Cervical cancer hauv ICD-10 yog categorized li malignant neoplasm. Nyob rau hauv rooj plaub thaum lub qog nyob rau hauv lub zos, ces nws code nyob rau hauv lub ICD yog C53.0, thiab sab nraum - C53.1. Nrog rau qhov mob ntawm lub ncauj tsev menyuam uas dhau mus dhau ib lossis ntau qhov kev qhia hauv zos, nws tau muab rau tus lej C53.8. Qhov kev faib tawm no tsis suav tias yog kev kho mob thiab tsis cuam tshuam rau kev xaiv kho.
Statistics
Ntawm txhua hom kab mob oncological ntawm poj niam qhov chaw mos, mob qog noj ntshav yog kwv yees li 15% thiab nyob qib 3 tom qab malignant neoplasms ntawm endometrium thiab lub mis. Qhov kev kuaj mob no txhua xyoo lav lub neej ntawm ntau dua 200,000 tus poj niam thoob ntiaj teb. Nyob rau hauv Russia, hom oncology no nyob rau qib 5 ntawm qhov ua rau tuag ntawm cov poj niam los ntawm cov qog malignant. Nyob rau hauv xyoo tas los no, cov kab mob oncological no tau dhau los ua kev txiav txim siab feem ntau hauv cov poj niam hnub nyoog qis dua 40 xyoo.xyoo.
Txoj kev kho tus kheej
Cov kws kho mob ua raws li cov qauv kev kho mob qog noj ntshav hauv tsev menyuam (raws li ICD-10 - C53), siv cov txheej txheem tshiab ntawm kev phais, kev kho hluav taws xob thiab cov tshuaj tiv thaiv kab mob zoo tshaj plaws. Nyob rau tib lub sijhawm, ib tus neeg mus rau qhov kev xaiv ntawm txoj kev kho rau txhua tus neeg mob yog qhov tseem ceeb heev. Kev siv cov txheej txheem kuaj mob niaj hnub no, kev kho mob, suav nrog cov txheej txheem phais, kev tiv thaiv kab mob, tshuaj tua kab mob, hluav taws xob tso cai rau cov kws kho mob kom muaj sia nyob ntawm cov poj niam mob.
Vim txoj kev loj hlob
Tam sim no, cov kws tshawb fawb tsis tau tsim cov yam ntxwv uas ua rau muaj kev mob qog noj ntshav hauv tsev menyuam (raws li ICD-10 - C53). Nws ntseeg tau tias cov txheej txheem oncological tsim nyob rau hauv kev cuam tshuam ntawm ntau yam ua rau. Kev kis kab mob, tshuaj lom neeg lub cev, kev puas tsuaj rau cov ntaub so ntswg ntawm lub ncauj tsev menyuam yog suav tias yog exogenous.
Cov yam ntxwv endogenous hauv qab no hauv kev txhim kho cov txheej txheem pathological no txawv:
- hormonal imbalance;
- genetic predisposition;
- metabolic ntshawv siab;
- txo qis hauv kev tiv thaiv kab mob ntawm poj niam lub cev.
HPV
Hauv 90% ntawm cov neeg mob, qhov pib ua rau tus kab mob no yog HPV. Feem ntau, mob qog nqaij hlav ua rau 16, 31, 18, 33 hom. Feem ntau, tus kab mob 16 tau kuaj pom hauv tsev menyuam hauv plab. Tus kab mob ntawdkoom nyob rau hauv lub mechanism ntawm qhov pib ntawm pathology, kis tau los ntawm kev sib deev kev sib cuag. Feem ntau, txoj kev rov zoo li qub tshwm sim. Tab sis yog tias cov kab mob pathogenic muaj nyob rau hauv lub ncauj tsev menyuam tas li, cov qog nqaij hlav cancer yuav loj tuaj.
mob rhiab
Cov yam tseem ceeb uas ua rau muaj kev txhim kho pathology suav nrog cov txheej txheem inflammatory ntawm cov chav kawm ntev. Nws ua rau muaj kev hloov pauv ntawm dystrophic hauv cov qauv ntawm epithelium ntawm lub ncauj tsev menyuam, uas thaum kawg ua rau muaj kev loj hlob ntawm cov teeb meem loj. Ib qho tseem ceeb sib npaug ntawm txoj kev loj hlob ntawm oncology ntawm hom no yog suav tias yog kev raug mob thaum lub sij hawm rho menyuam, thaum yug me nyuam, nrog rau qee yam tshuaj tiv thaiv.
