CHEN DOAN UNG FU i .

Gioi D hav
,
N
binh UTI

1) Dichte the
thing mas .
2 Yeutothran loI Carcinom tebo
gai
↑

13 % Y
:
und :

Hut'this i a tuyen'
uny
the
thiring gay Chef 19 % +
lin quan 80-90 %: Tlgian hut +
40 % Carcinom :

-
gap'30 [an mi
&
↑ So "these hut Nam > 40 %
nguy wong-
+ ·

+ Yentonghengkep tipxuho chat : :

+
Throla co Tuloc :
-
carcinogen Loa
-
&

there but +
Lin quan thula ++ + + · nam # ni
-
VitriFrungtm quan the la ++
-
saw Lien
lang
-

W
·
Asbestos
.
ng
C
-
trong phol ↓ -
·

Hop chathunco : Ihau that

S
hitnhie
-
· Chloral
methyl ether , + Thorquenhut : thoenhe >
- nicotinthip' - + saw hon +
+ ++ ·
Vi tri
↑ ngoai vi

IAHs , hi diesel carcinom muyen't [ ·

than that +++
sus"x Moho Chi'diem
- &
Onhiem pi bithaydoi 6923-25
Sink hoc atypical adenomatous/
-
mtr :
·
+ al& el
-
&
gen · :

&

dienho
Kim Lai tot bien alveolar
hyperplasia (AAH)
-

·
: chromim ,
niket C
gen
:
Cyclin D,
p53 ,
MDMC

Arsenic sua cha XRCC1 ERCCC

& .

gen :
,

do t
-
bien-

EGFR TAGM

tebo
-

Carcinom tuyen' (te bao on Carcinom nho :

·
10 % ·
20 %

3) Tm soatung the phi .

·
Namy ni ·
Nam > ni

The best CT scan lieuxa this

-

Khuyen car NCCN 2016- nhom I : Lin

quan
thu La + + lin
quan
thro la + + ++
-
- & al + ·

&
·

↑ X-quangnguic va th
2 chung to
Loc
"
New tam soatung the pho cho nhom'
·
I-nguoinguy co cao : · Vitrgo
U ai
-
vi ·
V:
tritrung tam
chieu qua +
Two 55-74 ·
Ihu that +++ · Hoatri ++ +
-

Dien Eln nhanh

+
Hutthu 30
goi .
nam ,
in hut
hanging dui is .
nam ·
Din tien'nhanh dicanxatt,
·

Kluyen car ASCO

S

+
~

va ACCI : ·
New rm sout cho InhomI
&

hangnam
-
Tam soat CT scan lieu Twi
· =
thap +
y, 50

hutthro 30 goi Hunter

~

chox : 55-74t +
↓
7
, .
nam
+ /[0goinaim
. Cothem cas'YINC
hayda Stop 15nam
+
10 :

Tam soat CT scan Khong Kluyen cao cho tin can mac this Benk sie
· -

ung -
:

Intuo, Faunguic-Khanting
&
est

ph, Symtomes
hut 130 goi nam 55tutory Ho-horaman
-Benh
↳ .
,
dual :· > .

orging hut >15nam ,

or to benk phot a inhutt ·
Mining pho tadien HIC Pancoast >

cothe and -- / --

glien quanden HIC cheneptinh mach

&

not3 hang ng den Cac triew chun

S ~

kno tri uT
·
-
tiep radon ·
-
7
,
hay co the
gian Song Kivong ngan . -
nguy conghenghiep. -
buonxam Lantuicho
triving chutren , : .

Trinching do dican TK khuti-dauxiong-sot-sut

-

· : can

Bienhien ni tiet
. Sink
4 benh hoc
-
Carcinom tuyen' : 40% ① corticotropic
y

effect Bienhinthankinhn
cgannhau(throng bin him trong
:
yes can s

Dotbinirong
&

Carcinom te
-

Ho bao 25-30 %
HER VEGF, MMIS
gai tebaonho Cushing dien Wink :
> HC
Kho Khan Klingoighcig .

chalice
: :
,
ple matt suy chin' day
-

ras ,
p53 , CX-2 Carcinom tebo lin : 10-15 % small cell carcinoma
Kim chuyen Loa Fang Kaliman
, ·
He Th
ngoaibien : di cam ,
Faw ,
---
mat chu

