fac m\u1ea1c \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n b\u1eb1ng d\u1ecbch \u1ed5 b\u1ee5ng hay t\u1eafc ru\u1ed9t, di c\u0103n gan\u00a0 hay di c\u0103n bu\u1ed3ng tr\u1ee9ng.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">T\u00f9y theo c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng ho\u1eb7c kh\u00f4ng v\u00e0 giai \u0111o\u1ea1n ph\u00e1t hi\u1ec7n\u00a0 b\u1ec7nh c\u00f3 th\u1ec3 chia ra c\u00e1c nh\u00f3m:\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">T\u00ecnh c\u1edd ph\u00e1t hi\u1ec7n b\u1ec7nh khi kh\u00e1m ki\u1ec3m tra s\u1ee9c kh\u1ecfe c\u00f3 n\u1ed9i soi d\u1ea1 d\u00e0y. <\/span><\/li>\n<li><span style=\"font-weight: 400;\">C\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh k\u1ebft h\u1ee3p kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng. <\/span><\/li>\n<li><span style=\"font-weight: 400;\">Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c hi\u1ec7u, ch\u1ec9 ph\u00e1t hi\u1ec7n khi c\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n di c\u0103n.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Nh\u00f3m bi\u1ec3u hi\u1ec7n b\u1ec7nh \u1edf giai \u0111o\u1ea1n mu\u1ed9n, c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng: d\u1ecbch \u1ed5 b\u1ee5ng, di c\u0103n\u00a0 gan, t\u1eafc ru\u1ed9t \u2026\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<h3>3.2. C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n<h4>3.2.1. Ch\u1ee5p X quang<\/h4>\n<p><span style=\"font-weight: 400;\">Ch\u1ee5p X-quang d\u1ea1 d\u00e0y c\u00f3 thu\u1ed1c c\u1ea3n quang: l\u00e0 ph\u01b0\u01a1ng ph\u00e1p kinh \u0111i\u1ec3n ch\u1ea9n \u0111o\u00e1n\u00a0 UTDD. T\u1ed5n th\u01b0\u1eddng UTDD s\u1ebd t\u1ed3n t\u1ea1i th\u01b0\u1eddng xuy\u00ean tr\u00ean c\u00e1c phim ch\u1ee5p h\u00e0ng lo\u1ea1t.\u00a0 Ngo\u00e0i ra tr\u00ean phim ch\u1ee5p c\u00f3 thu\u1ed1c c\u1ea3n quang sau 6 gi\u1edd c\u00f3 h\u00ecnh \u1ea3nh c\u1ee7a h\u1eb9p m\u00f4n v\u1ecb nh\u01b0 h\u00ecnh \u1ea3nh tuy\u1ebft r\u01a1i \u2026 Ng\u00e0y nay, v\u1edbi s\u1ef1 ti\u1ebfn b\u1ed9 c\u1ee7a n\u1ed9i soi \u0111\u00e3 d\u1ea7n thay th\u1ebf ch\u1ee5p\u00a0 X-quang d\u1ea1 d\u00e0y.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">X-quang tim ph\u1ed5i: ph\u00e1t hi\u1ec7n c\u00e1c di c\u0103n ph\u1ed5i. N\u1ebfu c\u00f3 t\u1ed5n th\u01b0\u01a1ng tr\u00ean X-quang c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng th\u00eam c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh kh\u00e1c nh\u01b0 CLVT.\u00a0<\/span><\/p>\n<h4>3.2.2. N\u1ed9i soi d\u1ea1 d\u00e0y b\u1eb1ng \u1ed1ng m\u1ec1m<\/h4>\n<p><span style=\"font-weight: 400;\">N\u1ed9i soi \u1ed1ng soi m\u1ec1m k\u1ebft h\u1ee3p v\u1edbi sinh thi\u1ebft l\u00e0 bi\u1ec7n ph\u00e1p quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n\u00a0 UTDD. N\u1ed9i soi cho bi\u1ebft v\u1ecb tr\u00ed v\u00e0 t\u00ednh ch\u1ea5t c\u1ee7a kh\u1ed1i u. \u0110\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a n\u1ed9i soi tr\u00ean\u00a0 95% v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 ti\u1ebfn tri\u1ec3n. Khi sinh thi\u1ebft qua n\u1ed9i soi t\u1eeb 6 \u0111\u1ebfn 8\u00a0 m\u1ea3nh cho k\u1ebft qu\u1ea3 ch\u1ea9n \u0111o\u00e1n \u0111\u00fang tr\u00ean 95%.