Exogenous thiab endogenous yam
Rau exogenous ua rau mob qog noj ntshav hauv tsev menyuam (raws li ICD-10 - C53), cov kws tshaj lij suav nrog kev sib deev thaum ntxov nrog ntau tus neeg sib deev, nrog rau kev haus luam yeeb. Cov yam ntxwv endogenous hauv qab no sawv tawm:
- nce hauv cov ntshav estrogen;
- kab mob tiv thaiv kab mob hauv cov poj niam, suav nrog kev muaj tus kab mob HIV;
- siv sijhawm ntev ntawm qhov ncauj hormonal contraceptives.
Tsis txhob hnov qab txog ntau yam kev phom sij ntawm kev ua haujlwm, kev ua neej zoo thiab kev ua neej.
Symptoms of disease
Thaum pib ntawm nws qhov tsim, mob qog noj ntshav hauv tsev menyuam (raws li ICD-10 - C53) tsis pom muaj kab mob uas tuaj yeem cuam tshuam rau tus poj niam. Tsuas yog thaum qhov kev loj hlob tsis zoo pib tawg, cov cim qhia hauv qab no tshwm sim:
- dawb ntawm ntau yam xwm;
- mob, feem ntau nyob hauv plab plab, nraub qaum, thiab qhov quav;
- los ntshav uas tshwm sim hauv zos, txawm tias mob me me los ntawm kev tawg ntawm cov hlab ntsha me me ntawm cov qog tsim, nyob rau sab nraud.
Tus mob oncological tuaj yeem metastasize los ntawm cov hlab ntsha lymphatic rau hauv cov phab ntsa ntawm qhov chaw mos los ntawm sprouting nyob rau hauv qhov chaw ntawm nws kev sib cuag nrog ib tug oncological qog. Lub ureter feem ntau tiv taus cov qog loj hlob. Ntau zaus, cov kws kho mob tshwj xeeb pom qhov compression ntawm cov ureters los ntawm oncological infiltrates, vim li ntawd, cov zis tawm ntawm cov zis yog cuam tshuam.
Kev loj hlob ntawm cov qog hauv qhov quav qhia qhov tsis saib xyuas ntawm cov txheej txheem oncological. Lub mucous daim nyias nyias ntawm lub qhov quav, raws li txoj cai, tsis nyob twj ywm ntawm cov qog rau lub sijhawm ntev. Tsis tshua muaj, mob qog noj ntshav hauv tsev menyuam tuaj yeem kis mus rau zes qe menyuam thiab cov hlab ntsha. Metastases rau cov ntaub so ntswg nyob deb thiab cov kabmob hauv cov neeg mob uas tsis kho yog tsawg.
Gynecologists muaj kev xav tias mob qog noj ntshav feem ntau tseem yog "cov txheej txheem hauv zos" ntev. Metastasis yog qhov tsawg heev, uas muab cov tsos mob ntawm tus kab mob. Qhov kub ntawm cov poj niam mob yog khaws cia rau hauv siab, qee zaum muab sijhawm rau kev zam txim. Cancer cachexia tau pom nyob rau theem lig ntawm oncological qog tsim thiab tuaj yeem tshwm sim los ntawm ntau yamCov teeb meem pathological.
Cov tsos mob ntawm mob qog noj ntshav (ICD-10 - C53) yuav tsum tsis txhob hnov qab.
Nrog rau kev loj hlob ntawm cov qog nqaij hlav, tag nrho lub ncauj tsev menyuam lossis nws cov ntu ntu tshwm sim ntom ntom rau qhov kov, nthuav dav, cov mucous membrane yog thickened. Feem ntau, anomalies ntawm integumentary epithelium yog pom nyob rau hauv qhov chaw. Nws tsis yog qhov tsis yooj yim uas pom cov ntaub so ntswg ntau dhau ntawm daim tawv nqaij dawb ntawm ntau cov duab thiab ntau thiab tsawg.
Yuav ua li cas yog tias xav tias mob qog noj ntshav hauv tsev menyuam (raws li ICD-10, code C53)?