I
S
~

Mat trinke." nang

crabin
(Apthamtha
&

Tac do Dican tiFADH than

-

a
Giamulatin
-
'cap
:
ng Thos hoatin nao ban -mas matdien
-

> -
chong
-

- :
.
↳ hat trien bin ADH
↓
effect ⑬
Ap
ag wor -

meetthing that
Matsu chef tb theo
Lap trink tang calciman
S ② flieu ing giving ITH
Met moi-wis ,

chep' lien nieu

Singkhopgi
Da
Sao tuc Carcinom tebao gai >
tiefhormone giong ITH >
-

Cheng Khatiio
Taobon'
Sink mach
taubungter nang thi valor dan
chantay
Lan
-

Yam ⑪ ung hung sink duc appho" beah xiing > ngon'tay dri trong
Hier -

Tang -

-
carcinom tuyen ,
thenho ,
Agai > Hitchatting sinhdu >
-
thing to
v ottaning /thank xwong
"mol
Teo tinh hoan
-
dua many xwory 9/
 (an Lam
sang Chuan Joan ton
this
thing hghi ng
-

ung pla -

1) X-quangpho :
giatri 3) MRI (Magnetic resonance
imagin g)
Bun
&

ai bien Vaitrokonhiu nhu Fri Tank

-
-

+
ngo -
+
CTscan
giaxam
- ~
-
tuy song tot sing ~ &

lan
Ton
nghen trung tam
M
di can
+ throng
"tac , ,
you Lan cac can &/
-
trung that%...
-
Tran dich truc
X-quang pho
,
-

hol

X-quang Dinangng
+

+
5
+
1 ai Fu dui
&
Kph +
1" chidinh thing qui ,
thedinh O
cac'Hung CT
hay LET scan

12
phathien c'kq mohoc tren
M

+ L
de 80 % UTI -

2 cm
phathin bang CT .

&
Y I
trung
tem

Viem photo ra
&
bien
&

un
goan man

Xahink xwing (Radionuclide scanning)

-

4)

+ Danh chotlhop g can can nha chicin

2) I die tri triet de hay cotrieu ching di
CT-scannguc i
Y -

thi bang
-

T bo
+ Vaitrotrong : ton
"thing who (1cm) , nach can 97
xwong
-
1 Sink Kim ↓ hoc dai

,
-

-
trung that quan
thank soi he sink thief
xuyen guic 2-
p :

thief bangkim
&
-

Banhgiaxam Lanchung quank Soiphequan choc hut

-

chai te bno
-

than 2 Sink
+
:
huguc, &
- :
~
, , ..

can truc
xuyen phi quan chaite' bang
I
that
living it 5) LET (Iositron
&
Sink thie thank
&
than Emission
Tomography) 3 Kim
xuyen
-

TDMI
song trung , ,
L
, -

giaFor
&

cua benh

b
dican 1
clxacao
Y

thing gan , thiring Elgia To

Bank : than +
to , Lan tran nguc
+ I .

M Long
-
S /
&

Diavaohapther glucose fluorodeoxyglucose wa

·
coVAT: 4
ngua
ngue
no ...
+ ,
y

that this
trong phathir tebo busn
can hach
Kocang Sink wink hem Choo
-

di
+ tin
- trung -
,

nghi
&

-
Hachy1cm
Giving Kink'- .
dican + Giatri tien toan
diving trong plhien hach N1 or N2
-
hut b
/ and
Kim

Hach
-

-
kn trongbenk cann Khon
nhung giatri tin Joan () Mongnguic
-
di kem viem pho she 65 % 90 %. 4 -
W
&

guhaimbenhnhibnisil
tanghen hay gianVphix kqmho Lank .
tink a
↑

↓
Hach <1cm co'the th actinh knutru: epidemois
BN is Ton
+ thining ughing UTP -
Lam IET
. carcinoma

