{"id":24491,"date":"2023-04-28T03:38:24","date_gmt":"2023-04-27T20:38:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24491"},"modified":"2023-04-28T03:38:24","modified_gmt":"2023-04-27T20:38:24","slug":"cac-he-thong-phan-loai-ung-thu-gan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/28\/cac-he-thong-phan-loai-ung-thu-gan\/","title":{"rendered":"C\u00e1c h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i ung th\u01b0 t\u1ebf b\u00e0o gan"},"content":{"rendered":"

Ung th\u01b0 t\u1ebf b\u00e0o gan l\u00e0 lo\u1ea1i ung th\u01b0 ph\u00e1t tri\u1ec3n t\u1eeb t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 gan, chi\u1ebfm ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan. C\u00f3 nhi\u1ec1u thang \u0111i\u1ec3m kh\u00e1c nhau \u0111\u1ec3 ph\u00e2n lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 gan, bao g\u1ed3m k\u00edch th\u01b0\u1edbc c\u1ee7a kh\u1ed1i u, s\u1ed1 l\u01b0\u1ee3ng kh\u1ed1i u, m\u1ee9c \u0111\u1ed9 ph\u00e2n h\u00f3a c\u1ee7a t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a b\u1ec7nh. Vi\u1ec7c ph\u00e2n lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 gan gi\u00fap \u0111\u01b0a ra d\u1ef1 \u0111o\u00e1n v\u1ec1 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n

1. H\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i TNM<\/h2>\n

H\u1ec7 th\u1ed1ng TNM c\u1ee7a \u1ee6y ban Ung th\u01b0 M\u1ef9 (AJCC) l\u00e0 m\u1ed9t h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i ung th\u01b0 d\u1ef1a tr\u00ean ba y\u1ebfu t\u1ed1 ch\u00ednh: k\u00edch th\u01b0\u1edbc c\u1ee7a kh\u1ed1i u (T), t\u00ecnh tr\u1ea1ng c\u00e1c n\u00fat b\u1ea1ch huy\u1ebft (N) v\u00e0 m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a ung th\u01b0 (M).<\/p>\n

– T (Tumor): x\u00e1c \u0111\u1ecbnh k\u00edch th\u01b0\u1edbc v\u00e0 m\u1ee9c \u0111\u1ed9 x\u00e2m chi\u1ebfm c\u1ee7a kh\u1ed1i u trong c\u01a1 quan b\u1ec7nh nh\u00e2n.
\n– N (Node): \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u00e1c n\u00fat b\u1ea1ch huy\u1ebft xung quanh kh\u1ed1i u, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a ung th\u01b0 qua h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u v\u00e0 m\u1ea1ch b\u1ea1ch huy\u1ebft.
\n– M (Metastasis): x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a ung th\u01b0 \u0111\u1ebfn c\u00e1c b\u1ed9 ph\u1eadn kh\u00e1c trong c\u01a1 th\u1ec3.<\/p>\n

\"\"
h\u1ec7 th\u1ed1ng TNM c\u1ee7a \u1ee6y ban Ung th\u01b0 M\u1ef9 (AJCC)<\/figcaption><\/figure>\n

H\u1ec7 th\u1ed1ng TNM \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a ung th\u01b0 v\u00e0 gi\u00fap x\u00e1c \u0111\u1ecbnh k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p. Ngo\u00e0i ra, h\u1ec7 th\u1ed1ng TNM c\u0169ng cung c\u1ea5p th\u00f4ng tin v\u1ec1 t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 d\u1ef1 \u0111o\u00e1n v\u1ec1 t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n trong t\u01b0\u01a1ng lai.<\/p>\n

2.\u00a0Ph\u00e2n lo\u1ea1i\u00a0<\/strong>ung th\u01b0 t\u1ebf b\u00e0o gan theo Barcelona (Barcelona Clinic Cancer: BCLC)<\/strong><\/h2>\n

Ung th\u01b0 gan \u0111\u01b0\u1ee3c chia l\u00e0m 5 giai \u0111o\u1ea1n: 0, A, B, C, v\u00e0 D d\u1ef1a tr\u00ean ch\u1ec9 s\u1ed1 Child-Pugh\/Okuda, ch\u1ec9 s\u1ed1 PS (Performance score), s\u1ed1 l\u01b0\u1ee3ng v\u00e0 t\u00ecnh tr\u1ea1ng kh\u1ed1i u.<\/p>\n

