![\"minh-hoa-ung-thu-co-tu-cung-pho-bien\"](\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20201220_132120_290098_57.max-1800x1800-1-300x178.jpg\")
2. Ch\u1ea9n \u0111o\u00e1n ung th\u01b0 c\u1ed5 t\u1eed cung<\/h2>\n2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 c\u1ed5 t\u1eed cung<\/h3>\n2.1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h4>\n\n- Ra m\u00e1u b\u1ea5t th\u01b0\u1eddng \u1edf \u00e2m \u0111\u1ea1o: ra m\u00e1u sau giao h\u1ee3p, gi\u1eefa hai k\u1ef3 kinh, sau m\u00e3n kinh, sau \u0111\u1ea1i ti\u1ec7n g\u1eafng s\u1ee9c.<\/li>\n
- Ra kh\u00ed h\u01b0 nhi\u1ec1u, kh\u00ed h\u01b0 l\u1eabn m\u00e1u, c\u00f3 m\u00f9i h\u00f4i.<\/li>\n
- \u0110au v\u00f9ng h\u1ea1 v\u1ecb, \u0111au ngang c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng.<\/li>\n
- C\u00f3 th\u1ec3 bi\u1ebfng \u0103n, s\u00fat c\u00e2n, suy th\u1eadn, ph\u00f9 hai ch\u00e2n, r\u00f2 ph\u00e2n v\u00e0 n\u01b0\u1edbc ti\u1ec3u qua \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o\u2026 khi b\u1ec7nh \u1edf giai \u0111o\u1ea1n mu\u1ed9n.<\/li>\n
- Kh\u00e1m l\u00e2m s\u00e0ng:<\/li>\n<\/ul>\n
+ Th\u0103m kh\u00e1m \u00e2m \u0111\u1ea1o b\u1eb1ng tay v\u00e0 m\u1ecf v\u1ecbt: \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung, m\u1ee9c \u0111\u1ed9 lan tr\u00e0n c\u1ee7a kh\u1ed1i u ra v\u00f9ng t\u00fai c\u00f9ng v\u00e0 th\u00e0nh \u00e2m \u0111\u1ea1o. Quan s\u00e1t tr\u1ef1c ti\u1ebfp t\u1ed5n th\u01b0\u01a1ng v\u00e0 sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc: h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng t\u1ea1i c\u1ed5 t\u1eed cung: u th\u1ec3 s\u00f9i, lo\u00e9t, s\u00f9i lo\u00e9t, th\u00e2m nhi\u1ec5m. C\u1ea7n \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc kh\u1ed1i u v\u00e0 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n c\u1ee7a kh\u1ed1i u v\u00e0o \u00e2m \u0111\u1ea1o, t\u00fai c\u00f9ng. Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u: sinh thi\u1ebft t\u1ea1i r\u00eca kh\u1ed1i u.<\/p>\n
+ Th\u0103m tr\u1ef1c tr\u00e0ng: \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n v\u00e0o d\u00e2y ch\u1eb1ng r\u1ed9ng, tr\u1ef1c tr\u00e0ng (n\u1ebfu c\u00f3).<\/p>\n
+ N\u1ebfu kh\u1ed1i u kh\u00f4ng r\u00f5 r\u00e0ng c\u1ea7n ki\u1ec3m tra b\u00ean trong \u1ed1ng c\u1ed5 t\u1eed cung, c\u00f3 th\u1ec3 n\u1ea1o ho\u1eb7c h\u00fat \u1ed1ng c\u1ed5 t\u1eed cung \u0111\u1ec3 l\u1ea5y b\u1ec7nh ph\u1ea9m.<\/p>\n
2.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n\n- X\u00e9t nghi\u1ec7m t\u1ebf b\u00e0o h\u1ecdc c\u1ed5 t\u1eed cung-\u00e2m \u0111\u1ea1o (Test PAP):<\/li>\n<\/ul>\n
+ L\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0, ung th\u01b0 \u1edf giai \u0111o\u1ea1n s\u1edbm v\u00e0 \u0111u\u1ee3c d\u00f9ng trong s\u00e0ng l\u1ecdc ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 \u1edf c\u1ed9ng \u0111\u1ed3ng.<\/p>\n
+ Qu\u1ec7t t\u1ebf b\u00e0o bong c\u1ed5 trong v\u00e0 c\u1ed5 ngo\u00e0i t\u1eed cung, nhu\u1ed9m soi ph\u00e1t hi\u1ec7n t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng.<\/p>\n
\n- Khi phi\u1ebfn \u0111\u1ed3 nghi ng\u1edd c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea7n ti\u1ebfn h\u00e0nh soi c\u1ed5 t\u1eed cung v\u00e0 sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/li>\n<\/ul>\n
+ Soi c\u1ed5 t\u1eed cung: gi\u00fap quan s\u00e1t t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung \u1edf giai \u0111o\u1ea1n s\u1edbm, x\u00e1c \u0111\u1ecbnh v\u00f9ng ranh gi\u1edbi t\u1ed5n th\u01b0\u01a1ng, qua \u0111\u00f3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed sinh thi\u1ebft ch\u00ednh x\u00e1c. \u0110\u1ec3 quan s\u00e1t r\u00f5 t\u1ed5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 l\u00e0m nghi\u1ec7m ph\u00e1p Schiller (nghi\u1ec7m ph\u00e1t Lugol): iod s\u1ebd l\u00e0m cho nh\u1eefng t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng (c\u00f3 ch\u1ee9a glycogen) tr\u1edf n\u00ean s\u1eabm m\u00e0u, nh\u1eefng t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng s\u1ebd kh\u00f4ng \u0111\u1ed5i m\u00e0u v\u00e0 ti\u1ebfn h\u00e0nh sinh thi\u1ebft v\u00f9ng kh\u00f4ng \u0111\u1ed5i m\u00e0u.<\/p>\n
+ Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng: d\u00f9ng k\u00ecm sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc.<\/p>\n
+ Kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung: l\u00e0 bi\u1ec7n ph\u00e1p l\u1ea5y b\u1ec7nh ph\u1ea9m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u1ed3ng th\u1eddi c\u0169ng l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ed5 t\u1eed cung giai \u0111o\u1ea1n t\u1ea1i ch\u1ed7.<\/p>\n
\n- C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n: si\u00eau \u00e2m \u1ed5 b\u1ee5ng, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, c\u1ed9ng h\u01b0\u1edfng t\u1eeb, n\u1ed9i soi b\u00e0ng quang-tr\u1ef1c tr\u00e0ng\u2026<\/li>\n
- X\u00e9t nghi\u1ec7m ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u1ed1i u (tumor marker): CEA, CA12-5, SCC t\u0103ng cao trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. C\u00f3 gi\u00e1 tr\u1ecb theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ph\u00e1t hi\u1ec7n b\u1ec7nh t\u00e1i ph\u00e1t, di c\u0103n xa.<\/li>\n
- X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n 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 tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n.<\/li>\n
- X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n
- Ch\u1ee5p PET\/CT v\u1edbi 18<\/sup>F-FDG tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u nguy\u00ean ph\u00e1t, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh; ch\u1ee5p sau \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n; m\u00f4 ph\u1ecfng l\u1eadp k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb.<\/li>\n
- X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed: Gi\u1ea3i tr\u00ecnh t\u1ef1 nhi\u1ec1u gen.<\/li>\n<\/ul>\n
2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n\n- \u00a0Giai \u0111o\u1ea1n s\u1edbm: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: vi\u00eam l\u1ed9 tuy\u1ebfn c\u1ed5 t\u1eed cung, lo\u00e9t c\u1ed5 t\u1eed cung.<\/li>\n
- \u00a0Giai \u0111o\u1ea1n mu\u1ed9n: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: l\u1ed9 tuy\u1ebfn nhi\u1ec5m khu\u1ea9n, lao c\u1ed5 t\u1eed cung, giang mai c\u1ed5 t\u1eed cung, polyp c\u1ed5 t\u1eed cung, u nh\u00fa c\u1ed5 t\u1eed cung.<\/li>\n<\/ul>\n
2.3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/h3>\n