6) Te bohoc Iam( -
sputum cycology
( 7) Sink thief bang Kim xuyen than nguic
+ Lay ti S
nhien or do nia mic muoi un
truing ,
3 mai (percutaneous FNA)

mongay tang Inang X. K

+ KIncing & diving/kinh
T
n
,
95% even U <1 cm

thing trungtam
/
S

huong dan
~ >
33

KInangtang Dud CT ,
~

UTtgai X-quang
- 13
new ton
+
S
, , + .
va- - -
Cac: tri Khac:
hachtrene
-

ulon , lay chic nhieu man

+ gan , thingthan ,

that
&
8) Soi &, he 9Uan 9) Soi
(Mediastinoscopy(
trung
ing
&
in
toan chinkxac , de Chitinh binh tintrin
+
Soi mem
- an ,
chin
.
-
+
triving
: xam Ian
,
u

Knang Chairua-
Iam 4th hoc sink thiev cac ton that' nachIn tren CT or LET scan
+
or
trung ,
-
, Scan

thes nhin gdLSI ,

ng thay 90 %
Giatri trong X giaitian (vitri , sink thief hach trung that thattoi ben (N5)
i
+ +
X
trong hop nach -
trung hay
phon
-S
quathanh phe quan) con 10 the to
that-tran
hachthroug
1)

&

10) Soi
-
co man hink hotro (VAT)
long nguc
thoracoscopy) cogiathi trong
-

magphadlichmany phtna,
+ VAT (Video -
assited
'
-
Dra giai doan
-

xe> m
,
Giup-cotton throng sink thi hah
-
bin
↓ "ngoai - &
-
,

~ &

trung that ,
dank
gia TDMI
UNG THLY VU (1910 - International
dayof Breast Cancer)
Triuchun
-

g :

·
Dank gia' T :+ U mat do
--
swing cing , giv hankor ,
di
--

cong&

t hoc
·

↳ han Lai Bun vutheo Dich it movulan '

-
WHO
-
sovs can can ,
throng
va I daw

Laung thei throng gat gay tivong nhies

~
Cothe' gay tief cich
- in m ·
cua bin mo marto nau.
&

nhat v
·
Buou ·
Lymphoma ·
&
&
+
num vu

,swing Kichthu
&

Bun Bin do di can plu mis.

&
mo what cho Ghinhan : vitri
.
wa
trung ·
+ a
-
, ,

,
·
Buou soi-bin mo ·
Bun
Danong · Xuatdo ungthi Cgioi
-

>
-
LTvu
top I .
d
dicting us thank da
gua
.
trenbrie
- -

World L

-
HanhgiaN Hich di can the
-I

Yng to hin
-
&

Sangthiring Tac diem givi

&

·
Buon ca num xn .
c ·
Xuatung
do this
gay chet 2 - UTXUtop # ·
:
+ 1cm ,
from ,

ac biet. cha
&

(relative) co the dink vo mo Lan can

↳m
sang ·
W :
top - top #V ,

thing ? Dan
I
" tren don 3 ---

Hach nach duo don

+ ,
cung
to
/
ws
~

Year ben
nguy
-
tien si dinh Binh ly benh su cungthi xu' Dankgiam Khothe sayhohap'doTDMI , many tim
·
Ditruyen :
47 gia
:
L
· : ,

Dot bin gen BRCA-1 v BRCA2 , p53, thing dangnhu ting san ?hink
Ton' , +
Gan to ,
ang-bung
b
.
Yentokha Twi 35-50 Nhulau m -
wi n
ITEN
,
STK11 ,
CDH1 ... :
tangnhanh. + ,
buon non ,

· Niti : Cokink som ,

man kink tre Matc movu
day-
notri +
Daunhix"
wo
ng , yea liet chi ,
tien tien

khng sinh con

,
co con muoin Phinhimbrixa ion LocEphonga , Khong te cho
↓
3

Dung ni titestrogen Kedas :

nivu the la; thia can-bed phi
-

Bia ,

Gen Hoichun &

LITvu Linkten'Sot)
Ung the Khaclien
G quan
.