\"\"
B\u1ea3ng ph\u00e2n lo\u1ea1i theo Barcelona<\/figcaption><\/figure>\n

B\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n 0, A, B, v\u00e0 C c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1eadn g\u1ed1c (0 v\u00e0 A) hay h\u1ed7 tr\u1ee3 (B v\u00e0 C) b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ti\u00eau chu\u1ea9n. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn qua c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean, v\u1ed1n l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 c\u1ee7a m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p m\u1edbi tr\u01b0\u1edbc khi \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng ph\u1ed5 bi\u1ebfn. B\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n D c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c nh\u1eb1m l\u00e0m gi\u1ea3m \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh. Kh\u00f4ng c\u00f3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0o gi\u00fap k\u00e9o d\u00e0i s\u1ef1 s\u1ed1ng trong giai \u0111o\u1ea1n n\u00e0y.<\/p>\n

–\u00a0<\/em><\/strong>G<\/em><\/strong>iai\u00a0\u0111o\u1ea1n\u00a0\u0111\u1ea7u\u00a0(BCLC\u00a00\u00a0hay\u00a0A)<\/em><\/strong>:<\/em><\/strong><\/p>\n

Ph\u1eabu thu\u1eadt c\u1eaft gan l\u00e0 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean v\u1edbi t\u1ec9 l\u1ec7 s\u1ed1ng s\u00f3t sau 5 n\u0103m l\u00e0 70%. \u0110\u1ed1i t\u01b0\u1ee3ng th\u00edch h\u1ee3p cho ph\u1eabu thu\u1eadt l\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c kh\u1ed1i u n\u1eb1m \u0111\u01a1n l\u1ebb, kh\u00f4ng b\u1ecb t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda (portal hypertension) v\u00e0 gan c\u00f2n ho\u1ea1t \u0111\u1ed9ng t\u1ed1t. Th\u00f4ng th\u01b0\u1eddng, to\u00e0n b\u1ed9 thu\u1ef3 gan ch\u1ee9a t\u1ebf b\u00e0o ung th\u01b0 c\u1ea7n \u0111\u01b0\u1ee3c c\u1eaft b\u1ecf.
\nGh\u00e9p gan l\u00e0 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t d\u00e0nh cho b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 c\u1eaft b\u1ecf th\u00f9y gan, nh\u01b0ng c\u00f3 t\u00ecnh tr\u1ea1ng kh\u1ed1i u ph\u00f9 h\u1ee3p theo ti\u00eau chu\u1ea9n Milan (1 kh\u1ed1i u nh\u1ecf h\u01a1n 5 cm hay t\u1ed1i \u0111a<\/em>\u00a03 kh\u1ed1i u v\u00e0 kh\u00f4ng kh\u1ed1i n\u00e0o l\u1edbn h\u01a1n 3 cm, v\u00e0 c\u00e1c kh\u1ed1i kh\u00f4ng lan v\u00e0o m\u1ea1ch m\u00e1u hay ra b\u00ean ngo\u00e0i gan<\/em>). \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 gh\u00e9p gan v\u00e0 c\u00f3 1 kh\u1ed1i nh\u1ecf h\u01a1n 2 cm, \u0111\u1ed1t t\u1ebf b\u00e0o b\u1eb1ng s\u00f3ng nhi\u1ec7t l\u00e0 li\u1ec7u ph\u00e1p t\u1ed1i \u01b0u v\u1edbi kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t-5 n\u0103m t\u1eeb 50 – 70%.<\/p>\n

–\u00a0<\/em><\/strong>G<\/em><\/strong>iai\u00a0\u0111o\u1ea1n\u00a0gi\u1eefa\u00a0(BCLC\u00a0B)<\/em><\/strong><\/p>\n

\u0110\u1eb7c \u0111i\u1ec3m b\u1ec7nh giai \u0111o\u1ea1n n\u00e0y l\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a nhi\u1ec1u\u00a0 \u00e1c t\u00ednh, c\u00e1c m\u1ea1ch m\u00e1u t\u1eadp trung trong t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 \u0111\u00e3 l\u00e2y lan ra ngo\u00e0i gan. Tuy nhi\u00ean, ch\u1ee9c n\u0103ng gan v\u1eabn c\u00f2n, v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh ch\u01b0a ph\u00e1t ra ngo\u00e0i. Ho\u00e1 tr\u1ecb n\u1ed9i soi qua \u1ed1ng th\u00f4ng \u0111\u1ed9ng m\u1ea1ch (transcatheter arterial chemoembolization, TACE) l\u00e0 li\u1ec7u ph\u00e1p ti\u00eau chu\u1ea9n v\u1edbi th\u1eddi gian s\u1ed1ng s\u00f3t t\u1eeb 26-40 th\u00e1ng.<\/p>\n

–\u00a0<\/em><\/strong>G<\/em><\/strong>iai\u00a0\u0111o\u1ea1n\u00a0g\u1ea7n\u00a0cu\u1ed1i\u00a0(BCLC\u00a0C)<\/em><\/strong>:<\/em><\/strong><\/p>\n