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nh\u1edd c\u00e1c ti\u1ebfn b\u1ed9 nh\u01b0 n\u1ed9i soi ph\u00f3ng \u0111\u1ea1i, n\u1ed9i soi \u00e1nh s\u00e1ng xanh, n\u1ed9i soi k\u1ebft h\u1ee3p v\u1edbi\u00a0 ph\u01b0\u01a1ng ph\u00e1p nhu\u1ed9m m\u00e0u \u0111\u1ec3 ch\u1ec9 \u0111i\u1ec3m v\u00f9ng b\u1ea5m sinh thi\u1ebft\u2026cho \u0111\u1ed9 ch\u00ednh x\u00e1c cao,\u00a0 ph\u00e1t hi\u1ec7n c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u00f2n r\u1ea5t nh\u1ecf, gi\u00fap cho ch\u1ea9n \u0111o\u00e1n s\u1edbm UTDD.\u00a0<\/span><\/p>\n<h4>3.2.3. Si\u00eau \u00e2m qua th\u00e0nh b\u1ee5ng v\u00e0 si\u00eau \u00e2m n\u1ed9i soi<\/h4>\n<p><span style=\"font-weight: 400;\">Si\u00eau \u00e2m qua th\u00e0nh b\u1ee5ng gi\u00fap \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u1ea1 d\u00e0y v\u00e0 t\u00ecnh tr\u1ea1ng di c\u0103n\u00a0 h\u1ea1ch, ph\u00e1t hi\u1ec7n c\u00e1c t\u1ed5n th\u01b0\u01a1ng th\u1ee9 ph\u00e1t, d\u1ecbch \u1ed5 b\u1ee5ng&#8230; Tuy nhi\u00ean, \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a\u00a0 si\u00eau \u00e2m ph\u1ee5 thu\u1ed9c r\u1ea5t nhi\u1ec1u y\u1ebfu t\u1ed1.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">K\u1ef9 thu\u1eadt si\u00eau \u00e2m k\u1ebft h\u1ee3p n\u1ed9i soi ti\u00eau ho\u00e1 v\u00e0 si\u00eau \u00e2m c\u00f3 \u0111\u1ea7u d\u00f2 t\u1ea7n s\u1ed1 cao (7,5- 12MHz) gi\u00fap x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n c\u1ee7a u nguy\u00ean ph\u00e1t qua c\u00e1c l\u1edbp\u00a0 c\u1ee7a th\u00e0nh d\u1ea1 d\u00e0y v\u00e0 t\u1ed5 ch\u1ee9c xung quanh h\u01a1n so v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt kh\u00e1c, nh\u1ea5t l\u00e0 v\u1edbi\u00a0 kh\u1ed1i u \u1edf giai \u0111o\u1ea1n s\u1edbm. \u0110\u1ed1i v\u1edbi \u0111\u00e1nh gi\u00e1 s\u1ef1 di c\u0103n h\u1ea1ch l\u00e2n c\u1eadn th\u00ec c\u00f3 ph\u1ea7n h\u1ea1n ch\u1ebf nh\u1ea5t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p di c\u0103n xa th\u00e0nh d\u1ea1 d\u00e0y.\u00a0<\/span><\/p>\n<h4>3.2.4. N\u1ed9i soi \u1ed5 b\u1ee5ng<\/h4>\n<p><span style=\"font-weight: 400;\">N\u1ed9i soi \u1ed5 b\u1ee5ng x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c t\u00ecnh tr\u1ea1ng x\u00e2m l\u1ea5n u v\u00e0o c\u01a1 quan l\u00e2n c\u1eadn, di c\u0103n\u00a0 gan, di c\u0103n ph\u00fac m\u1ea1c. Gi\u00fap \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c giai \u0111o\u1ea1n, tr\u00e1nh \u0111\u01b0\u1ee3c m\u1edf b\u1ee5ng th\u0103m\u00a0 d\u00f2 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh lan r\u1ed9ng kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c.\u00a0<\/span><\/p>\n<h4>3.2.5. Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CLVT)<\/h4>\n<p><span style=\"font-weight: 400;\">CLVT \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ch\u1ee7 y\u1ebfu \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh giai \u0111o\u1ea1n nh\u01b0 s\u1ef1 x\u00e2m l\u1ea5n c\u1ee7a kh\u1ed1i u v\u1edbi\u00a0 th\u00e0nh \u1ed1ng ti\u00eau h\u00f3a, s\u1ef1 di c\u0103n v\u00e0o c\u00e1c t\u1ea1ng, h\u1ea1ch trong \u1ed5 b\u1ee5ng. Ngo\u00e0i ra, CLVT c\u00f2n\u00a0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh giai \u0111o\u1ea1n ti\u1ebfn xa.