Binciken Mahaifa

**Binciken mahaifa**  shi ne tsari na ganowa da cire nama ko sel marasa kyau a cikin mahaifa kafin cutar kansar mahaifa ta taso/bayyana. Ta hanyar niyya don ganowa da magance neoplasia na mahaifa tun da wuri, tantancewar mahaifa yana nufin rigakafin cutar kansa ta mahaifa ta biyu. Hanyoyi da yawa na nunawa don kansar mahaifa sune gwajin Pap (wanda kuma aka sani da Pap smear ko cytology na al'ada), cytology na tushen ruwa, gwajin DNA na HPV da dubawa na gani tare da acetic acid . Gwajin Pap da cytology na tushen ruwa sun yi tasiri wajen rage aukuwa da yawan mace-mace na kansar mahaifa a cikin ƙasashe masu tasowa amma ba a cikin ƙasashe masu tasowa ba. Hanyoyin tantancewa waɗanda za a iya amfani da su a cikin ƙananan albarkatun ƙasa a cikin ƙasashe masu tasowa sune gwajin DNA na HPV da duban gani.

## Shawarwari
Kasashe daban-daban suna da shawarwarin tantancewar mahaifa daban-daban.

* A cikin Turai, yawancin ƙasashe suna ba da shawara ko bayar da bincike tsakanin shekarun 25 zuwa 64. Dangane da jagororin Turai na 2015 don gwajin cutar kansar mahaifa, gwajin farko na HPV na yau da kullun bai kamata ya fara ƙasa da shekaru 30 ba. Ana iya amfani da gwaji na farko don oncogenic HPV a cikin tsarin tushen yawan jama'a don tantance kansar mahaifa. A Ingila, shirin gwajin mahaifa na NHS yana samuwa ga mata masu shekaru 25 zuwa 64; mata masu shekaru 25 zuwa 49 suna samun gayyata duk shekara 3 kuma mata masu shekaru 50 zuwa 64 suna samun gayyatar duk shekara 5.

* A {asar Amirka, ana ba da shawarar yin gwaji ga mata masu shekaru 21-65, ba tare da la'akari da shekaru a lokacin fara jima'i ko wasu halayen haɗari ba. Ga mata masu lafiya masu shekaru 21-29 waɗanda ba su taɓa yin smear mara kyau ba, gwajin cutar kansar mahaifa tare da cytology na mahaifa (Pap smear) ya kamata ya faru kowace shekara 3, ba tare da la’akari da matsayin rigakafin HPV ba. Abin da aka fi so don mata masu shekaru 30-65 shine "gwaji tare", wanda ya haɗa da haɗin gwajin cytology na mahaifa da gwajin HPV, kowane shekaru 5. Duk da haka, yana da kyau a gwada wannan rukunin shekaru tare da yin gwajin Pap kadai a kowace shekara 3. A cikin matan da suka haura shekaru 65, ana iya dakatar da yin gwajin cutar kansar mahaifa idan babu sakamakon binciken da ba a saba gani ba a cikin shekaru 10 da suka gabata kuma babu tarihin raunuka masu girma.

* A Ostiraliya, ana ba da gwaje-gwaje ga mata masu shekaru 18-70, kowace shekara biyu. Wannan ta Pap smear ne, kuma ba tare da la'akari da tarihin jima'i ba.  [ yana buƙatar sabuntawa ] A Kanada, inda aka shirya shirye-shiryen nunawa a matakin lardi, shawarar gabaɗaya ita ce ba za a fara gwajin yau da kullun ba har zuwa shekaru 25 in babu takamaiman dalilai, sannan a duba kowane shekaru uku har zuwa shekaru 69. A cikin Ontario, "Shirin Nazarin Cervical na Ontario ya ba da shawarar cewa matan da ke yin jima'i ko kuma suna yin jima'i suna yin gwajin Pap a kowace shekara 3 tun daga shekaru 21." 

* A cikin ƙasashe masu ƙarancin albarkatu, ana yanke shawara game da tantancewar mahaifa bisa la'akari da albarkatun da ake da su don haka yawanci ba zai yiwu a ba da gwajin mahaifa akai-akai ba. Babban tasiri akan rage ciwon sankarar mahaifa ya bayyana yana faruwa ne daga tantance mata masu shekaru 30 zuwa 39, don haka ana iya tura albarkatun zuwa wannan rukunin.

## Tsarin nunawa
Hanyoyin gwajin mata ta amfani da Pap smear, cytology na tushen ruwa, ko gwajin HPV iri ɗaya ne. Ana tattara samfurin sel daga mahaifa ta hanyar amfani da spatula ko ƙaramin goga. Sannan ana bincika sel ɗin don kowane rashin daidaituwa.