M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c coi l\u00e0 c\u00f3 li\u00ean quan nhi\u1ec1u \u0111\u1ebfn ung th\u01b0 c\u1ed5 t\u1eed cung nh\u01b0: quan h\u1ec7 t\u00ecnh d\u1ee5c s\u1edbm, v\u1edbi nhi\u1ec1u ng\u01b0\u1eddi, sinh \u0111\u1ebb nhi\u1ec1u, v\u1ec7 sinh sinh d\u1ee5c k\u00e9m. Nhi\u1ec5m Human papiloma virus (HPV)<\/a>: l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra 70% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Bao g\u1ed3m 140 typ, trong \u0111\u00f3 c\u00f3 20 typ li\u00ean quan \u0111\u1ebfn ung th\u01b0, \u0111\u1eb7c bi\u1ec7t typ 6, 11, 16, 18 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong ung th\u01b0 c\u1ed5 t\u1eed cung. HPV typ 16 li\u00ean quan \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y t\u1ebf b\u00e0o l\u1edbn, HPV typ 18 li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u00edt bi\u1ec7t h\u00f3a v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn.<\/p>\n2.4. Ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc<\/h3>\n
B\u1ec7nh ph\u1ea9m \u0111\u01b0\u1ee3c l\u1ea5y qua sinh thi\u1ebft, kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung, b\u1ec7nh ph\u1ea9m sau ph\u1eabu thu\u1eadt. Bao g\u1ed3m c\u00e1c typ: ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y: chi\u1ebfm tr\u00ean 90%. Ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn, tuy\u1ebfn v\u1ea3y, u lympho, sarcoma\u2026<\/p>\n
2.5. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung c\u1ee7a Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 Qu\u1ed1c t\u1ebf (FIGO, 2018) v\u00e0 ph\u00e2n lo\u1ea1i TNM theo AJCC (2017).<\/p>\n
B\u1ea3ng 1. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung<\/p>\n
\n\n\nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nT (kh\u1ed1i u)<\/td>\n <\/td>\n <\/td>\n<\/tr>\n \nTx<\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nT0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 kh\u1ed1i u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nTis<\/sub><\/td>\n0<\/td>\n Ung th\u01b0 t\u1ea1i ch\u1ed7<\/td>\n<\/tr>\n \nT1<\/sub><\/td>\nI<\/td>\n U c\u00f2n khu tr\u00fa t\u1ea1i t\u1eed cung<\/td>\n<\/tr>\n \nT1A <\/sub><\/td>\nI1A<\/sub><\/td>\nUng th\u01b0 x\u00e2m l\u1ea5n x\u00e1c \u0111\u1ecbnh tr\u00ean vi th\u1ec3. X\u00e2m l\u1ea5n m\u00f4 \u0111\u1ec7m s\u00e2u \u22645mm t\u1eeb m\u00e0ng \u0111\u00e1y v\u00e0 r\u1ed9ng \u22647mm.<\/td>\n<\/tr>\n \nT1a1 <\/sub><\/td>\nIA1<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22643mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1a2 <\/sub><\/td>\nIA2<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22645mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1b <\/sub><\/td>\nIB<\/sub><\/td>\nU c\u00f2n khu tr\u00fa t\u1ea1i c\u1ed5 t\u1eed cung, k\u00edch th\u01b0\u1edbc l\u1edbn h\u01a1n T1a<\/sub>\/IA2 <\/sub><\/td>\n<\/tr>\n\nIB1<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc \u22642cm<\/td>\n<\/tr>\n \nIB2 <\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc 2-4cm<\/td>\n<\/tr>\n \nIB3<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n \nT2<\/sub><\/td>\nII<\/td>\n Ung th\u01b0 x\u00e2m l\u1ea5n qu\u00e1 c\u1ed5 t\u1eed cung nh\u01b0ng ch\u01b0a lan \u0111\u1ebfn v\u00e1ch ch\u1eadu hay ch\u01b0a t\u1edbi 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o<\/td>\n<\/tr>\n \nT2a <\/sub><\/p>\nT2a <\/sub><\/p>\nT2a<\/sub><\/td>\nIIA <\/sub><\/p>\nIIA1<\/sub><\/p>\nIIA2<\/sub><\/td>\nCh\u01b0a x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/p>\nU k\u00edch th\u01b0\u1edbc \u22644cm<\/p>\n
U k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n
\nT2b <\/sub><\/td>\nIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/td>\n<\/tr>\n \nT3<\/sub><\/td>\nIII<\/td>\n U x\u00e2m l\u1ea5n \u0111\u1ebfn v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c x\u00e2m l\u1ea5n 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o v\u00e0\/ho\u1eb7c g\u00e2y \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT3A<\/sub><\/td>\nIIIA<\/sub><\/td>\nU x\u00e2m l\u1ea5n \u0111\u1ebfn 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o, ch\u01b0a x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu<\/td>\n<\/tr>\n \nT3B<\/sub><\/td>\nIIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c g\u00e2y th\u1eadn \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT4<\/sub><\/td>\nIVA<\/sub><\/td>\nU x\u00e2m l\u1ea5n ra ngo\u00e0i khung ch\u1eadu ho\u1eb7c x\u00e2m l\u1ea5n b\u00e0ng quang, tr\u1ef1c tr\u00e0ng (c\u00f3 b\u1eb1ng ch\u1ee9ng gi\u1ea3i ph\u1eabu b\u1ec7nh)<\/td>\n<\/tr>\n \nN (H\u1ea1ch v\u00f9ng): di c\u0103n h\u1ea1ch v\u00f9ng (h\u1ea1ch v\u00f9ng bao g\u1ed3m h\u1ea1ch quanh CTC, d\u00e2y ch\u1eb1ng r\u1ed9ng, h\u1ea1ch h\u1ed1 b\u1ecbt, h\u1ea1ch ch\u1eadu g\u1ed1c, ch\u1eadu trong, ch\u1eadu ngo\u00e0i, tr\u01b0\u1edbc x\u01b0\u01a1ng c\u00f9ng, x\u01b0\u01a1ng c\u00f9ng).<\/td>\n<\/tr>\n \nNx <\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nN0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nN0(i+) <\/sub><\/td>\n<\/td>\n C\u00e1c t\u1ebf b\u00e0o u t\u00e1ch bi\u1ec7t \u1edf h\u1ea1ch v\u00f9ng k\u00edch th\u01b0\u1edbc \u22640,2mm<\/td>\n<\/tr>\n \nN1<\/td>\n <\/td>\n Di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nM: Di c\u0103n xa<\/td>\n<\/tr>\n \nM0<\/sub><\/td>\n<\/td>\n Ch\u01b0a c\u00f3 di c\u0103n xa<\/td>\n<\/tr>\n \nM1<\/sub><\/td>\nIVB<\/sub><\/td>\nDi c\u0103n xa (bao g\u1ed3m lan tr\u00e0n ph\u00fac m\u1ea1c, h\u1ea1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, h\u1ea1ch trung th\u1ea5t, h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, gan, ph\u1ed5i, x\u01b0\u01a1ng)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
B\u1ea3ng 2. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
\n\n\nGiai \u0111o\u1ea1n<\/td>\n T<\/td>\n M<\/td>\n<\/tr>\n \nI<\/td>\n T1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA<\/sub><\/td>\nT1a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA1<\/sub><\/td>\nT1a1 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA2 <\/sub><\/td>\nT1a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB<\/sub><\/td>\nT1b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB1 <\/sub><\/td>\nT1b1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB2 <\/sub><\/td>\nT1b2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nII<\/td>\n T2<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA<\/sub><\/td>\nT2a<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA1<\/sub><\/td>\nT2a1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA2<\/sub><\/td>\nT2a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIB<\/sub><\/td>\nT2b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIII<\/td>\n T3<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIA<\/sub><\/td>\nT3a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIB<\/sub><\/td>\nT3b<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVA<\/sub><\/td>\nT4<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVB<\/sub><\/td>\nTb\u1ea5t k\u1ef3 <\/sub><\/td>\nM1<\/sub><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n","protected":false},"excerpt":{"rendered":"