IHAN LOAI HINHANH HOL TUYENVU-

-

Can Lam
sang
-
:
&

-
vi-bung tring Bungtring
&
tien -I &

BRCA 1/2 70 % ,
liet
- fugen +
Xet no man (A 15-3 : 0-
-
dung tur soat hay X
c the ding thro doi clien ti
in
Li-Fraumeni 50 % Sarcoma momem no
p53 , >
-

Tuyen'giap noi ti Hink and Loc

S

ITEN Cowden 70-80 %

cung , mac
-
&
+
:

Daitric trang da day bringthing Si m v nhi anh buin

-

30 %
STI If
Leutz-Jeghers , , · :
Elgia v nach

Da day
-
-

CDH11 39 % MRIvU
HDGC
To nhay dac hi
-
: va .
car
·
&

·
X-quanguguc Sin , ambung ,
&-
Xa Winkxwing &
↑

CT scan dank
, MRI ,
LET-CT
giup gia
di can
Dien tien'tu nhien

cua tien
·
Th
ung
the hink thank
trong canangtuyen thing
hoac
L
trong cacong dan sa
· T va xm Ian mixung quant . C the lan ra toi da
Gian phan
-

wagachbachat
bink
.
-
thing gip nhat thing
T
+ Dang GIB : carcinoma ;

natla
ongtuyen
&
-

&

:
-
carcinom vu

di on
M

Wai Khac: Sarcom

sing ben. -
-
Dicanxa no ,
+ :
Xuing , I3
hol ,
gan , hach
& Lymphom
diben .
Brin di can u not Khac

T'barhoc
-
this himn
+
:
bang FNA
thi mo
L S
S

Mohoc sink brin gom

this -glikim
+
S

Tinh Im
sang sink
hung · an

&
THENG GAL MuEN (late) sink thief ho the bang butchan khong
som
·

Sink thief
&

X
time ms
I I > ·
&

Tham Kham'suc Khoe ve hoa Bun tien trien tai ch ~o rut da da ↓ FNA bang Kim who (Core Biopsy)
· ·
U cuc
trong .

--
gy : , ,
: choc but
-
·
Mohoc : :

Chinkvac vin
-

Fink Ki Fink sieu tief dich num

vu1 ben Sui let dan dacam mumvutut Lanktinh bun sol
· -
viem obsess
&
, qua , , ·
:
-
tuyen , , +

Itching thing gap

-

---
-sorbangnhi Xuathien hact nach top Sol"boc ~ ,
thay
-

tren don do'I don Bien

chung hin
·
am ; tam *
,
,
.... +
C

anh
phutay Nghing Horthing dangnhu Fang xmnhap Lay taicho dang grad mo hoc
&

. ·
:
, +
Xac dink do , , .

Delam homo min dich

-

Khothe -
san mo # o tien hinh .
&
Galan tran
dauxwing chong phan nhom'sink hoc
~

: C .
·
, .
+ ,

dav du , bun min

-
yeuliet chi, Actinh'
bung &
, , ... · : carcinoma , sarcoma , ...
 Chuan Joan UTXu nhom sinh Dia vo Pier ph af Ni Tit + Nich
&

↳han hoc : o ER ,
-

·
: Lieu > :
-

Ki67 qua HMMD

/

ll chemTOR (everolimus)
-

Lam IR HERL ICR : Tac -tremblinco HR)

sang , , , ·
dong
-
:

Aluminal A vicche' CDIC 4/6 (Ribociclib ,

Palbociclib)

↑
Luminal B -
Nhamdich CHER2+ ) >
-
Trastuzumab
(Herceptin )
↓
HERL
Hink anh Gian D
,
hu benk. ↓
Tam am -

Lieu phap'HOAt NHM-DiCH: T-DM1 (adcylaQ) : bunHERC din

G
&

· Trastuzumab emtansine : vie che truyntinhiu tangtoMER

·
DM1 :
chagay +b .

· Chuan Joan' phan biet :

-an
·
Ditoan ·
- =
"turen
1 ai to
+
Buon so I I an
Y
&

Bron
die the
-
3
+
-

⑰can Tim at
Ungthi Vither ACS
-

+ Thay dois'
a
&
bac * so

m
S

+ Brin
&
+ Ihu
nit 'nguy
cotrung binh :

+
Bun
netrong ing >
Twi 40-44 co'the hia chon tam so atnhi and .
hangnam
dangban Chamaro set Two : 45-54 nen de tm sat bang anh
=

Mothua
nhi .
↳ hang nam

i
nam/Ln
-

co'the
Tren 55
hang nam hoc 2 va
-

> y
tiep tuc
-

ching no "con Song tren 10 nam .