Don ɗaukar samfurin sel, likitan kula da lafiyar ya saka kayan aiki, wanda ake kira speculum, a cikin farji . Tashin hankali yana da hannaye biyu waɗanda ke shimfiɗa bangon farji baya don ganin mahaifar mahaifa . Sa'an nan kuma, suna goge saman cervix tare da spatula ko ƙaramin goga. Wannan yana tattara samfurin sel daga saman Layer na mahaifa.

Tare da smear Pap, ƙwayoyin da aka tattara ta amfani da spatula ana shafa su a kan nunin faifai don dubawa a ƙarƙashin na'urar gani . A cikin cytology na tushen ruwa, ana ɗaukar samfurin sel ta amfani da ƙaramin goga. Ana saka sel a cikin akwati na ruwa, kuma ana bincikar su don rashin daidaituwa. Kwayoyin mahaifa da za a gwada don HPV ana tattara su ta irin wannan hanya.

### Cire sel marasa al'ada
Ana iya gaya wa mata cewa suna da CIN ( cervical intraepithelial neoplasia ), ko CIS ( carcinoma in situ ) - waɗannan sharuɗɗan sun bayyana matakan daban-daban na rashin daidaituwa da aka samu a cikin ƙwayoyin mahaifa. Ana iya cire ko lalata ƙwayoyin da ba su da kyau ta amfani da ɗayan hanyoyi daban-daban.

Zubar da Laser da cryotherapy suna magance kawai ɓangaren mahaifar mahaifa wanda ya ƙunshi ƙwayoyin da ba na al'ada ba. Zubar da Laser yana amfani da Laser don ƙone ƙwayoyin da ba su da kyau, yayin da cryotherapy yana amfani da binciken sanyi don daskare sel. Waɗannan hanyoyin suna ba da damar sel na yau da kullun su yi girma a wurinsu. Hanyar katsewar madauki na lantarki (wanda ake kira LLETZ ko 'babban madauki na yanki na canji' a cikin Burtaniya ), conization na mahaifa (ko cone biopsy ) da hysterectomy cire duk yankin da ke dauke da sel waɗanda zasu iya zama pre-cancer ko haɓaka zuwa kansar mahaifa. .

## Nau'in dubawa
Akwai nau'ikan hanyoyin tantancewa iri-iri. A cikin Amurka, ana yin gwajin mahaifa ta hanyar amfani da gwajin Pap (ko 'smear test'),  kodayake shirye-shiryen tantancewar Burtaniya sun canza hanyar tantancewa zuwa cytology na tushen ruwa a cikin 2008. 

### cytology na al'ada
A cikin smear na al'ada na Pap, likitan da ke tattara ƙwayoyin sel yana shafa su akan faifan microscope kuma yana amfani da gyara. Gabaɗaya, ana aika nunin zuwa dakin gwaje-gwaje don kimantawa.

Nazarin daidaiton rahoton cytology na al'ada:

* hankali 50%
* musamman 94%

### Liquid-based monolayer cytology
Tun daga tsakiyar 1990s, ana ƙara amfani da dabarun da suka dogara kan sanya samfurin a cikin vial mai ɗauke da matsakaicin ruwa wanda ke adana sel. Biyu daga cikin nau'ikan sune Sure-Path (TriPath Imaging) da Thin-Prep ( Cytyc Corp). Kafofin watsa labarai sune tushen ethanol da farko don Sure-Path da methanol don ThinPrep. Da zarar an sanya shi a cikin vial, ana sarrafa samfurin a cikin dakin gwaje-gwaje zuwa cikin siraren tantanin halitta, tabo, kuma a duba shi ta hanyar hangen nesa. Samfurin ruwa yana da fa'idar kasancewa dacewa da babban haɗarin gwajin HPV kuma yana iya rage samfuran marasa gamsarwa daga 4.1% zuwa 2.6%. Samfurin da ya dace yana da mahimmanci ga daidaiton gwajin, kamar yadda tantanin halitta wanda ba ya cikin samfurin ba za a iya kimanta shi ba.

Nazarin daidaiton rahoton cytology tushen tushen ruwa:

* hankali 61% zuwa 66%, (kodayake wasu binciken sun ba da rahoton ƙara yawan hankali daga smears na tushen ruwa )
* musamman 82% zuwa 91%

### Gwajin papillomavirus na mutum
Kwayar cutar papillomavirus (HPV) shine sanadin kusan dukkanin lokuta na ciwon daji na mahaifa. Yawancin mata za su yi nasarar kawar da cututtukan HPV a cikin watanni 18. Wadanda ke da kamuwa da cuta mai tsawo tare da nau'in haɗari mai girma (misali nau'in 16, 18, 31, 45) sun fi kamuwa da ciwon Intraepithelial Neoplasia na Cervical, saboda tasirin da HPV ke da shi akan DNA.

## Duba kuma

* CervicalCheck

## Manazarta