<\/span><\/p>\n<h4>3.2.6. Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI)<\/h4>\n<p><span style=\"font-weight: 400;\">Cho th\u00f4ng tin v\u1ec1 t\u1ed5n th\u01b0\u01a1ng u c\u0169ng nh\u01b0 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n v\u00e0 di c\u0103n. <\/span><\/p>\n<h4>3.2.7. X\u1ea1 h\u00ecnh<\/h4>\n<p><span style=\"font-weight: 400;\">X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi <\/span><span style=\"font-weight: 400;\">99m<\/span><span style=\"font-weight: 400;\">Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n\u00a0 th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u\u00a0 tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n. Ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng t\u1eeb r\u1ea5t s\u1edbm so v\u1edbi\u00a0 ch\u1ee5p X-quang th\u00f4ng th\u01b0\u1eddng. T\u1eeb \u0111\u00f3, gi\u00fap l\u1ef1a ch\u1ecdn bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p. T\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 \u1edf x\u01b0\u01a1ng s\u01b0\u1eddn, x\u01b0\u01a1ng ch\u1eadu, x\u01b0\u01a1ng c\u1ed9t s\u1ed1ng\u2026\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi <\/span><span style=\"font-weight: 400;\">99m<\/span><span style=\"font-weight: 400;\">Tc -DTPA \u0111\u1ec3 \u0111\u00e1nh\u00a0 gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.\u00a0<\/span><\/p>\n<h4>3.2.8. PET\/CT (Positron Emission Tomography\/ Computer Tomography)<\/h4>\n<p><span style=\"font-weight: 400;\">PET\/CT c\u00f3 gi\u00e1 tr\u1ecb trong ph\u00e1t hi\u1ec7n c\u00e1c t\u1ed5n th\u01b0\u01a1ng nguy\u00ean ph\u00e1t t\u1ea1i d\u1ea1 d\u00e0y, t\u1ed5n\u00a0 th\u01b0\u01a1ng x\u00e2m l\u1ea5n, di c\u0103n h\u1ea1ch, di c\u0103n xa t\u1edbi c\u00e1c t\u1ea1ng xa, di c\u0103n x\u01b0\u01a1ng. Ch\u1ec9 \u0111\u1ecbnh c\u1ee7a\u00a0 PET\/CT l\u00e0 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n b\u1ec7nh, ph\u00e1t hi\u1ec7n t\u00e1i ph\u00e1t, di c\u0103n, \u0111\u00e1nh gi\u00e1 \u0111\u00e1p \u1ee9ng sau\u00a0 \u0111i\u1ec1u tr\u1ecb.\u00a0<\/span><\/p>\n<h4>3.2.9. C\u00e1c ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m ung th\u01b0<\/h4>\n<p><span style=\"font-weight: 400;\">Kh\u00e1ng nguy\u00ean ung th\u01b0 b\u00e0o thai CEA t\u0103ng trong kho\u1ea3ng 33% trong s\u1ed1 UTDD. Khi\u00a0 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u00e1c nh\u01b0 CA19-9 v\u00e0 CA72-4 c\u00f3 gi\u00e1 tr\u1ecb trong theo d\u00f5i\u00a0 sau \u0111i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u01a1ng b\u1ec7nh.\u00a0<\/span><\/p>\n<h4>3.2.10. M\u00f4 b\u1ec7nh h\u1ecdc<\/h4>\n<p><span style=\"font-weight: 400;\">N\u0103m 2000, T\u1ed5 ch\u1ee9c Y t\u1ebf Th\u1ebf gi\u1edbi (TCYTTG) \u0111\u01b0a ra ph\u00e2n lo\u1ea1i UTDD \u0111\u00e3 \u0111\u01b0\u1ee3c\u00a0 s\u1eeda \u0111\u1ed5i, bao g\u1ed3m c\u1ea3 ph\u00e2n lo\u1ea1i c\u1ee7a Lauren v\u00e0 c\u00f3 b\u1ed5 sung th\u00eam t\u00edp m\u00f4 h\u1ecdc ung th\u01b0\u00a0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o nh\u1ecf v\u00e0 c\u00e1c t\u00edp m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u01b0\u1ee3c m\u00e3 h\u00f3a.