{"id":21882,"date":"2023-04-16T17:46:10","date_gmt":"2023-04-16T10:46:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21882"},"modified":"2023-04-17T12:32:10","modified_gmt":"2023-04-17T05:32:10","slug":"tieu-chuan-chan-doan-ung-thu-bieu-mo-te-bao-gan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/tieu-chuan-chan-doan-ung-thu-bieu-mo-te-bao-gan\/","title":{"rendered":"Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan"},"content":{"rendered":"<div><strong>Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan, hay c\u00f2n g\u1ecdi l\u00e0 ung th\u01b0 gan, l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y ung th\u01b0 gan bao g\u1ed3m: vi\u00eam gan do virus vi\u00eam gan B ho\u1eb7c C, u\u1ed1ng r\u01b0\u1ee3u nhi\u1ec1u ho\u1eb7c u\u1ed1ng qu\u00e1 li\u1ec1u trong th\u1eddi gian d\u00e0i, b\u00e9o ph\u00ec, ti\u1ec3u \u0111\u01b0\u1eddng, &#8230; Ung th\u01b0 b\u1eaft ngu\u1ed3n t\u1eeb c\u00e1c t\u1ebf b\u00e0o trong gan v\u00e0 c\u00f3 th\u1ec3 lan sang c\u00e1c b\u1ed9 ph\u1eadn kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3. V\u00ec v\u1eady vi\u1ec7c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan l\u00e0 r\u1ea5t quan tr\u1ecdng.<\/strong><\/div>\n<div>\n<figure id=\"attachment_22350\" aria-describedby=\"caption-attachment-22350\" style=\"width: 225px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-22350 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-450564725-612x612-1-225x300.jpg\" alt=\"ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan l\u00e0 r\u1ea5t quan tr\u1ecdng.\" width=\"225\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-450564725-612x612-1-225x300.jpg 225w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-450564725-612x612-1.jpg 459w\" sizes=\"(max-width: 225px) 100vw, 225px\" \/><figcaption id=\"caption-attachment-22350\" class=\"wp-caption-text\">Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan l\u00e0 r\u1ea5t quan tr\u1ecdng.<\/figcaption><\/figure>\n<\/div>\n<div>\n<p>&nbsp;<\/p>\n<h2><b>1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan<\/b><\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng vi\u1ec7c ki\u1ec3m tra v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf l\u00e0:<\/p>\n<p>Khi t\u1ed5n th\u01b0\u01a1ng \u1edf gan c\u00f3 m\u1ed9t trong ba ti\u00eau chu\u1ea9n sau:<\/p>\n<p>&#8211; H\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh c\u1ee7a ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan tr\u00ean CT scan b\u1ee5ng c\u00f3 c\u1ea3n quang ho\u1eb7c MRI b\u1ee5ng c\u00f3 t\u01b0\u01a1ng ph\u1ea3n t\u1eeb + AFP \u2265 400 ng\/ml.<\/p>\n<p>&#8211; H\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh c\u1ee7a ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan tr\u00ean CT scan b\u1ee5ng c\u00f3 c\u1ea3n quang ho\u1eb7c MRI b\u1ee5ng c\u00f3 t\u01b0\u01a1ng ph\u1ea3n t\u1eeb + AFP t\u0103ng cao h\u01a1n b\u00ecnh th\u01b0\u1eddng (nh\u01b0ng ch\u01b0a \u0111\u1ebfn 400 ng\/ml) + c\u00f3 nhi\u1ec5m HBV v\u00e0\/ho\u1eb7c HCV. C\u00f3 th\u1ec3 l\u00e0m sinh thi\u1ebft gan \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh n\u1ebfu b\u00e1c s\u0129 l\u00e2m s\u00e0ng th\u1ea5y c\u1ea7n thi\u1ebft.<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u1ee7 c\u00e1c ti\u00eau chu\u1ea9n n\u00f3i tr\u00ean \u0111\u1ec1u ph\u1ea3i l\u00e0m sinh thi\u1ebft kh\u1ed1i u gan (c\u00f3 th\u1ec3 ph\u1ea3i l\u00e0m nhi\u1ec1u l\u1ea7n) \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh. N\u1ebfu sinh thi\u1ebft l\u1ea1i v\u1eabn \u00e2m t\u00ednh th\u00ec c\u00f3 th\u1ec3 theo d\u00f5i v\u00e0 l\u00e0m l\u1ea1i c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh h\u1ecdc v\u00e0 ch\u1ec9 d\u1ea5u sinh h\u1ecdc m\u1ed7i 2 th\u00e1ng.