Ung th\u01b0 c\u1ed5 t\u1eed cung l\u00e0 b\u1ec7nh ung th\u01b0 ph\u1ed5 bi\u1ebfn \u1edf ph\u1ee5 n\u1eef nhi\u1ec1u n\u01b0\u1edbc tr\u00ean th\u1ec3 gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n ph\u00e1t hi\u1ec7n ung th\u01b0 c\u1ed5 t\u1eed cung s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n […]<\/p>\n","protected":false},"author":43,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\n
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2.1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h4>\n\n- Ra m\u00e1u b\u1ea5t th\u01b0\u1eddng \u1edf \u00e2m \u0111\u1ea1o: ra m\u00e1u sau giao h\u1ee3p, gi\u1eefa hai k\u1ef3 kinh, sau m\u00e3n kinh, sau \u0111\u1ea1i ti\u1ec7n g\u1eafng s\u1ee9c.<\/li>\n
- Ra kh\u00ed h\u01b0 nhi\u1ec1u, kh\u00ed h\u01b0 l\u1eabn m\u00e1u, c\u00f3 m\u00f9i h\u00f4i.<\/li>\n
- \u0110au v\u00f9ng h\u1ea1 v\u1ecb, \u0111au ngang c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng.<\/li>\n
- C\u00f3 th\u1ec3 bi\u1ebfng \u0103n, s\u00fat c\u00e2n, suy th\u1eadn, ph\u00f9 hai ch\u00e2n, r\u00f2 ph\u00e2n v\u00e0 n\u01b0\u1edbc ti\u1ec3u qua \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o\u2026 khi b\u1ec7nh \u1edf giai \u0111o\u1ea1n mu\u1ed9n.<\/li>\n
- Kh\u00e1m l\u00e2m s\u00e0ng:<\/li>\n<\/ul>\n
+ Th\u0103m kh\u00e1m \u00e2m \u0111\u1ea1o b\u1eb1ng tay v\u00e0 m\u1ecf v\u1ecbt: \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung, m\u1ee9c \u0111\u1ed9 lan tr\u00e0n c\u1ee7a kh\u1ed1i u ra v\u00f9ng t\u00fai c\u00f9ng v\u00e0 th\u00e0nh \u00e2m \u0111\u1ea1o. Quan s\u00e1t tr\u1ef1c ti\u1ebfp t\u1ed5n th\u01b0\u01a1ng v\u00e0 sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc: h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng t\u1ea1i c\u1ed5 t\u1eed cung: u th\u1ec3 s\u00f9i, lo\u00e9t, s\u00f9i lo\u00e9t, th\u00e2m nhi\u1ec5m. C\u1ea7n \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc kh\u1ed1i u v\u00e0 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n c\u1ee7a kh\u1ed1i u v\u00e0o \u00e2m \u0111\u1ea1o, t\u00fai c\u00f9ng. Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u: sinh thi\u1ebft t\u1ea1i r\u00eca kh\u1ed1i u.<\/p>\n
+ Th\u0103m tr\u1ef1c tr\u00e0ng: \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n v\u00e0o d\u00e2y ch\u1eb1ng r\u1ed9ng, tr\u1ef1c tr\u00e0ng (n\u1ebfu c\u00f3).<\/p>\n
+ N\u1ebfu kh\u1ed1i u kh\u00f4ng r\u00f5 r\u00e0ng c\u1ea7n ki\u1ec3m tra b\u00ean trong \u1ed1ng c\u1ed5 t\u1eed cung, c\u00f3 th\u1ec3 n\u1ea1o ho\u1eb7c h\u00fat \u1ed1ng c\u1ed5 t\u1eed cung \u0111\u1ec3 l\u1ea5y b\u1ec7nh ph\u1ea9m.<\/p>\n
2.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n\n- X\u00e9t nghi\u1ec7m t\u1ebf b\u00e0o h\u1ecdc c\u1ed5 t\u1eed cung-\u00e2m \u0111\u1ea1o (Test PAP):<\/li>\n<\/ul>\n
+ L\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0, ung th\u01b0 \u1edf giai \u0111o\u1ea1n s\u1edbm v\u00e0 \u0111u\u1ee3c d\u00f9ng trong s\u00e0ng l\u1ecdc ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 \u1edf c\u1ed9ng \u0111\u1ed3ng.<\/p>\n
+ Qu\u1ec7t t\u1ebf b\u00e0o bong c\u1ed5 trong v\u00e0 c\u1ed5 ngo\u00e0i t\u1eed cung, nhu\u1ed9m soi ph\u00e1t hi\u1ec7n t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng.<\/p>\n
\n- Khi phi\u1ebfn \u0111\u1ed3 nghi ng\u1edd c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea7n ti\u1ebfn h\u00e0nh soi c\u1ed5 t\u1eed cung v\u00e0 sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/li>\n<\/ul>\n
+ Soi c\u1ed5 t\u1eed cung: gi\u00fap quan s\u00e1t t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung \u1edf giai \u0111o\u1ea1n s\u1edbm, x\u00e1c \u0111\u1ecbnh v\u00f9ng ranh gi\u1edbi t\u1ed5n th\u01b0\u01a1ng, qua \u0111\u00f3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed sinh thi\u1ebft ch\u00ednh x\u00e1c. \u0110\u1ec3 quan s\u00e1t r\u00f5 t\u1ed5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 l\u00e0m nghi\u1ec7m ph\u00e1p Schiller (nghi\u1ec7m ph\u00e1t Lugol): iod s\u1ebd l\u00e0m cho nh\u1eefng t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng (c\u00f3 ch\u1ee9a glycogen) tr\u1edf n\u00ean s\u1eabm m\u00e0u, nh\u1eefng t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng s\u1ebd kh\u00f4ng \u0111\u1ed5i m\u00e0u v\u00e0 ti\u1ebfn h\u00e0nh sinh thi\u1ebft v\u00f9ng kh\u00f4ng \u0111\u1ed5i m\u00e0u.<\/p>\n
+ Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng: d\u00f9ng k\u00ecm sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc.<\/p>\n
+ Kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung: l\u00e0 bi\u1ec7n ph\u00e1p l\u1ea5y b\u1ec7nh ph\u1ea9m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u1ed3ng th\u1eddi c\u0169ng l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ed5 t\u1eed cung giai \u0111o\u1ea1n t\u1ea1i ch\u1ed7.<\/p>\n
\n- C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n: si\u00eau \u00e2m \u1ed5 b\u1ee5ng, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, c\u1ed9ng h\u01b0\u1edfng t\u1eeb, n\u1ed9i soi b\u00e0ng quang-tr\u1ef1c tr\u00e0ng\u2026<\/li>\n
- X\u00e9t nghi\u1ec7m ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u1ed1i u (tumor marker): CEA, CA12-5, SCC t\u0103ng cao trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. C\u00f3 gi\u00e1 tr\u1ecb theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ph\u00e1t hi\u1ec7n b\u1ec7nh t\u00e1i ph\u00e1t, di c\u0103n xa.<\/li>\n
- X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n 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 tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n.<\/li>\n
- X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n
- Ch\u1ee5p PET\/CT v\u1edbi 18<\/sup>F-FDG tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u nguy\u00ean ph\u00e1t, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh; ch\u1ee5p sau \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n; m\u00f4 ph\u1ecfng l\u1eadp k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb.<\/li>\n
- X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed: Gi\u1ea3i tr\u00ecnh t\u1ef1 nhi\u1ec1u gen.<\/li>\n<\/ul>\n
2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n\n- \u00a0Giai \u0111o\u1ea1n s\u1edbm: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: vi\u00eam l\u1ed9 tuy\u1ebfn c\u1ed5 t\u1eed cung, lo\u00e9t c\u1ed5 t\u1eed cung.<\/li>\n