\u00a0\u00a0<\/span><\/p>\n<h4>3.2.11. Sinh h\u1ecdc ph\u00e2n t\u1eed<\/h4>\n<p><span style=\"font-weight: 400;\">Nh\u1edd c\u00e1c ti\u1ebfn b\u1ed9 trong sinh h\u1ecdc ph\u00e2n t\u1eed \u0111\u00e3 x\u00e1c \u0111\u1ecbnh nh\u1eefng bi\u1ebfn \u0111\u1ed5i gen c\u0169ng nh\u01a3 c\u00e1c\u00a0 y\u1ebfu t\u1ed1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o ung th\u01b0 bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y. G\u1ed3m c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0: HER2, E cadherin, EGFR, DNA thay \u0111\u1ed5i s\u1ed1 l\u01b0\u1ee3ng b\u1ea3n sao, m\u1ea5t \u1ed5n \u0111\u1ecbnh di truy\u1ec1n:\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; HER2 (ErbB-2 hay HER-2\/neu): l\u00e0 th\u1ee5 th\u1ec3 c\u1ee7a y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng bi\u1ec3u b\u00ec &#8211; EGFR\u00a0 n\u1eb1m tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o. Gi\u1eef vai tr\u00f2 \u0111i\u1ec1u h\u00f2a s\u1ef1 ph\u00e2n b\u00e0o, s\u1ef1 s\u1ed1ng v\u00e0 bi\u1ec7t h\u00f3a c\u1ee7a\u00a0 nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o. K\u1ebft qu\u1ea3 c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 b\u1ed9c l\u1ed9 HER2 \u1edf \u0111o\u1ea1n ti\u1ebfp\u00a0 n\u1ed1i th\u1ef1c qu\u1ea3n &#8211; d\u1ea1 d\u00e0y cao h\u01a1n (24%-32%) so v\u1edbi c\u00e1c kh\u1ed1i u t\u1ea1i d\u1ea1 d\u00e0y (12%-18%).\u00a0 Khi bi\u1ec3u hi\u1ec7n b\u1ed9c l\u1ed9 qu\u00e1 m\u1ee9c HER2 l\u00e0m gia t\u0103ng nguy c\u01a1 ung th\u01b0. X\u00e9t nghi\u1ec7m\u00a0 th\u1ef1c hi\u1ec7n qua nhu\u1ed9m h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch ho\u1eb7c k\u1ef9 thu\u1eadt FISH (Fluorescent insitu\u00a0 hybridization), Dual ISH v\u00e0 gi\u1ea3i tr\u00ecnh t\u1ef1 gene. <\/span><span style=\"font-weight: 400;\">V\u1edbi UTDD giai \u0111o\u1ea1n mu\u1ed9n c\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb \u0111\u00edch trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 b\u1ed9c l\u1ed9 HER2.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; MSI (microsatellite instability \u2013m\u1ea5t \u1ed5n \u0111\u1ecbnh v\u1ecb v\u1ec7 tinh) ho\u1eb7c dMMR (deficient mismatch repair \u2013 thi\u1ebfu h\u1ee5t h\u1ec7 th\u1ed1ng s\u1eeda ch\u1eefa gh\u00e9p c\u1eb7p sai): s\u1ef1 m\u1ea5t \u1ed5n \u0111\u1ecbnh v\u1ecb v\u1ec7 tinh (MSI) l\u00e0 s\u1ef1 t\u00edch t\u1ee5 c\u00e1c l\u1ed7i trong v\u00f9ng vi v\u1ec7 tinh c\u1ee7a DNA d\u1eabn \u0111\u1ebfn s\u1ef1 t\u0103ng \u0111\u1ed9t\u00a0 bi\u1ebfn v\u00e0 do thi\u1ebfu h\u1ee5t h\u1ec7 th\u1ed1ng s\u1eeda ch\u1eefa gh\u00e9p c\u1eb7p sai DNA. C\u00e1c tr\u01b0\u1eddng h\u1ee3p MSI\u00a0 bi\u1ec3u hi\u1ec7n cao ho\u1eb7c c\u00f3 thi\u1ebfu h\u1ee5t h\u1ec7 th\u1ed1ng s\u1eeda ch\u1eefa gh\u00e9p c\u1eb7p sai l\u00e0 c\u00e1c y\u1ebfu t\u1ed1 bi\u1ec3u\u00a0 hi\u1ec7n ti\u00ean l\u01b0\u01a1ng x\u1ea5u c\u1ee7a b\u1ec7nh v\u00e0 l\u00e0 y\u1ebfu t\u1ed1 ch\u1ec9 \u0111i\u1ec3m b\u1ec7nh c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb \u1ee9c\u00a0 ch\u1ebf \u0111i\u1ec3m mi\u1ec5n d\u1ecbch. X\u00e9t nghi\u1ec7m th\u1ef1c hi\u1ec7n qua nhu\u1ed9m h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch ho\u1eb7c k\u1ef9 <\/span><span style=\"font-weight: 400;\">thu\u1eadt x\u00e9t nghi\u1ec7m khu\u1ebfch \u0111\u1ea1i chu\u1ed7i ADN polymerase <\/span><b>(<\/b><span style=\"font-weight: 400;\">PCR), gi\u1ea3i tr\u00ecnh t\u1ef1 gene.