Thu\u1ed1c sorafenib, m\u1ed9t ch\u1ea5t ng\u0103n ch\u1eb7n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a nhi\u1ec1u men k\u00edch ho\u1ea1t nh\u00f3m tyrosine, cho ph\u00e9p n\u00e2ng cao r\u00f5 r\u1ec7t t\u1ec9 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a b\u1ec7nh nh\u00e2n ung th\u01b0 giai \u0111o\u1ea1n cu\u1ed1i t\u1eeb 7,9 \u2013 10,7 th\u00e1ng. Hi\u1ec7u qu\u1ea3 c\u1ee7a sorafenib th\u1ec3 hi\u1ec7n tr\u00ean t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i ung th\u01b0 gan, v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n ch\u00e2u \u00c1 nhi\u1ec5m si\u00eau vi B.<\/p>\n

3. Ph\u00e2n lo\u1ea1i\u00a0<\/strong>ung th\u01b0 t\u1ebf b\u00e0o gan theo CLIP<\/a> (Cancer of the Liver Italian Program)<\/strong><\/h2>\n

CLIP (Cancer of the Liver Italian Program) l\u00e0 m\u1ed9t h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i ung th\u01b0 t\u1ebf b\u00e0o gan \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n t\u1ea1i \u00dd, d\u1ef1a tr\u00ean m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 ch\u00ednh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh:<\/p>\n

1. B\u1ec7nh l\u00fd gan
\n2. L\u01b0\u1ee3ng alpha-fetoprotein (AFP) trong m\u00e1u
\n3. K\u00edch th\u01b0\u1edbc c\u1ee7a kh\u1ed1i u
\n4. S\u1ed1 l\u01b0\u1ee3ng v\u00f9ng b\u1ecb x\u00e2m l\u1ea5n b\u1edfi kh\u1ed1i u<\/p>\n

D\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y, CLIP chia ung th\u01b0 t\u1ebf b\u00e0o gan th\u00e0nh ba giai \u0111o\u1ea1n kh\u00e1c nhau:<\/p>\n

– Giai \u0111o\u1ea1n 0: ung th\u01b0 t\u1ebf b\u00e0o gan \u1edf giai \u0111o\u1ea1n s\u1edbm, kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng c\u00f3 x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u01a1 quan kh\u00e1c.
\n– Giai \u0111o\u1ea1n 1: ung th\u01b0 t\u1ebf b\u00e0o gan \u0111\u00e3 x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u01a1 quan xung quanh ho\u1eb7c lan ra c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn.
\n– Giai \u0111o\u1ea1n 2: ung th\u01b0 t\u1ebf b\u00e0o gan \u0111\u00e3 lan ra to\u00e0n b\u1ed9 gan ho\u1eb7c x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u01a1 quan kh\u00e1c ngo\u00e0i gan.<\/p>\n

H\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i CLIP \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a ung th\u01b0 t\u1ebf b\u00e0o gan v\u00e0 gi\u00fap x\u00e1c \u0111\u1ecbnh k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p. N\u00f3 c\u0169ng cung c\u1ea5p th\u00f4ng tin v\u1ec1 t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 d\u1ef1 \u0111o\u00e1n v\u1ec1 t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n trong t\u01b0\u01a1ng lai.<\/p>\n

4. Ph\u00e2n lo\u1ea1i Child-Pugh<\/h2>\n

Child-Pugh l\u00e0 m\u1ed9t h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a suy gan m\u1ea1n t\u00ednh. H\u1ec7 th\u1ed1ng n\u00e0y \u0111\u01b0\u1ee3c \u0111\u1eb7t theo t\u00ean c\u1ee7a hai nh\u00e0 nghi\u00ean c\u1ee9u ng\u01b0\u1eddi Anh l\u00e0 Child v\u00e0 Pugh.<\/p>\n

H\u1ec7 th\u1ed1ng Child-Pugh s\u1eed d\u1ee5ng n\u0103m y\u1ebfu t\u1ed1 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng suy gan m\u1ea1n t\u00ednh, bao g\u1ed3m:<\/p>\n