- \u00a0Giai \u0111o\u1ea1n mu\u1ed9n: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: l\u1ed9 tuy\u1ebfn nhi\u1ec5m khu\u1ea9n, lao c\u1ed5 t\u1eed cung, giang mai c\u1ed5 t\u1eed cung, polyp c\u1ed5 t\u1eed cung, u nh\u00fa c\u1ed5 t\u1eed cung.<\/li>\n<\/ul>\n
2.3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/h3>\n
M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c coi l\u00e0 c\u00f3 li\u00ean quan nhi\u1ec1u \u0111\u1ebfn ung th\u01b0 c\u1ed5 t\u1eed cung nh\u01b0: quan h\u1ec7 t\u00ecnh d\u1ee5c s\u1edbm, v\u1edbi nhi\u1ec1u ng\u01b0\u1eddi, sinh \u0111\u1ebb nhi\u1ec1u, v\u1ec7 sinh sinh d\u1ee5c k\u00e9m. Nhi\u1ec5m Human papiloma virus (HPV)<\/a>: l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra 70% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Bao g\u1ed3m 140 typ, trong \u0111\u00f3 c\u00f3 20 typ li\u00ean quan \u0111\u1ebfn ung th\u01b0, \u0111\u1eb7c bi\u1ec7t typ 6, 11, 16, 18 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong ung th\u01b0 c\u1ed5 t\u1eed cung. HPV typ 16 li\u00ean quan \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y t\u1ebf b\u00e0o l\u1edbn, HPV typ 18 li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u00edt bi\u1ec7t h\u00f3a v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn.<\/p>\n2.4. Ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc<\/h3>\n
B\u1ec7nh ph\u1ea9m \u0111\u01b0\u1ee3c l\u1ea5y qua sinh thi\u1ebft, kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung, b\u1ec7nh ph\u1ea9m sau ph\u1eabu thu\u1eadt. Bao g\u1ed3m c\u00e1c typ: ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y: chi\u1ebfm tr\u00ean 90%. Ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn, tuy\u1ebfn v\u1ea3y, u lympho, sarcoma\u2026<\/p>\n
2.5. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung c\u1ee7a Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 Qu\u1ed1c t\u1ebf (FIGO, 2018) v\u00e0 ph\u00e2n lo\u1ea1i TNM theo AJCC (2017).<\/p>\n
B\u1ea3ng 1. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung<\/p>\n
\n\n\nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nT (kh\u1ed1i u)<\/td>\n <\/td>\n <\/td>\n<\/tr>\n \nTx<\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nT0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 kh\u1ed1i u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nTis<\/sub><\/td>\n0<\/td>\n Ung th\u01b0 t\u1ea1i ch\u1ed7<\/td>\n<\/tr>\n \nT1<\/sub><\/td>\nI<\/td>\n U c\u00f2n khu tr\u00fa t\u1ea1i t\u1eed cung<\/td>\n<\/tr>\n \nT1A <\/sub><\/td>\nI1A<\/sub><\/td>\nUng th\u01b0 x\u00e2m l\u1ea5n x\u00e1c \u0111\u1ecbnh tr\u00ean vi th\u1ec3. X\u00e2m l\u1ea5n m\u00f4 \u0111\u1ec7m s\u00e2u \u22645mm t\u1eeb m\u00e0ng \u0111\u00e1y v\u00e0 r\u1ed9ng \u22647mm.<\/td>\n<\/tr>\n \nT1a1 <\/sub><\/td>\nIA1<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22643mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1a2 <\/sub><\/td>\nIA2<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22645mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1b <\/sub><\/td>\nIB<\/sub><\/td>\nU c\u00f2n khu tr\u00fa t\u1ea1i c\u1ed5 t\u1eed cung, k\u00edch th\u01b0\u1edbc l\u1edbn h\u01a1n T1a<\/sub>\/IA2 <\/sub><\/td>\n<\/tr>\n\nIB1<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc \u22642cm<\/td>\n<\/tr>\n \nIB2 <\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc 2-4cm<\/td>\n<\/tr>\n \nIB3<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n \nT2<\/sub><\/td>\nII<\/td>\n Ung th\u01b0 x\u00e2m l\u1ea5n qu\u00e1 c\u1ed5 t\u1eed cung nh\u01b0ng ch\u01b0a lan \u0111\u1ebfn v\u00e1ch ch\u1eadu hay ch\u01b0a t\u1edbi 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o<\/td>\n<\/tr>\n \nT2a <\/sub><\/p>\nT2a <\/sub><\/p>\nT2a<\/sub><\/td>\nIIA <\/sub><\/p>\nIIA1<\/sub><\/p>\nIIA2<\/sub><\/td>\nCh\u01b0a x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/p>\nU k\u00edch th\u01b0\u1edbc \u22644cm<\/p>\n
U k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n
\nT2b <\/sub><\/td>\nIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/td>\n<\/tr>\n \nT3<\/sub><\/td>\nIII<\/td>\n U x\u00e2m l\u1ea5n \u0111\u1ebfn v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c x\u00e2m l\u1ea5n 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o v\u00e0\/ho\u1eb7c g\u00e2y \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT3A<\/sub><\/td>\nIIIA<\/sub><\/td>\nU x\u00e2m l\u1ea5n \u0111\u1ebfn 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o, ch\u01b0a x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu<\/td>\n<\/tr>\n \nT3B<\/sub><\/td>\nIIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c g\u00e2y th\u1eadn \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT4<\/sub><\/td>\nIVA<\/sub><\/td>\nU x\u00e2m l\u1ea5n ra ngo\u00e0i khung ch\u1eadu ho\u1eb7c x\u00e2m l\u1ea5n b\u00e0ng quang, tr\u1ef1c tr\u00e0ng (c\u00f3 b\u1eb1ng ch\u1ee9ng gi\u1ea3i ph\u1eabu b\u1ec7nh)<\/td>\n<\/tr>\n \nN (H\u1ea1ch v\u00f9ng): di c\u0103n h\u1ea1ch v\u00f9ng (h\u1ea1ch v\u00f9ng bao g\u1ed3m h\u1ea1ch quanh CTC, d\u00e2y ch\u1eb1ng r\u1ed9ng, h\u1ea1ch h\u1ed1 b\u1ecbt, h\u1ea1ch ch\u1eadu g\u1ed1c, ch\u1eadu trong, ch\u1eadu ngo\u00e0i, tr\u01b0\u1edbc x\u01b0\u01a1ng c\u00f9ng, x\u01b0\u01a1ng c\u00f9ng).<\/td>\n<\/tr>\n \nNx <\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nN0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nN0(i+) <\/sub><\/td>\n<\/td>\n C\u00e1c t\u1ebf b\u00e0o u t\u00e1ch bi\u1ec7t \u1edf h\u1ea1ch v\u00f9ng k\u00edch th\u01b0\u1edbc \u22640,2mm<\/td>\n<\/tr>\n \nN1<\/td>\n <\/td>\n Di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nM: Di c\u0103n xa<\/td>\n<\/tr>\n \nM0<\/sub><\/td>\n<\/td>\n Ch\u01b0a c\u00f3 di c\u0103n xa<\/td>\n<\/tr>\n \nM1<\/sub><\/td>\nIVB<\/sub><\/td>\nDi c\u0103n xa (bao g\u1ed3m lan tr\u00e0n ph\u00fac m\u1ea1c, h\u1ea1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, h\u1ea1ch trung th\u1ea5t, h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, gan, ph\u1ed5i, x\u01b0\u01a1ng)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
B\u1ea3ng 2. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