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; PD-L1 (programmed death-ligand 1: th\u1ee5 th\u1ec3 g\u00e2y ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh\u00a0 1): khi c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y b\u1ed9c l\u1ed9 tr\u00ean t\u1ebf b\u00e0o ung th\u01b0, n\u00f3 s\u1ebd g\u1eafn v\u1edbi t\u1ebf b\u00e0o T mi\u1ec5n\u00a0 d\u1ecbch t\u1ea1i v\u1ecb tr\u00ed PD-1, n\u00ean s\u1ebd l\u00e0m cho t\u1ebf b\u00e0o T kh\u00f4ng nh\u1eadn di\u1ec7n t\u1ebf b\u00e0o \u00e1c t\u00ednh.\u00a0 \u0110i\u1ec1u tr\u1ecb mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean c\u01a1 s\u1edf g\u1eafn \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 l\u00e0m cho t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch\u00a0 nh\u1eadn di\u1ec7n \u0111\u01b0\u1ee3c t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 g\u00e2y ch\u1ebft theo ch\u01b0\u01a1ng tr\u00ecnh. X\u00e9t nghi\u1ec7m th\u1ef1c\u00a0 hi\u1ec7n qua nhu\u1ed9m h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch ho\u1eb7c k\u1ef9 thu\u1eadt FISH, gi\u1ea3i tr\u00ecnh t\u1ef1 gene.<\/span><\/p>\n<h3><b>3.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh\u00a0<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">&#8211; L\u00e2m s\u00e0ng.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; C\u1eadn l\u00e2m s\u00e0ng:\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u1eddng x\u00e1c \u0111\u1ecbnh qua n\u1ed9i soi.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">H\u00ecnh \u1ea3nh h\u1ecdc (si\u00eau \u00e2m n\u1ed9i soi, CT, MRI, PET\/CT \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n). <\/span><\/li>\n<li><span style=\"font-weight: 400;\">M\u00f4 b\u1ec7nh h\u1ecdc: l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh ung th\u01b0 <\/span><\/li>\n<\/ul>\n<h3><b>3.4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t\u00a0<\/b><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">Vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Lo\u1ea1n s\u1ea3n d\u1ea1 d\u00e0y\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">U lympho bi\u1ec3u hi\u1ec7n \u1edf d\u1ea1 d\u00e0y\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">U m\u00f4 \u0111\u1ec7m \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (GIST) bi\u1ec3u hi\u1ec7n t\u1ea1i d\u1ea1 d\u00e0y\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">M\u1ed9t s\u1ed1 ung th\u01b0 kh\u00e1c di c\u0103n, x\u00e2m l\u1ea5n d\u1ea1 d\u00e0y\u00a0<\/span><\/li>\n<\/ul>\n<h3><b>3.5. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n\u00a0<\/b><\/h3>\n<p><strong>X\u1ebfp lo\u1ea1i T.N.M, giai \u0111o\u1ea1n theo AJCC 2017 phi\u00ean b\u1ea3n l\u1ea7n th\u1ee9 8<\/strong><\/p>\n<p><b>X\u1ebfp nh\u00f3m giai \u0111o\u1ea1n theo m\u1ee9c \u0111\u1ed9 lan tr\u00e0n c\u1ee7a b\u1ec7nh:\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; <\/span><b><i>Ung th\u01b0 d\u1ea1 d\u00e0y s\u1edbm (Early Gastric Cancer &#8211; EGC): <\/i><\/b><span style=\"font-weight: 400;\">\u0111\u01b0\u1ee3c hi\u1ec7p h\u1ed9i ung th\u01b0 d\u1ea1 d\u00e0y x\u00e1c \u0111\u1ecbnh n\u0103m 1962 g\u1ed3m c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 d\u1ea1 d\u00e0y m\u1edbi x\u00e2m l\u1ea5n n\u00f4ng\u00a0 \u0111\u1ebfn m\u1ee9c T1 (thu\u1ed9c giai \u0111o\u1ea1n I: T1N0M0; T1N1M0; T2N0M0).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; <\/span><b><i>Ung th\u01b0 d\u1ea1 d\u00e0y ti\u1ebfn tri\u1ec3n (Advanced stages Gastric Cancer): <\/i><\/b><span style=\"font-weight: 400;\">g\u1ed3m nh\u00f3m ng\u01b0\u1eddi\u00a0 b\u1ec7nh thu\u1ed9c giai \u0111o\u1ea1n T3-T4b; N2-3; M0-M1.\u00a0<\/span><\/p>\n<h3><b>3.6. S\u00e0ng l\u1ecdc &#8211; ph\u00e1t hi\u1ec7n s\u1edbm:\u00a0<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">UTDD l\u00e0 b\u1ec7nh c\u00f3 th\u1ec3 s\u00e0ng l\u1ecdc, ph\u00e1t hi\u1ec7n s\u1edbm \u0111\u01b0\u1ee3c, tuy nhi\u00ean t\u1ea1i Vi\u1ec7t Nam ch\u01b0a\u00a0 tri\u1ec3n khai \u0111\u01b0\u1ee3c ch\u01b0\u01a1ng tr\u00ecnh s\u00e0ng l\u1ecdc qu\u1ed1c gia. \u0110\u1ed1i t\u01b0\u1ee3ng s\u00e0ng l\u1ecdc c\u1ea7n l\u01b0u \u00fd nh\u1eefng\u00a0 ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh UTDD ho\u1eb7c b\u1ec7nh l\u00fd \u00e1c t\u00ednh \u0111\u01b0\u01a1ng ti\u00eau h\u00f3a. Ti\u1ec1n s\u1eed vi\u00eam\u00a0 lo\u00e9t d\u1ea1 d\u00e0y m\u00e3n t\u00ednh.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Do c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh giai \u0111o\u1ea1n s\u1edbm th\u01b0\u1eddng kh\u00f4ng r\u00f5 ho\u1eb7c kh\u00e1 m\u01a1 h\u1ed3 n\u00ean\u00a0 vi\u1ec7c s\u00e0ng l\u1ecdc ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o n\u1ed9i soi d\u1ea1 d\u00e0y. C\u00e1c k\u1ef9 thu\u1eadt ngo\u00e0i n\u1ed9i soi th\u00f4ng\u00a0 th\u01b0\u1eddng c\u00f2n bao g\u1ed3m n\u1ed9i soi ph\u00f3ng \u0111\u1ea1i, n\u1ed9i soi nhu\u1ed9m m\u00e0u c\u00f3 ch\u1ec9 \u0111i\u1ec3m \u2026\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110\u1ed9 tu\u1ed5i khuy\u1ebfn c\u00e1o n\u00ean n\u1ed9i soi t\u1ea7m so\u00e1t kh\u00e1c nhau t\u00f9y qu\u1ed1c gia: t\u1ea1i Nh\u1eadt b\u1ea3n\u00a0 khuy\u1ebfn c\u00e1o ch\u1ee5p d\u1ea1 d\u00e0y \u0111\u1ed1i quang k\u00e9p h\u00e0ng n\u0103m cho nh\u1eefng ng\u01b0\u1eddi t\u1eeb 50 tu\u1ed5i tr\u1edf l\u00ean ho\u1eb7c n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean m\u1ed7i 2 ho\u1eb7c 3 n\u0103m. H\u00e0n Qu\u1ed1c khuy\u1ebfn c\u00e1o n\u1ed9i soi ti\u00eau\u00a0 h\u00f3a tr\u00ean cho ng\u01b0\u1eddi t\u1eeb 40 tu\u1ed5i tr\u1edf l\u00ean m\u1ed7i 2 n\u0103m. Theo nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1ec1 UTDD\u00a0 t\u1ea1i Vi\u1ec7t Nam cho th\u1ea5y \u0111\u1ed9 tu\u1ed5i m\u1eafc ng\u00e0y c\u00e0ng tr\u1ebb do \u0111\u00f3 nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed vi\u00eam\u00a0 lo\u00e9t d\u1ea1 d\u00e0y m\u00e3n t\u00ednh, nhi\u1ec5m HP c\u1ea7n theo d\u00f5i th\u01b0\u1eddng xuy\u00ean. Nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3\u00a0 ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u1ea7n n\u1ed9i soi th\u01b0\u1eddng xuy\u00ean t\u1eeb 40 tu\u1ed5i tr\u1edf l\u00ean. C\u00f2n l\u1ea1i n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n\u00a0 n\u1ed9i soi ki\u1ec3m tra t\u1eeb 45-50 tu\u1ed5i.