Zatsopano pa Kuyeza Khansa ya M'chiberekero: Kugwirizana kwa Malangizo a WHO ndi Pulatifomu Yodziwira HPV Yokha Yodziyimira Yokha

1. Mavuto Padziko Lonse a Khansa ya M'chiberekero ndi Kuyezetsa Matenda

Khansa ya pachibelekero ikadali vuto lalikulu padziko lonse lapansi pankhani ya thanzi la anthu, ngakhale kuti imatha kupewedwa kwambiri poyesa bwino komanso kuchitapo kanthu mwachangu. Malinga ndi bungwe la World Health Organization (WHO), milandu yatsopano yokwana 662,000 ndi imfa 349,000 zinachitika padziko lonse lapansi mu 2022, zomwe zaika khansayi ngati yachinayi yofala kwambiri komanso chifukwa chachinayi chachikulu cha imfa zokhudzana ndi khansa pakati pa akazi. Matendawa akupezeka kwambiri m'maiko osauka komanso apakati (LMICs), komwe kuchuluka kwa anthu omwe amafa ndi kuchuluka kwa anthu omwe ali ndi ndalama zambiri kumakhala kwakukulu kuposa m'malo omwe ali ndi ndalama zambiri. Izi zimachitika makamaka chifukwa chosowa mapulogalamu abwino kwambiri oyezetsa komanso kuzindikira bwino ndi kuchiza zilonda zomwe zisanachitike khansa, zomwe zimawonjezeka ndi:

-Kusowa kapena kufooka kwa zomangamanga zowunikira:Kusowa kwa ntchito zowunikira zomwe zikupezeka mosavuta komanso zotsimikizika.

-Zoletsa pa zinthu:Malo osungiramo zinthu ochepa, malo osungiramo zinthu ozizira, komanso magetsi odalirika.

-Kusowa kwa anthu ogwira ntchito:Kusowa kwa ogwira ntchito ophunzitsidwa bwino m'ma laboratori ndi m'zipatala.

-Kuchedwa ndi kutayika kwa zotsatira:Kuchedwa kwa nthawi pakati pa kusonkhanitsa zitsanzo ndi kupezeka kwa zotsatira, zomwe zimapangitsa kuti kuchedwetsedwe kwa chithandizo chamankhwala kapena odwala asapezeke kuti atsatire [1].

2. Etiology ndi Molecular Basis of Cervical Carcinogenesis

Matenda osatha a papillomavirus ya anthu (HR-HPV) yomwe ili pachiwopsezo chachikulu ndi chifukwa chofunikira cha khansa ya pachibelekero. Pakati pa mitundu yoposa 200 ya HPV yomwe yadziwika, mitundu yosachepera 12 yaikidwa m'gulu la matenda oyambitsa khansa (Gulu 1) ndi International Agency for Research on Cancer (IARC).

Pa mulingo wa mamolekyu, khansa yomwe imayambitsa HPV imayendetsedwa makamaka ndi ma virus oncoproteins E6 ndi E7. E6 imalimbikitsa kuwonongeka kwa puloteni yoletsa chotupa p53, pomwe E7 imagwira ntchito molimbika kuti puloteni ya retinoblastoma (Rb) isagwire ntchito, zomwe zimapangitsa kuti maselo asamayende bwino komanso kuti maselo asinthe molakwika.

3. Njira Zowunikira Zovomerezeka ndi WHO

Bungwe la World Health Organization limalimbikitsa kuyesa kwa HPV nucleic acid (NAT) ngati njira yoyamba yowunikira khansa ya pachibelekero.

Anthu ambiri:HPV DNA kapena mRNA-based NATs

Azimayi omwe ali ndi kachilombo ka HIV:Ma NAT ochokera ku HPV DNA

Nthawi zowunikira:

Akazi azaka zapakati pa 30 ndi 65: Zaka 5 mpaka 10 zilizonse

Azimayi omwe ali ndi kachilombo ka HIV: Zaka 3-5 zilizonse

Poyerekeza ndi njira zogwiritsira ntchito cytology, kuyezetsa HPV kumasonyezakukhudzidwa kwakukulundipo amaperekamtengo wapamwamba kwambiri woneneratu zoipa, zomwe zimathandiza kuti nthawi yowunikira ikhale yayitali komanso yotsika mtengo.

4. WHO ikufuna kudziwa zambiri zokhudza mayeso a HPV

Bungwe la WHO lapanga njira yodziwiraMbiri ya Zogulitsa Zolinga (TPP)pa mayeso oyesera a HPV omwe cholinga chake ndi kugwiritsidwa ntchito m'malo omwe ali ndi anthu ochepa komanso omwe alibe zinthu zambiri.[1]

Makhalidwe ofunikira ndi awa:

-Kugwirizana ndi zitsanzo zomwe zasonkhanitsidwa zokha

-Kuzindikira mitundu yambiri ya HPV yomwe ili pachiwopsezo chachikulu (mitundu ≥12)

-Ntchito ya anthu osaphunzitsidwa ku labotale

-Zotsatira zimapezeka mkati mwa nthawi imodzi yokumana ndi dokotala

Mfundo zimenezi zimathandiza kuyezetsa malo osamalira odwala komanso njira zoyezera ndi kuchiza matenda.