\n\n\nGiai \u0111o\u1ea1n<\/td>\n T<\/td>\n M<\/td>\n<\/tr>\n \nI<\/td>\n T1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA<\/sub><\/td>\nT1a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA1<\/sub><\/td>\nT1a1 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA2 <\/sub><\/td>\nT1a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB<\/sub><\/td>\nT1b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB1 <\/sub><\/td>\nT1b1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB2 <\/sub><\/td>\nT1b2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nII<\/td>\n T2<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA<\/sub><\/td>\nT2a<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA1<\/sub><\/td>\nT2a1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA2<\/sub><\/td>\nT2a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIB<\/sub><\/td>\nT2b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIII<\/td>\n T3<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIA<\/sub><\/td>\nT3a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIB<\/sub><\/td>\nT3b<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVA<\/sub><\/td>\nT4<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVB<\/sub><\/td>\nTb\u1ea5t k\u1ef3 <\/sub><\/td>\nM1<\/sub><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n","protected":false},"excerpt":{"rendered":"
Ung th\u01b0 c\u1ed5 t\u1eed cung l\u00e0 b\u1ec7nh ung th\u01b0 ph\u1ed5 bi\u1ebfn \u1edf ph\u1ee5 n\u1eef nhi\u1ec1u n\u01b0\u1edbc tr\u00ean th\u1ec3 gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n ph\u00e1t hi\u1ec7n ung th\u01b0 c\u1ed5 t\u1eed cung s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n […]<\/p>\n","protected":false},"author":43,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\n
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+ Th\u0103m kh\u00e1m \u00e2m \u0111\u1ea1o b\u1eb1ng tay v\u00e0 m\u1ecf v\u1ecbt: \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung, m\u1ee9c \u0111\u1ed9 lan tr\u00e0n c\u1ee7a kh\u1ed1i u ra v\u00f9ng t\u00fai c\u00f9ng v\u00e0 th\u00e0nh \u00e2m \u0111\u1ea1o. Quan s\u00e1t tr\u1ef1c ti\u1ebfp t\u1ed5n th\u01b0\u01a1ng v\u00e0 sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc: h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng t\u1ea1i c\u1ed5 t\u1eed cung: u th\u1ec3 s\u00f9i, lo\u00e9t, s\u00f9i lo\u00e9t, th\u00e2m nhi\u1ec5m. C\u1ea7n \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc kh\u1ed1i u v\u00e0 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n c\u1ee7a kh\u1ed1i u v\u00e0o \u00e2m \u0111\u1ea1o, t\u00fai c\u00f9ng. Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u: sinh thi\u1ebft t\u1ea1i r\u00eca kh\u1ed1i u.<\/p>\n
+ Th\u0103m tr\u1ef1c tr\u00e0ng: \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n v\u00e0o d\u00e2y ch\u1eb1ng r\u1ed9ng, tr\u1ef1c tr\u00e0ng (n\u1ebfu c\u00f3).<\/p>\n
+ N\u1ebfu kh\u1ed1i u kh\u00f4ng r\u00f5 r\u00e0ng c\u1ea7n ki\u1ec3m tra b\u00ean trong \u1ed1ng c\u1ed5 t\u1eed cung, c\u00f3 th\u1ec3 n\u1ea1o ho\u1eb7c h\u00fat \u1ed1ng c\u1ed5 t\u1eed cung \u0111\u1ec3 l\u1ea5y b\u1ec7nh ph\u1ea9m.<\/p>\n
2.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n\n- X\u00e9t nghi\u1ec7m t\u1ebf b\u00e0o h\u1ecdc c\u1ed5 t\u1eed cung-\u00e2m \u0111\u1ea1o (Test PAP):<\/li>\n<\/ul>\n
+ L\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0, ung th\u01b0 \u1edf giai \u0111o\u1ea1n s\u1edbm v\u00e0 \u0111u\u1ee3c d\u00f9ng trong s\u00e0ng l\u1ecdc ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 \u1edf c\u1ed9ng \u0111\u1ed3ng.<\/p>\n
+ Qu\u1ec7t t\u1ebf b\u00e0o bong c\u1ed5 trong v\u00e0 c\u1ed5 ngo\u00e0i t\u1eed cung, nhu\u1ed9m soi ph\u00e1t hi\u1ec7n t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng.<\/p>\n
\n- Khi phi\u1ebfn \u0111\u1ed3 nghi ng\u1edd c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea7n ti\u1ebfn h\u00e0nh soi c\u1ed5 t\u1eed cung v\u00e0 sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/li>\n<\/ul>\n
+ Soi c\u1ed5 t\u1eed cung: gi\u00fap quan s\u00e1t t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung \u1edf giai \u0111o\u1ea1n s\u1edbm, x\u00e1c \u0111\u1ecbnh v\u00f9ng ranh gi\u1edbi t\u1ed5n th\u01b0\u01a1ng, qua \u0111\u00f3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed sinh thi\u1ebft ch\u00ednh x\u00e1c. \u0110\u1ec3 quan s\u00e1t r\u00f5 t\u1ed5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 l\u00e0m nghi\u1ec7m ph\u00e1p Schiller (nghi\u1ec7m ph\u00e1t Lugol): iod s\u1ebd l\u00e0m cho nh\u1eefng t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng (c\u00f3 ch\u1ee9a glycogen) tr\u1edf n\u00ean s\u1eabm m\u00e0u, nh\u1eefng t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng s\u1ebd kh\u00f4ng \u0111\u1ed5i m\u00e0u v\u00e0 ti\u1ebfn h\u00e0nh sinh thi\u1ebft v\u00f9ng kh\u00f4ng \u0111\u1ed5i m\u00e0u.<\/p>\n
+ Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng: d\u00f9ng k\u00ecm sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc.<\/p>\n
+ Kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung: l\u00e0 bi\u1ec7n ph\u00e1p l\u1ea5y b\u1ec7nh ph\u1ea9m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u1ed3ng th\u1eddi c\u0169ng l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ed5 t\u1eed cung giai \u0111o\u1ea1n t\u1ea1i ch\u1ed7.<\/p>\n
\n- C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n: si\u00eau \u00e2m \u1ed5 b\u1ee5ng, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, c\u1ed9ng h\u01b0\u1edfng t\u1eeb, n\u1ed9i soi b\u00e0ng quang-tr\u1ef1c tr\u00e0ng\u2026<\/li>\n
- X\u00e9t nghi\u1ec7m ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u1ed1i u (tumor marker): CEA, CA12-5, SCC t\u0103ng cao trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. C\u00f3 gi\u00e1 tr\u1ecb theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ph\u00e1t hi\u1ec7n b\u1ec7nh t\u00e1i ph\u00e1t, di c\u0103n xa.<\/li>\n
- X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n 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 tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n.<\/li>\n
- X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n
- Ch\u1ee5p PET\/CT v\u1edbi 18<\/sup>F-FDG tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u nguy\u00ean ph\u00e1t, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh; ch\u1ee5p sau \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n; m\u00f4 ph\u1ecfng l\u1eadp k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb.<\/li>\n
- X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed: Gi\u1ea3i tr\u00ecnh t\u1ef1 nhi\u1ec1u gen.<\/li>\n<\/ul>\n
2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n\n- \u00a0Giai \u0111o\u1ea1n s\u1edbm: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: vi\u00eam l\u1ed9 tuy\u1ebfn c\u1ed5 t\u1eed cung, lo\u00e9t c\u1ed5 t\u1eed cung.<\/li>\n
- \u00a0Giai \u0111o\u1ea1n mu\u1ed9n: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: l\u1ed9 tuy\u1ebfn nhi\u1ec5m khu\u1ea9n, lao c\u1ed5 t\u1eed cung, giang mai c\u1ed5 t\u1eed cung, polyp c\u1ed5 t\u1eed cung, u nh\u00fa c\u1ed5 t\u1eed cung.<\/li>\n<\/ul>\n
2.3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/h3>\n