\u00a0<\/span><\/p>\n<p><a class=\"link-in-body\" href=\"https:\/\/www.vinmec.com\/\"><b class=\"link-in-body\">B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/b><\/a>\u00a0\u0111\u00e3 \u0111\u01b0a h\u1ec7 th\u1ed1ng m\u00e1y m\u00f3c, thi\u1ebft b\u1ecb g\u00e2y m\u00ea ph\u1eabu thu\u1eadt hi\u1ec7n \u0111\u1ea1i \u0111\u1ea1t chu\u1ea9n v\u00e0o c\u00f4ng t\u00e1c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n, g\u00e2y m\u00ea v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn d\u1ea1 d\u00e0y, ti\u00eau h\u00f3a. \u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, Qu\u00fd kh\u00e1ch vui l\u00f2ng b\u1ea5m s\u1ed1 <a class=\"contact-button link-in-body\" href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/chi-dinh-cat-toan-bo-da-day\/?link_type=related_posts#\"><b class=\"link-in-body\">HOTLINE<\/b><\/a>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0<a class=\"appointment-button link-in-body\" href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/chi-dinh-cat-toan-bo-da-day\/?link_type=related_posts#\"><b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b><\/a>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0<a class=\"link-in-body\" href=\"https:\/\/www.vinmec.com\/myvinmec\/\" target=\"_blank\" rel=\"noopener\">\u1ee9ng d\u1ee5ng MyVinmec<\/a>\u00a0\u0111\u1ec3 qu\u1ea3n l\u00fd, theo d\u00f5i l\u1ecbch v\u00e0 \u0111\u1eb7t h\u1eb9n m\u1ecdi l\u00fac m\u1ecdi n\u01a1i ngay tr\u00ean \u1ee9ng d\u1ee5ng.<\/p>\n<p>Ngu\u1ed3n: B\u1ed9 Y t\u1ebf. H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 d\u1ea1 d\u00e0y.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 d\u1ea1 d\u00e0y (UTDD) l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh ung th\u01b0 (UT) ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean\u00a0 th\u1ebf gi\u1edbi. UTDD \u0111\u1ee9ng th\u1ee9 3 \u1edf c\u1ea3 hai gi\u1edbi sau ung th\u01b0 gan v\u00e0 ung th\u01b0 ph\u1ed5i v\u1edbi t\u1ef7 l\u1ec7 m\u1eafc\u00a0 chu\u1ea9n theo tu\u1ed5i l\u00e0 11,38\/100.000 d\u00e2n. Trong \u0111\u00f3, lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn chi\u1ebfm\u00a0 ch\u1ee7 [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":19078,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n ung th\u01b0 d\u1ea1 d\u00e0y theo B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"Ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 c\u00e1c t\u1ebf b\u00e0o d\u1ea1 d\u00e0y ph\u00e1t tri\u1ec3n m\u1ea5t ki\u1ec3m so\u00e1t, t\u1ea1o th\u00e0nh c\u00e1c kh\u1ed1i u t\u1ea1i d\u1ea1 d\u00e0y, c\u00f3 th\u1ec3 lan ra xung quanh v\u00e0 di c\u0103n xa.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n ung th\u01b0 d\u1ea1 d\u00e0y theo B\u1ed9 Y t\u1ebf - 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