S

Nguy co do+ bien truyen

- - -
cao : BRCA H2 di lien
+ ↑ gen , quan
hoc tincan Xa triving ngua
ungthivu .

Di tri
-

:
phan that a clie Taw .
=> Tam
-2
so atsomti nam 30 Hi bang
i
MRL /Nhie and
-

S
- Bronco'the
Lieu duong tink' (HRH)
- -

the hormon
IYhas noi
c tiet +
-

tatchuc -
Lin
quan
>
hang buong thing :
-

·
Bangthud
· than that
S
cat bobuing trung.
·
Xabung thing

> Tamoxifen :
Ganva IHOA the the
"estrogen +b brin
bat hoat Aromatase lezyme chuyen
Als :
< androgen estrogen) >
-

Khi man Kink

> chiding
&

Fluxetrant :
ganvao the the' estrogen va PHAN REchurs:

Hoatri :
rungto, bun non met mi ,

to tink For tim

thing
than :
,
gan , ,
he TK
/
S

he
-
two huyet .

San IT baston It doan thi now

hach.
Xat
:
,
san

haitu da mis
-
viem ,
va S han

suytim , xophi tuton

dang
bin' tas two

king
&
itank molank giain ba. ,
HONG NGUA va TAM SOATUNG Tc'th CunIG &HONG TIEN TM SOAF :
&

-
CACGIAi DOAN TIEN LING Tt- I

Tam quan cu tam soatung this co'ti 1Tebas hocxetn IAP vo 13 XeEng HIV DNA
trong cong &
.
quy
: . .

↑
·
Tran cu : IT thing top 3 World ·
Tile K coti
cung giam
70 %
&
-
that hin
-
bo gentIX trong benh phain Fu +b CTC .

·
gan50 % te vong
Y : tmsoat. >
-
·
Tile <giv car do bo sot so % -
Xhopti trong Among hip conguy con'
5
cao
/ & I
tebo tink, I tinkling
Thing gap 40-60twi Trungbinh 48-setu. Agian ti
S

CT2 troe. Kodai >Dink

· .

bong ↓
-
soat -
&

- Donhay zao
nhungdo tac him kem' trong phat him ton thing CIN 2-3
Yen to nguy co :
I
HIV : Chinh'
·
type 16x 18
-
I
·
Hutthe La 2 -
Xetn ,
to how
- nhung dich :
-

Thus trank Thai-i

drong wong nhay
het chat I
bo how
-
· &
Loai , protein va
·
Suy giam mien dich -
·
th mar ti; 14
- Quan sat CTC voi acid acetic -
VIA .

thir acidjolic ,
Ihanbocactbcong what . Dacid bang mat
1
che to an (3-5 % ) brixo CTC sat
·
Vita
taich Xm Lan ·

I
acetic
Wang , quan
Conhiu ban' tinh 7
he som 16th tang 50 % Lai thin -
throngsan itphut
Kluangcodinh + b
-

· , quan · .

Sink nhieln sink

Buy Tricarcum
-

·
,
con kui con tre ·

&
1 . 1. D'acid acetic s lam
long ket protein tebo tin ung the tao phan
---
Tink kte get Kem
ing trang tren be mat CTL vacothequan sat bang mat throing
&
·
trang .

SosanhAnhungvIA
&

phap phong nua i h

-

. Logia'tri tindoantung Ging IAI nhungdethic hien I

1
flung
I
test som
g quy -
, ,

·
CAF1 : +
Trankcacyea
-
to
nguy
co I
va the doi hon .

Il coti wo the
phonggua Chic Do Ti van Tit Lambai 1-2 % sovig % 1
Test chuquan
ngu, Kham'
cung ,
:
+ · : .

1
. Dac
trung
-
dien tien
~
t nhien zo'1 Goan tierung /
&
Tiem'
chung ·
Am Fink'gias that ~
C 1 .
Itchink xac's ngui man sau Kinh
.

tien trien -
Tamsoat'
&
cham CAIC
Khong Khac biet do nhay
~ -
: I
S
·
+ ·
-

Khong Khac -
bit do c him layHvL-SIL voi
&

Giai Joan
tienung cotheThathim
bang cas thathi Khi Quansat CT2 Kinhphong Jai-VIAM
2
2 som 5
+
I
·
_

2
, . .