M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c coi l\u00e0 c\u00f3 li\u00ean quan nhi\u1ec1u \u0111\u1ebfn ung th\u01b0 c\u1ed5 t\u1eed cung nh\u01b0: quan h\u1ec7 t\u00ecnh d\u1ee5c s\u1edbm, v\u1edbi nhi\u1ec1u ng\u01b0\u1eddi, sinh \u0111\u1ebb nhi\u1ec1u, v\u1ec7 sinh sinh d\u1ee5c k\u00e9m. Nhi\u1ec5m Human papiloma virus (HPV)<\/a>: l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra 70% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Bao g\u1ed3m 140 typ, trong \u0111\u00f3 c\u00f3 20 typ li\u00ean quan \u0111\u1ebfn ung th\u01b0, \u0111\u1eb7c bi\u1ec7t typ 6, 11, 16, 18 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong ung th\u01b0 c\u1ed5 t\u1eed cung. HPV typ 16 li\u00ean quan \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y t\u1ebf b\u00e0o l\u1edbn, HPV typ 18 li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u00edt bi\u1ec7t h\u00f3a v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn.<\/p>\n2.4. Ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc<\/h3>\n
B\u1ec7nh ph\u1ea9m \u0111\u01b0\u1ee3c l\u1ea5y qua sinh thi\u1ebft, kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung, b\u1ec7nh ph\u1ea9m sau ph\u1eabu thu\u1eadt. Bao g\u1ed3m c\u00e1c typ: ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y: chi\u1ebfm tr\u00ean 90%. Ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn, tuy\u1ebfn v\u1ea3y, u lympho, sarcoma\u2026<\/p>\n
2.5. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung c\u1ee7a Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 Qu\u1ed1c t\u1ebf (FIGO, 2018) v\u00e0 ph\u00e2n lo\u1ea1i TNM theo AJCC (2017).<\/p>\n
B\u1ea3ng 1. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung<\/p>\n
\n\n\nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nT (kh\u1ed1i u)<\/td>\n <\/td>\n <\/td>\n<\/tr>\n \nTx<\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nT0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 kh\u1ed1i u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \nTis<\/sub><\/td>\n0<\/td>\n Ung th\u01b0 t\u1ea1i ch\u1ed7<\/td>\n<\/tr>\n \nT1<\/sub><\/td>\nI<\/td>\n U c\u00f2n khu tr\u00fa t\u1ea1i t\u1eed cung<\/td>\n<\/tr>\n \nT1A <\/sub><\/td>\nI1A<\/sub><\/td>\nUng th\u01b0 x\u00e2m l\u1ea5n x\u00e1c \u0111\u1ecbnh tr\u00ean vi th\u1ec3. X\u00e2m l\u1ea5n m\u00f4 \u0111\u1ec7m s\u00e2u \u22645mm t\u1eeb m\u00e0ng \u0111\u00e1y v\u00e0 r\u1ed9ng \u22647mm.<\/td>\n<\/tr>\n \nT1a1 <\/sub><\/td>\nIA1<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22643mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1a2 <\/sub><\/td>\nIA2<\/sub><\/td>\nX\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22645mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \nT1b <\/sub><\/td>\nIB<\/sub><\/td>\nU c\u00f2n khu tr\u00fa t\u1ea1i c\u1ed5 t\u1eed cung, k\u00edch th\u01b0\u1edbc l\u1edbn h\u01a1n T1a<\/sub>\/IA2 <\/sub><\/td>\n<\/tr>\n\nIB1<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc \u22642cm<\/td>\n<\/tr>\n \nIB2 <\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc 2-4cm<\/td>\n<\/tr>\n \nIB3<\/sub><\/td>\nU k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n \nT2<\/sub><\/td>\nII<\/td>\n Ung th\u01b0 x\u00e2m l\u1ea5n qu\u00e1 c\u1ed5 t\u1eed cung nh\u01b0ng ch\u01b0a lan \u0111\u1ebfn v\u00e1ch ch\u1eadu hay ch\u01b0a t\u1edbi 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o<\/td>\n<\/tr>\n \nT2a <\/sub><\/p>\nT2a <\/sub><\/p>\nT2a<\/sub><\/td>\nIIA <\/sub><\/p>\nIIA1<\/sub><\/p>\nIIA2<\/sub><\/td>\nCh\u01b0a x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/p>\nU k\u00edch th\u01b0\u1edbc \u22644cm<\/p>\n
U k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n
\nT2b <\/sub><\/td>\nIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/td>\n<\/tr>\n \nT3<\/sub><\/td>\nIII<\/td>\n U x\u00e2m l\u1ea5n \u0111\u1ebfn v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c x\u00e2m l\u1ea5n 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o v\u00e0\/ho\u1eb7c g\u00e2y \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT3A<\/sub><\/td>\nIIIA<\/sub><\/td>\nU x\u00e2m l\u1ea5n \u0111\u1ebfn 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o, ch\u01b0a x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu<\/td>\n<\/tr>\n \nT3B<\/sub><\/td>\nIIIB <\/sub><\/td>\nU x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c g\u00e2y th\u1eadn \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \nT4<\/sub><\/td>\nIVA<\/sub><\/td>\nU x\u00e2m l\u1ea5n ra ngo\u00e0i khung ch\u1eadu ho\u1eb7c x\u00e2m l\u1ea5n b\u00e0ng quang, tr\u1ef1c tr\u00e0ng (c\u00f3 b\u1eb1ng ch\u1ee9ng gi\u1ea3i ph\u1eabu b\u1ec7nh)<\/td>\n<\/tr>\n \nN (H\u1ea1ch v\u00f9ng): di c\u0103n h\u1ea1ch v\u00f9ng (h\u1ea1ch v\u00f9ng bao g\u1ed3m h\u1ea1ch quanh CTC, d\u00e2y ch\u1eb1ng r\u1ed9ng, h\u1ea1ch h\u1ed1 b\u1ecbt, h\u1ea1ch ch\u1eadu g\u1ed1c, ch\u1eadu trong, ch\u1eadu ngo\u00e0i, tr\u01b0\u1edbc x\u01b0\u01a1ng c\u00f9ng, x\u01b0\u01a1ng c\u00f9ng).<\/td>\n<\/tr>\n \nNx <\/sub><\/td>\n<\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nTNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \nN0<\/sub><\/td>\n<\/td>\n Kh\u00f4ng di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nN0(i+) <\/sub><\/td>\n<\/td>\n C\u00e1c t\u1ebf b\u00e0o u t\u00e1ch bi\u1ec7t \u1edf h\u1ea1ch v\u00f9ng k\u00edch th\u01b0\u1edbc \u22640,2mm<\/td>\n<\/tr>\n \nN1<\/td>\n <\/td>\n Di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \nM: Di c\u0103n xa<\/td>\n<\/tr>\n \nM0<\/sub><\/td>\n<\/td>\n Ch\u01b0a c\u00f3 di c\u0103n xa<\/td>\n<\/tr>\n \nM1<\/sub><\/td>\nIVB<\/sub><\/td>\nDi c\u0103n xa (bao g\u1ed3m lan tr\u00e0n ph\u00fac m\u1ea1c, h\u1ea1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, h\u1ea1ch trung th\u1ea5t, h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, gan, ph\u1ed5i, x\u01b0\u01a1ng)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
B\u1ea3ng 2. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