<\/p>\n<p>&#8211; C\u00f3 b\u1eb1ng ch\u1ee9ng gi\u1ea3i ph\u1eabu b\u1ec7nh l\u00fd l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan.<\/p>\n<p><i>*\u00a0<\/i><i>H\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh tr\u00ean CT scan b\u1ee5ng c\u00f3 c\u1ea3n quang ho\u1eb7c MRI b\u1ee5ng c\u00f3 t\u01b0\u01a1ng ph\u1ea3n t\u1eeb: (c\u00e1c) kh\u1ed1i u b\u1eaft thu\u1ed1c tr\u00ean th\u00ec \u0111\u1ed9ng m\u1ea1ch gan v\u00e0 th\u1ea3i thu\u1ed1c (wash-out) tr\u00ean th\u00ec t\u0129nh m\u1ea1ch c\u1eeda hay th\u00ec ch\u1eadm. N\u00ean ch\u1ee5p MRI v\u1edbi ch\u1ea5t t\u01b0\u01a1ng ph\u1ea3n t\u1eeb gan &#8211; m\u1eadt gadoxetate disodium (Gd-EOB-DTPA &#8211; gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid) \u0111\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan.<\/i><\/p>\n<\/div>\n<div>\n<figure style=\"width: 864px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/thuvienphapluat.vn\/doc2htm\/00447851_files\/image001.jpg\" alt=\"S\u01a1 \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan\" width=\"864\" height=\"345\" \/><figcaption class=\"wp-caption-text\">S\u01a1 \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan<\/figcaption><\/figure>\n<p><b>\u00a0<\/b><\/p>\n<\/div>\n<p><b>\u00a0<\/b><b>2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/b><\/p>\n<div>\n<p>&#8211; U m\u00e1u \u1edf gan (hemangioma): kh\u1ed1i u b\u1eaft thu\u1ed1c t\u0103ng d\u1ea7n t\u1eeb th\u00ec \u0111\u1ed9ng m\u1ea1ch gan \u0111\u1ebfn th\u00ec ch\u1eadm tr\u00ean CT scan ho\u1eb7c MRI, ch\u1ec9 d\u1ea5u sinh h\u1ecdc c\u1ee7a ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng nhi\u1ec5m HBV v\u00e0\/ho\u1eb7c HCV.<\/p>\n<p>&#8211; C\u00e1c u l\u00e0nh \u1edf gan nh\u01b0 u tuy\u1ebfn (adenoma), t\u0103ng sinh d\u1ea1ng n\u1ed1t (focal nodular hyperplasia \u2013 FNH), \u00e1p xe gan, n\u1ed1t v\u00f4i h\u00f3a \u1edf gan, \u2026: h\u00ecnh \u1ea3nh kh\u00f4ng \u0111i\u1ec3n h\u00ecnh tr\u00ean CT scan ho\u1eb7c MRI, ch\u1ec9 d\u1ea5u sinh h\u1ecdc c\u1ee7a ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng nhi\u1ec5m HBV v\u00e0\/ho\u1eb7c HCV, c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh nh\u1edd MRI b\u1ee5ng c\u00f3 t\u01b0\u01a1ng ph\u1ea3n t\u1eeb \u0111\u1eb7c hi\u1ec7u ho\u1eb7c sinh thi\u1ebft gan.<\/p>\n<p>&#8211; Ung th\u01b0 \u0111\u01b0\u1eddng m\u1eadt trong gan: kh\u1ed1i u b\u1eaft thu\u1ed1c kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u, kh\u00f4ng c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng th\u1ea3i thu\u1ed1c, ch\u1ec9 d\u1ea5u ung th\u01b0 CEA, CA 19.9 c\u00f3 th\u1ec3 t\u0103ng cao. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh nh\u1edd sinh thi\u1ebft gan.<\/p>\n<p>&#8211; Di c\u0103n gan c\u1ee7a c\u00e1c ung th\u01b0 kh\u00e1c (ung th\u01b0 d\u1ea1 d\u00e0y, ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng, ung th\u01b0 ph\u1ed5i, ung th\u01b0 v\u00fa, \u2026): h\u00ecnh \u1ea3nh b\u1eaft thu\u1ed1c d\u1ea1ng vi\u1ec1n tr\u00ean CT scan ho\u1eb7c MRI, c\u00e1c ch\u1ec9 d\u1ea5u ung th\u01b0 t\u01b0\u01a1ng \u1ee9ng t\u0103ng cao, c\u00f3 t\u1ed5n th\u01b0\u01a1ng nguy\u00ean ph\u00e1t, \u2026<\/p>\n<h2><b>3. Ph\u00e2n chia giai \u0111o\u1ea1n b\u1ec7nh<\/b><\/h2>\n<p>C\u00e1c H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb c\u1ee7a Nh\u00f3m