<

CES --
-

"tien Khang xm Ian Hier hoce Iam

giam lam mic dark gia Qu/sat'tric quan (C, 5X-4x)
Ihrong
> - · :
+
tri
L
the 1
.

mic to Forthing tien Khongton'kem disting w'thetamsoat-

Thitong b.
ton
3 - Dir te hiu qua vs cas
thing tienung ung
.
1 .
,
it
&
,
on we
langt
i
lay
1 Chinhin --
. ,
I mar duo C -

I
-

&

-
> It
dung .

. Quan satCTC vi
6 LugoL-VILI :

I I
cote
Tiem
Ching VaccinetIV I ·
Bidung dich Lugol iodine In CTL
I
7 .
Soi
cung
tigial 9-45two ,
&
⑮

·Quansatsubman
·
Lam gian 70-83%
nguyco ung this CTC +
phonol 3
I
·
Vaccine :
-Chedinh Khi
pap smear
ghi nhan bat thering
bap x sliv th idim
i
tam so at I -
0 5m2 tiem
, ,
0, 2 x 6
thang ing I
- Sithief xet no
quantrong is x

·
Chung ngua thing quy : mi gio v nam
gio 11-12t
I

I
-
Chia vo HIV
type 6 , 11 ,
16 , 18 ·
Coqua ngay -licho theo doi v div trngay .

I
-
Cha e
apdung rong raide tam soat .
Lin btip :
Hi aKhongguanhivatan
sin
on
·

I
-

raise
Nu 13-26tuo chea tim vaccine , ho tiem cluia
I
8
.
Kham'phukhoalamsang
.
I

vaccinenigiacciem
2. I
i li
& n
Rat quan
I · ·
trong
-
I
Nu 18-15 tuoi co' phoi nhiem thang thiphoptam at hi qua cas
r
+
nguy
co :
tiemchung I Diva 6 ·
so
L
&

giong HIV type

I
his Chia cas thank phan
↑
mang lai hi ich-"Inchoplu coghtd It him ton Kim am h , am dao
day I -
16 , IS ·
L
thing di :
& &
,
Chur
cung I
-
ni da
phoinhiem , Liichcho plu Tag
&
I
nhing chea
Algia
· giai Joan benh trong two I

nhier
&

!
ghed nhiem hip phat mun
vi 1
hay ching HIV. hien .

HIV 16 , 18

Hut ther > [ Yu tonam gion * Thigian bin' "

↳ cutb CTC :

-bo CTC Tick Thi

Te
trang giantrung bink (nam)

Tebao CTC binh thin Lan san nhe , TB 1 6

G
chegenp53
>
- .

vi
-

Te'bao bink
thing Lan san 2 2
W
Rb
, , nang
.

- &

Carcinom tai chi

Tebao binh
thing >
-

-
4 .
5

Tb bion phastrin UNGTW

 -
CHUAN -OAN-
Cac'tinh hun' thi binh su kit
-

Iams
-

G &
ang -

Kham'lam
thong qua xetno tam soat
-
that hi som
·
-
: -

sang. .

Tink
Wongthong gap Kham'movit
5
- B1 :
phait ghtdj
·
-

&

Xutluyet Kham' bang tay

+
am dao bat thro
Eng B2 :

hay huyet trang

&

+ Radich am dow B3 : Kham' tran than

·
Tinh - "tre
wrong : - Ex = GIB
-
+ Huyet trang In on
-
huyef do rat hi.
,

-
Baubung xung
-

+ duol
-

- -

Chay hoc phanra ng am dao

&
+ muc tien

Bing an
S

+ , sut can

+ Hach tren con.

g nam qua 10 nam

Chach)
Chach)
IHEN LOAI GATHEO FIGO (COOS) chink xachon
&

>
trong Elgia
klthioc va micd xam Lan
S
~

IET scan : la so 1
Y

tile di can wingthap

Lantrie
xam
-
trang Dicannach