\n\n\nGiai \u0111o\u1ea1n<\/td>\n T<\/td>\n M<\/td>\n<\/tr>\n \nI<\/td>\n T1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA<\/sub><\/td>\nT1a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA1<\/sub><\/td>\nT1a1 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIA2 <\/sub><\/td>\nT1a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB<\/sub><\/td>\nT1b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB1 <\/sub><\/td>\nT1b1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIB2 <\/sub><\/td>\nT1b2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nII<\/td>\n T2<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA<\/sub><\/td>\nT2a<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA1<\/sub><\/td>\nT2a1<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIA2<\/sub><\/td>\nT2a2 <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIB<\/sub><\/td>\nT2b <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIII<\/td>\n T3<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIA<\/sub><\/td>\nT3a <\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIIIB<\/sub><\/td>\nT3b<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVA<\/sub><\/td>\nT4<\/sub><\/td>\nM0<\/sub><\/td>\n<\/tr>\n\nIVB<\/sub><\/td>\nTb\u1ea5t k\u1ef3 <\/sub><\/td>\nM1<\/sub><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n","protected":false},"excerpt":{"rendered":"
Ung th\u01b0 c\u1ed5 t\u1eed cung l\u00e0 b\u1ec7nh ung th\u01b0 ph\u1ed5 bi\u1ebfn \u1edf ph\u1ee5 n\u1eef nhi\u1ec1u n\u01b0\u1edbc tr\u00ean th\u1ec3 gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n ph\u00e1t hi\u1ec7n ung th\u01b0 c\u1ed5 t\u1eed cung s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n […]<\/p>\n","protected":false},"author":43,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\n
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+ L\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0, ung th\u01b0 \u1edf giai \u0111o\u1ea1n s\u1edbm v\u00e0 \u0111u\u1ee3c d\u00f9ng trong s\u00e0ng l\u1ecdc ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 \u1edf c\u1ed9ng \u0111\u1ed3ng.<\/p>\n
+ Qu\u1ec7t t\u1ebf b\u00e0o bong c\u1ed5 trong v\u00e0 c\u1ed5 ngo\u00e0i t\u1eed cung, nhu\u1ed9m soi ph\u00e1t hi\u1ec7n t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng.<\/p>\n
- \n
- Khi phi\u1ebfn \u0111\u1ed3 nghi ng\u1edd c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea7n ti\u1ebfn h\u00e0nh soi c\u1ed5 t\u1eed cung v\u00e0 sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/li>\n<\/ul>\n
+ Soi c\u1ed5 t\u1eed cung: gi\u00fap quan s\u00e1t t\u1ed5n th\u01b0\u01a1ng c\u1ed5 t\u1eed cung \u1edf giai \u0111o\u1ea1n s\u1edbm, x\u00e1c \u0111\u1ecbnh v\u00f9ng ranh gi\u1edbi t\u1ed5n th\u01b0\u01a1ng, qua \u0111\u00f3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed sinh thi\u1ebft ch\u00ednh x\u00e1c. \u0110\u1ec3 quan s\u00e1t r\u00f5 t\u1ed5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 l\u00e0m nghi\u1ec7m ph\u00e1p Schiller (nghi\u1ec7m ph\u00e1t Lugol): iod s\u1ebd l\u00e0m cho nh\u1eefng t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng (c\u00f3 ch\u1ee9a glycogen) tr\u1edf n\u00ean s\u1eabm m\u00e0u, nh\u1eefng t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng s\u1ebd kh\u00f4ng \u0111\u1ed5i m\u00e0u v\u00e0 ti\u1ebfn h\u00e0nh sinh thi\u1ebft v\u00f9ng kh\u00f4ng \u0111\u1ed5i m\u00e0u.<\/p>\n
+ Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng: d\u00f9ng k\u00ecm sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng u \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc.<\/p>\n
+ Kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung: l\u00e0 bi\u1ec7n ph\u00e1p l\u1ea5y b\u1ec7nh ph\u1ea9m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u1ed3ng th\u1eddi c\u0169ng l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ed5 t\u1eed cung giai \u0111o\u1ea1n t\u1ea1i ch\u1ed7.<\/p>\n
- \n
- C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n: si\u00eau \u00e2m \u1ed5 b\u1ee5ng, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, c\u1ed9ng h\u01b0\u1edfng t\u1eeb, n\u1ed9i soi b\u00e0ng quang-tr\u1ef1c tr\u00e0ng\u2026<\/li>\n
- X\u00e9t nghi\u1ec7m ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u1ed1i u (tumor marker): CEA, CA12-5, SCC t\u0103ng cao trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. C\u00f3 gi\u00e1 tr\u1ecb theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ph\u00e1t hi\u1ec7n b\u1ec7nh t\u00e1i ph\u00e1t, di c\u0103n xa.<\/li>\n
- X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n 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 tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n.<\/li>\n
- X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n
- Ch\u1ee5p PET\/CT v\u1edbi 18<\/sup>F-FDG tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u nguy\u00ean ph\u00e1t, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh; ch\u1ee5p sau \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n; m\u00f4 ph\u1ecfng l\u1eadp k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb.<\/li>\n
- X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed: Gi\u1ea3i tr\u00ecnh t\u1ef1 nhi\u1ec1u gen.<\/li>\n<\/ul>\n
2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n
- \n
- \u00a0Giai \u0111o\u1ea1n s\u1edbm: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: vi\u00eam l\u1ed9 tuy\u1ebfn c\u1ed5 t\u1eed cung, lo\u00e9t c\u1ed5 t\u1eed cung.<\/li>\n
- \u00a0Giai \u0111o\u1ea1n mu\u1ed9n: c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi: l\u1ed9 tuy\u1ebfn nhi\u1ec5m khu\u1ea9n, lao c\u1ed5 t\u1eed cung, giang mai c\u1ed5 t\u1eed cung, polyp c\u1ed5 t\u1eed cung, u nh\u00fa c\u1ed5 t\u1eed cung.<\/li>\n<\/ul>\n
2.3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/h3>\n
M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c coi l\u00e0 c\u00f3 li\u00ean quan nhi\u1ec1u \u0111\u1ebfn ung th\u01b0 c\u1ed5 t\u1eed cung nh\u01b0: quan h\u1ec7 t\u00ecnh d\u1ee5c s\u1edbm, v\u1edbi nhi\u1ec1u ng\u01b0\u1eddi, sinh \u0111\u1ebb nhi\u1ec1u, v\u1ec7 sinh sinh d\u1ee5c k\u00e9m. Nhi\u1ec5m Human papiloma virus (HPV)<\/a>: l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra 70% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Bao g\u1ed3m 140 typ, trong \u0111\u00f3 c\u00f3 20 typ li\u00ean quan \u0111\u1ebfn ung th\u01b0, \u0111\u1eb7c bi\u1ec7t typ 6, 11, 16, 18 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong ung th\u01b0 c\u1ed5 t\u1eed cung. HPV typ 16 li\u00ean quan \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y t\u1ebf b\u00e0o l\u1edbn, HPV typ 18 li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u00edt bi\u1ec7t h\u00f3a v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn.<\/p>\n
2.4. Ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc<\/h3>\n
B\u1ec7nh ph\u1ea9m \u0111\u01b0\u1ee3c l\u1ea5y qua sinh thi\u1ebft, kho\u00e9t ch\u00f3p c\u1ed5 t\u1eed cung, b\u1ec7nh ph\u1ea9m sau ph\u1eabu thu\u1eadt. Bao g\u1ed3m c\u00e1c typ: ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y: chi\u1ebfm tr\u00ean 90%. Ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn, tuy\u1ebfn v\u1ea3y, u lympho, sarcoma\u2026<\/p>\n
2.5. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung c\u1ee7a Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 Qu\u1ed1c t\u1ebf (FIGO, 2018) v\u00e0 ph\u00e2n lo\u1ea1i TNM theo AJCC (2017).<\/p>\n