YKev kuaj mob ntawm pathology
Tam sim no, muaj ntau yam kev kuaj mob. Lub hauv paus rau kev kuaj mob ntawm ncauj tsev menyuam oncology yog kev kuaj xyuas tag nrho ntawm tus poj niam, qhov tseeb sau ntawm anamnesis ntawm lub neej thiab kab mob thiab kev tsis txaus siab, kev ntsuam xyuas txaus ntawm qhov mob hnyav ntawm tus neeg mob, kev kuaj mob gynecological siv iav. Cov txheej txheem hauv qab no los kuaj tus kab mob no yog siv:
- colposcopy;
- laboratory test for STIs;
- khoom siv rau kev kuaj ntshav;
- kev tshuaj ntsuam cytological.
Colposcopy yog suav tias yog ib txoj hauv kev zoo tshaj plaws rau kev kuaj mob qog noj ntshav ncaj qha (ICD-10 - C53) thiab cov mob ua ntej. Qhov ua tau zoo ntawm txoj kev no nce mus txog 80%. Oncologists muab nws nrog lwm yam technologies niaj hnub. Colposcopy tso cai rau koj los txiav txim siab qhov tob thiab qhov xwm txheej ntawm kev puas tsuaj rau lub ncauj tsev menyuam tag nrho, thaj tsam thiab qhov ntev ntawm thaj chaw cuam tshuam, txhawm rau ua tom qab ua tiav qee qhov morphological.research.
Cervicoscopy yog qhov tseem ceeb hauv kev kuaj mob ntawm pathology. Txoj kev tshawb no yog ua los ntawm hysteroscope. Cov txheej txheem no muaj qee qhov contraindications:
- xeeb tub;
- cov txheej txheem mob;
- bleeding.
Cervicoscopy tso cai rau koj los ntsuas qhov kev kho mob ntawm lub ncauj tsev menyuam kwj dej thiab qhia tau tias nce mus txog 150 zaug, uas ua rau lub hom phiaj biopsy ua tau. Ib txoj hauv kev zoo rau kev txiav txim siab qhov chaw ntawm cov qog yog kev tshawb fawb cytological, uas tau lees paub thoob ntiaj teb thiab pom zoo los ntawm WHO. Ua ke nrog colposcopy, qhov ua tau zoo ntawm txoj kev tshawb no nce mus txog 90-95%. Lub ntsiab lus ntawm cytology yog kev sau cov hlwb los ntawm lub ncauj tsev menyuam thiab lawv cov kev kuaj xyuas microscopic txhawm rau txheeb xyuas cov ntsiab lus pathological. Lub luag haujlwm txiav txim siab hauv kev kuaj mob yog muab rau kev kuaj histological ntawm biomaterial tau txais los ntawm biopsy.
Kev kho mob
Kev xaiv kev kho mob qog noj ntshav ntawm ncauj tsev menyuam (ICD-10 code - C53) yog txiav txim rau tus kheej. Kev kho mob yog nyob ntawm qhov tshwm sim ntawm cov txheej txheem oncological thiab qhov hnyav ntawm comorbidities. Lub hnub nyoog ntawm tus poj niam yog qhov tseem ceeb tshaj plaws. Cov txheej txheem kev kho tus kab mob ib txwm muaj xws li:
- phais;
- combined;
- beam.
Tam sim no, cov kws tshawb fawb tau mob siab kawm txog qhov muaj peev xwm ntawm chemoradiotherapy rau mob qog noj ntshav (raws li ICD-10, code - C53) thiabtshuaj kho mob.
Nyob rau hauv mob qog nqaij hlav intraepithelial hnyav, kev kuaj mob cais ntawm lub tsev menyuam thiab kev ua kom lub ncauj tsev menyuam yog ua los ntawm kev siv riam hluav taws xob, scalpel lossis laser beam.
Tam sim no, hauv kev kho mob qog noj ntshav ntawm theem 1 thiab theem 2, kev siv lub tsev menyuam thiab cov khoom siv txuas ntxiv (Wertheim txoj haujlwm) yog siv. Kev sib xyaw ua ke suav nrog kev kho hluav taws xob thiab kev phais hauv ib ntu sib txawv.