    \n
  1. M\u1ee9c \u0111\u1ed9 suy gi\u1ea3m ch\u1ee9c n\u0103ng gan (d\u1ef1a tr\u00ean n\u1ed3ng \u0111\u1ed9 bilirubin v\u00e0 albumin trong m\u00e1u)<\/strong><\/li>\n
  2. M\u1ee9c \u0111\u1ed9 suy gi\u1ea3m ch\u1ee9c n\u0103ng c\u01a1 th\u1ec3 (d\u1ef1a tr\u00ean INR – ch\u1ec9 s\u1ed1 \u0111\u00f4ng m\u00e1u)<\/strong><\/li>\n
  3. T\u00ecnh tr\u1ea1ng b\u1ec7nh x\u01a1 gan v\u00e0 t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch (d\u1ef1a tr\u00ean d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng)<\/strong><\/li>\n
  4. M\u1ee9c \u0111\u1ed9 ch\u1ea3y m\u00e1u t\u1eeb \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (d\u1ef1a tr\u00ean d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng)<\/strong><\/li>\n
  5. M\u1ee9c \u0111\u1ed9 suy gi\u1ea3m ch\u1ee9c n\u0103ng gan theo ti\u00eau chu\u1ea9n qu\u1ed1c t\u1ebf c\u1ee7a WHO (World Health Organization) (m\u00ecnh ngh\u0129 n\u1ebfu Tr\u00fac c\u00f3 th\u1ec3 match \u0111\u01b0\u1ee3c 5 y\u1ebfu t\u1ed1 \u0111\u1ecbnh l\u01b0\u1ee3ng trong \u1ea3nh ph\u00eda d\u01b0\u1edbi v\u1edbi 5 y\u1ebfu t\u1ed1 n\u00e0y th\u00ec s\u1ebd d\u1ec5 hi\u1ec3u h\u01a1n, h\u1ea1n ch\u1ebf t\u00ecnh tr\u1ea1ng kh\u00f4ng r\u00f5 t\u1ea1i sao \u1ea3nh kh\u00e1c text).<\/strong><\/li>\n<\/ol>\n
    \"\"
    B\u1ea3ng ph\u00e2n lo\u1ea1i Child-Pugh<\/figcaption><\/figure>\n

    D\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o m\u1ed9t trong ba l\u1edbp \u0111\u1ed9 nghi\u00eam tr\u1ecdng kh\u00e1c nhau (A, B ho\u1eb7c C), v\u1edbi l\u1edbp A l\u00e0 nh\u1eb9 nh\u1ea5t v\u00e0 l\u1edbp C l\u00e0 nghi\u00eam tr\u1ecdng nh\u1ea5t. \u0110\u00e1nh gi\u00e1 theo h\u1ec7 th\u1ed1ng Child-Pugh gi\u00fap \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh v\u1ec1 \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 \u0111o\u00e1n t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a b\u1ec7nh nh\u00e2n trong t\u01b0\u01a1ng lai.<\/p>\n

    Ngo\u00e0i ra c\u00f2n r\u1ea5t nhi\u1ec1u b\u1ea3ng \u0111i\u1ec3m v\u00e0 h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i kh\u00e1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb, theo d\u00f5i b\u1ec7nh l\u00fd tr\u00ean nh\u01b0 JIS ( Japan Integrated Staging Score ) c\u1ee7a Nh\u1eadt B\u1ea3n, VISUM-HCC ( Vienna Survival Model for HCC ) c\u1ee7a \u00c1o, CUPI ( Chinese University Prognostic Index ) c\u1ee7a Trung Qu\u1ed1c\u2026 M\u1ed7i h\u1ec7 th\u1ed1ng \u0111\u1ec1u c\u00f3 \u01b0u , nh\u01b0\u1ee3c \u0111i\u1ec3m ri\u00eang , nh\u01b0ng ch\u01b0a c\u00f3 h\u1ec7 th\u1ed1ng n\u00e0o \u0111\u01b0\u1ee3c xem l\u00e0 ho\u00e0n h\u1ea3o. Ri\u00eang c\u00e1ch ph\u00e2n chia giai \u0111o\u1ea1n ch\u1ee9c n\u0103ng gan c\u1ee7a Child-Pugh \u00e1p d\u1ee5ng cho x\u01a1 gan v\u1eabn c\u00f3 gi\u00e1 tr\u1ecb trong c\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 d\u1ef1 tr\u1eef ch\u1ee9c n\u0103ng gan.<\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Ung th\u01b0 t\u1ebf b\u00e0o gan l\u00e0 lo\u1ea1i ung th\u01b0 ph\u00e1t tri\u1ec3n t\u1eeb t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 gan, chi\u1ebfm ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan. C\u00f3 nhi\u1ec1u thang \u0111i\u1ec3m kh\u00e1c nhau \u0111\u1ec3 ph\u00e2n lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 gan, bao g\u1ed3m k\u00edch th\u01b0\u1edbc c\u1ee7a kh\u1ed1i u, s\u1ed1 l\u01b0\u1ee3ng kh\u1ed1i u, m\u1ee9c \u0111\u1ed9 ph\u00e2n h\u00f3a […]<\/p>\n","protected":false},"author":30,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\nC\u00e1c h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i ung th\u01b0 t\u1ebf b\u00e0o gan - Vinmec<\/title>\n<meta name=\"description\" content=\"Hi\u1ec7n nay c\u00f3 r\u1ea5t nhi\u1ec1u h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i ung th\u01b0 t\u1ebf b\u00e0o gan. 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