B\u1ea3ng 1. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n ung th\u01b0 c\u1ed5 t\u1eed cung<\/p>\n
\n\n
\n TNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \n T (kh\u1ed1i u)<\/td>\n <\/td>\n <\/td>\n<\/tr>\n \n Tx<\/sub><\/td>\n <\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \n T0<\/sub><\/td>\n <\/td>\n Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 kh\u1ed1i u nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n \n Tis<\/sub><\/td>\n 0<\/td>\n Ung th\u01b0 t\u1ea1i ch\u1ed7<\/td>\n<\/tr>\n \n T1<\/sub><\/td>\n I<\/td>\n U c\u00f2n khu tr\u00fa t\u1ea1i t\u1eed cung<\/td>\n<\/tr>\n \n T1A <\/sub><\/td>\n I1A<\/sub><\/td>\n Ung th\u01b0 x\u00e2m l\u1ea5n x\u00e1c \u0111\u1ecbnh tr\u00ean vi th\u1ec3. X\u00e2m l\u1ea5n m\u00f4 \u0111\u1ec7m s\u00e2u \u22645mm t\u1eeb m\u00e0ng \u0111\u00e1y v\u00e0 r\u1ed9ng \u22647mm.<\/td>\n<\/tr>\n \n T1a1 <\/sub><\/td>\n IA1<\/sub><\/td>\n X\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22643mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \n T1a2 <\/sub><\/td>\n IA2<\/sub><\/td>\n X\u00e2m nh\u1eadp d\u01b0\u1edbi l\u1edbp m\u00e0ng \u0111\u00e1y \u22645mm, r\u1ed9ng \u22647mm<\/td>\n<\/tr>\n \n T1b <\/sub><\/td>\n IB<\/sub><\/td>\n U c\u00f2n khu tr\u00fa t\u1ea1i c\u1ed5 t\u1eed cung, k\u00edch th\u01b0\u1edbc l\u1edbn h\u01a1n T1a<\/sub>\/IA2 <\/sub><\/td>\n<\/tr>\n \n IB1<\/sub><\/td>\n U k\u00edch th\u01b0\u1edbc \u22642cm<\/td>\n<\/tr>\n \n IB2 <\/sub><\/td>\n U k\u00edch th\u01b0\u1edbc 2-4cm<\/td>\n<\/tr>\n \n IB3<\/sub><\/td>\n U k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n \n T2<\/sub><\/td>\n II<\/td>\n Ung th\u01b0 x\u00e2m l\u1ea5n qu\u00e1 c\u1ed5 t\u1eed cung nh\u01b0ng ch\u01b0a lan \u0111\u1ebfn v\u00e1ch ch\u1eadu hay ch\u01b0a t\u1edbi 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o<\/td>\n<\/tr>\n \n T2a <\/sub><\/p>\n T2a <\/sub><\/p>\n
T2a<\/sub><\/td>\n
IIA <\/sub><\/p>\n IIA1<\/sub><\/p>\n
IIA2<\/sub><\/td>\n
Ch\u01b0a x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/p>\n U k\u00edch th\u01b0\u1edbc \u22644cm<\/p>\n
U k\u00edch th\u01b0\u1edbc >4cm<\/td>\n<\/tr>\n
\n T2b <\/sub><\/td>\n IIB <\/sub><\/td>\n U x\u00e2m l\u1ea5n d\u00e2y ch\u1eb1ng r\u1ed9ng<\/td>\n<\/tr>\n \n T3<\/sub><\/td>\n III<\/td>\n U x\u00e2m l\u1ea5n \u0111\u1ebfn v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c x\u00e2m l\u1ea5n 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o v\u00e0\/ho\u1eb7c g\u00e2y \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \n T3A<\/sub><\/td>\n IIIA<\/sub><\/td>\n U x\u00e2m l\u1ea5n \u0111\u1ebfn 1\/3 d\u01b0\u1edbi \u00e2m \u0111\u1ea1o, ch\u01b0a x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu<\/td>\n<\/tr>\n \n T3B<\/sub><\/td>\n IIIB <\/sub><\/td>\n U x\u00e2m l\u1ea5n v\u00e1ch ch\u1eadu v\u00e0\/ho\u1eb7c g\u00e2y th\u1eadn \u1ee9 n\u01b0\u1edbc th\u1eadn ho\u1eb7c l\u00e0m th\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng<\/td>\n<\/tr>\n \n T4<\/sub><\/td>\n IVA<\/sub><\/td>\n U x\u00e2m l\u1ea5n ra ngo\u00e0i khung ch\u1eadu ho\u1eb7c x\u00e2m l\u1ea5n b\u00e0ng quang, tr\u1ef1c tr\u00e0ng (c\u00f3 b\u1eb1ng ch\u1ee9ng gi\u1ea3i ph\u1eabu b\u1ec7nh)<\/td>\n<\/tr>\n \n N (H\u1ea1ch v\u00f9ng): di c\u0103n h\u1ea1ch v\u00f9ng (h\u1ea1ch v\u00f9ng bao g\u1ed3m h\u1ea1ch quanh CTC, d\u00e2y ch\u1eb1ng r\u1ed9ng, h\u1ea1ch h\u1ed1 b\u1ecbt, h\u1ea1ch ch\u1eadu g\u1ed1c, ch\u1eadu trong, ch\u1eadu ngo\u00e0i, tr\u01b0\u1edbc x\u01b0\u01a1ng c\u00f9ng, x\u01b0\u01a1ng c\u00f9ng).<\/td>\n<\/tr>\n \n Nx <\/sub><\/td>\n <\/td>\n Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \n TNM<\/td>\n FIGO<\/td>\n T\u1ed5n th\u01b0\u01a1ng<\/td>\n<\/tr>\n \n N0<\/sub><\/td>\n <\/td>\n Kh\u00f4ng di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \n N0(i+) <\/sub><\/td>\n <\/td>\n C\u00e1c t\u1ebf b\u00e0o u t\u00e1ch bi\u1ec7t \u1edf h\u1ea1ch v\u00f9ng k\u00edch th\u01b0\u1edbc \u22640,2mm<\/td>\n<\/tr>\n \n N1<\/td>\n <\/td>\n Di c\u0103n h\u1ea1ch v\u00f9ng<\/td>\n<\/tr>\n \n M: Di c\u0103n xa<\/td>\n<\/tr>\n \n M0<\/sub><\/td>\n <\/td>\n Ch\u01b0a c\u00f3 di c\u0103n xa<\/td>\n<\/tr>\n \n M1<\/sub><\/td>\n IVB<\/sub><\/td>\n Di c\u0103n xa (bao g\u1ed3m lan tr\u00e0n ph\u00fac m\u1ea1c, h\u1ea1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, h\u1ea1ch trung th\u1ea5t, h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, gan, ph\u1ed5i, x\u01b0\u01a1ng)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n
Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
B\u1ea3ng 2. Ph\u00e2n lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh<\/p>\n
\n\n
\n Giai \u0111o\u1ea1n<\/td>\n T<\/td>\n M<\/td>\n<\/tr>\n \n I<\/td>\n T1<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IA<\/sub><\/td>\n T1a <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IA1<\/sub><\/td>\n T1a1 <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IA2 <\/sub><\/td>\n T1a2 <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IB<\/sub><\/td>\n T1b <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IB1 <\/sub><\/td>\n T1b1<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IB2 <\/sub><\/td>\n T1b2 <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n II<\/td>\n T2<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIA<\/sub><\/td>\n T2a<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIA1<\/sub><\/td>\n T2a1<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIA2<\/sub><\/td>\n T2a2 <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIB<\/sub><\/td>\n T2b <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n III<\/td>\n T3<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIIA<\/sub><\/td>\n T3a <\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IIIB<\/sub><\/td>\n T3b<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IVA<\/sub><\/td>\n T4<\/sub><\/td>\n M0<\/sub><\/td>\n<\/tr>\n \n IVB<\/sub><\/td>\n Tb\u1ea5t k\u1ef3 <\/sub><\/td>\n M1<\/sub><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n","protected":false},"excerpt":{"rendered":"
Ung th\u01b0 c\u1ed5 t\u1eed cung l\u00e0 b\u1ec7nh ung th\u01b0 ph\u1ed5 bi\u1ebfn \u1edf ph\u1ee5 n\u1eef nhi\u1ec1u n\u01b0\u1edbc tr\u00ean th\u1ec3 gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n ph\u00e1t hi\u1ec7n ung th\u01b0 c\u1ed5 t\u1eed cung s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n […]<\/p>\n","protected":false},"author":43,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\n
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- X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n