Ung th\u01b0 gan Barcelona (BCLC), H\u1ed9i Nghi\u00ean c\u1ee9u b\u1ec7nh gan ch\u00e2u \u00c2u (EASL), H\u1ed9i Ung th\u01b0 N\u1ed9i khoa ch\u00e2u \u00c2u (ESMO) v\u00e0 H\u1ed9i Nghi\u00ean c\u1ee9u b\u1ec7nh gan Hoa K\u1ef3 (AASLD) ph\u00e2n chia ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan th\u00e0nh 5 giai \u0111o\u1ea1n b\u1ec7nh: 0 (r\u1ea5t s\u1edbm), A (s\u1edbm), B (trung gian), C (ti\u1ebfn tri\u1ec3n), D (cu\u1ed1i), \u0111\u1ec3 \u0111\u1ec1 ra c\u00e1ch \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n<p>Trong khi \u0111\u00f3, Hi\u1ec7p h\u1ed9i nghi\u00ean c\u1ee9u b\u1ec7nh gan ch\u00e2u \u00c1 Th\u00e1i B\u00ecnh D\u01b0\u01a1ng (APASL) kh\u00f4ng ph\u00e2n chia giai \u0111o\u1ea1n b\u1ec7nh, m\u00e0 d\u1ef1a tr\u00ean 6 y\u1ebfu t\u1ed1: di c\u0103n ngo\u00e0i gan, ch\u1ee9c n\u0103ng gan (\u0111\u00e1nh gi\u00e1 b\u1eb1ng h\u1ec7 th\u1ed1ng Child-Pugh), kh\u1ea3 n\u0103ng c\u1eaft gan \u0111\u01b0\u1ee3c, x\u00e2m nh\u1eadp m\u1ea1ch m\u00e1u l\u1edbn, s\u1ed1 l\u01b0\u1ee3ng u, k\u00edch th\u01b0\u1edbc u, \u0111\u1ec3 ch\u1ecdn l\u1ef1a c\u00e1c \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n<p>T\u1ea1i Vi\u1ec7t Nam, tr\u00ean th\u1ef1c t\u1ebf l\u00e2m s\u00e0ng, th\u01b0\u1eddng ch\u1ec9 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng b\u1ec7nh c\u00f2n kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb hay kh\u00f4ng, do \u0111\u00f3 c\u00f3 th\u1ec3 d\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 c\u1ee7a APASL \u0111\u1ec3 ch\u1ecdn l\u1ef1a c\u00e1ch \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u khoa h\u1ecdc th\u00ec c\u00f3 th\u1ec3 d\u1ef1a tr\u00ean ph\u00e2n chia giai \u0111o\u1ea1n b\u1ec7nh c\u1ee7a BCLC, EASL, ESMO hay AASLD (Ph\u1ee5 l\u1ee5c 5) \u0111\u1ec3 ch\u1ecdn ra nh\u00f3m b\u1ec7nh nh\u00e2n ph\u00f9 h\u1ee3p cho nghi\u00ean c\u1ee9u.<\/p>\n<p>T\u00f3m l\u1ea1i, ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ph\u00e1t hi\u1ec7n b\u1ec7nh s\u1edbm v\u00e0 t\u0103ng c\u01a1 h\u1ed9i \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3. V\u00ec ung th\u01b0 gan th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng s\u1edbm, n\u00ean c\u00e1c x\u00e9t nghi\u1ec7m s\u00e0ng l\u1ecdc th\u01b0\u1eddng xuy\u00ean l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft. i\u1ec7c ch\u1ea9n \u0111o\u00e1n s\u1edbm c\u00f3 th\u1ec3 gi\u00fap t\u0103ng c\u01a1 h\u1ed9i \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng, c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe cho b\u1ec7nh nh\u00e2n v\u00e0 gi\u00fap k\u00e9o d\u00e0i th\u1eddi gian s\u1ed1ng cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n<p><iframe loading=\"lazy\" title=\"Gh\u00e9p gan c\u1ee9u s\u1ed1ng ng\u01b0\u1eddi ung th\u01b0 gan, x\u01a1 gan giai \u0111o\u1ea1n cu\u1ed1i\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kYEePtrmllQ?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan, hay c\u00f2n g\u1ecdi l\u00e0 ung th\u01b0 gan, l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y ung th\u01b0 gan bao g\u1ed3m: vi\u00eam gan do virus vi\u00eam gan B ho\u1eb7c C, u\u1ed1ng r\u01b0\u1ee3u nhi\u1ec1u ho\u1eb7c u\u1ed1ng qu\u00e1 li\u1ec1u trong [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan - Vinmec<\/title>\n<meta name=\"description\" content=\"Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan, hay c\u00f2n g\u1ecdi l\u00e0 ung th\u01b0 gan, l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi. 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