5.Nsanja Yodziwira HPV Yokha Yokhala ndi Chiwopsezo Chachikulu

Dongosolo la Macro & Micro-Test la AIO800 limaperekanjira yogwirira ntchito yodziwikiratu yokha ya chitsanzokuphatikiza kuchotsa, kukulitsa, ndi kuzindikira nucleic acid mogwirizana ndi njira zowunikira zomwe bungwe la WHO limalimbikitsa.

5.1 Kayendedwe ka Ntchito Yoyeserera Yokha

Pulatifomuyi imagwirizanitsa kutulutsa, kukulitsa, ndi kuzindikira nucleic acid mu dongosolo limodzi lotsekedwa, zomwe zimafuna kuti wogwiritsa ntchito asamachitepo kanthu kwambiri. Kapangidwe kake:

-Amachepetsa kudalira anthu ogwira ntchito zasayansi

- Amachepetsa kusinthasintha kwa njira ndi chiopsezo cha kuipitsidwa

- Imathandizira kutumizidwa m'malo osamalira thanzi la anthu wamba

Nthawi yomweyo, mphamvu yake yogwiritsira ntchito imathandizira kugwiritsidwa ntchito m'ma laboratories akuluakulu, zomwe zimathandiza mapulogalamu akuluakulu owunikira.

5.2 Kufalikira kwa Genotyping Yaikulu

Dongosololi limazindikira mitundu 14 ya HPV yomwe ili pachiwopsezo chachikulu, kuphatikiza mitundu yonse 12 yoyambitsa khansa yomwe yagawidwa ndi IARC (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, ndi 59), komanso HPV66 ndi HPV68.

Chofunika kwambiri, chimaperekamtundu wa majini enienizotsatira zake, zomwe zimathandiza kugawa zoopsa m'magulu ndi kuyang'anira bwino zachipatala.

5.3 Kuzindikira Kusanthula ndi Zotsatira Zachipatala

Ndi malire opezeka a makope 300/mL, dongosololi limatha kuzindikira matenda a HPV otsika omwe amayambitsa:

- Kuzindikira msanga matenda okhudzana ndi matenda

-Kusintha kwabwino kwa kuneneratu kolakwika

- Chithandizo cha nthawi yayitali yowunikira

5.4 Chithandizo cha Kudziyesa Wekha

Nsanjayi imagwirizana ndi zonse ziwirizitsanzo za swab ya m'chiberekero ndi zitsanzo za mkodzo wodzisonkhanitsa wekhamogwirizana ndi malangizo a WHO kuti athetse zopinga zazikulu pakuyesa anthu, kuphatikizapo:

-Kupeza malo ochepa oti munthu azitha kupeza chithandizo chamankhwala

-Zoletsa za chikhalidwe cha anthu

-Kusasangalala kwa wodwala ndi kusankhidwa kwa dokotala

Kudziyesa nokha kwawonetsedwa kuti kumawonjezera kutenga nawo mbali mu mapulogalamu owunikira, makamaka pakati pa anthu omwe alibe chithandizo chokwanira.

5.5 Ukadaulo wa Reagent Wopangidwa ndi Lyophilized wa Kusungirako Malo Ozungulira

Pofuna kupititsa patsogolo kugwiritsidwa ntchito m'malo omwe ali ndi zinthu zochepa, dongosololi limaphatikizapoma reagents opangidwa ndi lyophilized (ouma mufiriji)zomwe zimakhala zokhazikika pa kutentha kozungulira, zomwe zimapereka zabwino zingapo zogwirira ntchito:

-Kudziyimira pawokha pa unyolo wozizira: Kumachotsa kufunika konyamula ndi kusungira mufiriji

-Kukhazikika bwino: Kumasunga umphumphu wa reagent pansi pa mikhalidwe yosinthasintha yachilengedwe

-Kukonza zinthu mosavuta: Kumachepetsa zofunikira pa zomangamanga ndi ndalama zogwirira ntchito

-Kufikika bwino: Kumathandizira kutumizidwa kumadera akutali kapena osakwanira mokwanira

6. Mapeto

Kusintha kuchoka pa kuyesa kwa maselo kupita ku kuyesa kwa HPV kukuwonetsa kusintha kwa njira yopewera khansa ya pachibelekero. Mwa kuyang'ana chomwe chimayambitsa matenda m'malo mosintha mawonekedwe, kuyezetsa HPV kumathandizakuzindikira koyambirira komanso kosavutaza anthu omwe ali pachiwopsezo.

Kuphatikiza apo, nsanja zodziwira maselo zokha zimapereka njira yothandiza yogonjetsera zopinga zomwe zilipo pakuyesa.magwiridwe antchito apamwamba komanso kusavuta kugwira ntchito komanso kuthandizira kudziyesa nokha,AIO800 ili ndi kuthekera kokulitsa kuchuluka kwa mayeso, kukonza kuzindikira msanga, komanso kuthandizira kuchepetsa kuchuluka kwa khansa ya pachibelekero padziko lonse lapansi.

Maumboni:

1. Bungwe la Zaumoyo Padziko Lonse. Yang'anani mbiri ya mankhwala kuti muyesedwe poyesa kachilombo ka papillomavirus ya anthu kuti mupeze khansa ya pachibelekero ndi khansa isanafike. Geneva: WHO; 2024.