Ib qho ntawm txoj haujlwm tseem ceeb ntawm ntau hom kab mob oncological hauv ntiaj teb niaj hnub no yog mob qog noj ntshav hauv cov poj niam. Lub hauv paus ntawm nws tsim yog hormonal hlwb uas kab ntawm lub cev. Zoo li lwm yam kev tsim tsis zoo, tus kab mob no tshwm sim los ntawm cov kab mob pathological ntawm cov khoom siv caj ces ntawm tes, thiab qhov no tshwm sim nyob rau hauv kev cuam tshuam ntawm lwm yam tsis zoo.
Ib xyoos ib zaug, mob qog noj ntshav tau kuaj pom hauv yuav luag 600,000 tus poj niam thaum kuaj. Lub insidiousness ntawm tus kab mob no yog tias tsis muaj cov cim qhia thiab tshwm sim.
Vim txoj kev loj hlob
Qhov tseem ceeb ntawm cov kab mob oncological tshwm sim nyob rau hauv kev cuam tshuam ntawm qee yam, ntawm cov uas yog cov poj niam laus hnub nyoog thiab ntev raug rau cov tshuaj phem thiab hluav taws xob.
Cov kev tshawb fawb soj ntsuam tau lees paub tias muaj qee qhov kev sib raug zoo ntawm lub ncauj tsev menyuam thiab papillomavirus. Cov neeg mob uas raug kuaj mob cancer ntawm lub ncauj tsev menyuam tom qab pom tias muaj tus kab mob no.
Tsis tas li ntawd, muaj ntau qhov laj thawj uas tuaj yeem ua rau kev loj hlob ntawm cov kab mob no:
- pib pib ntawm kev sib deev;
- abbortion;
- thaum ntxov cev xeeb tub;
- ntau tus khub deev;
- kab mob inflammatory ntawm cov kab mob hauv lub cev xeeb tub;
- kev tiv thaiv tsis muaj zog;
- siv sijhawm ntev ntawm cov tshuaj hormonal;
- smoking;
- mob ncauj tsev menyuam thaum lub sijhawm ua haujlwm.
Cervical dysplasia yog suav tias yog ib qho mob ua ntej, thiab qhov tshwm sim no tuaj yeem hloov mus ua mob qog noj ntshav. Cov yam ntxwv ntawm tus kab mob no yog kev loj hlob sai ntawm cov kab mob pathological.
Kev faib tawm
Kev faib tawm thoob ntiaj teb ntawm ncauj tsev menyuam carcinoma suav nrog ntau hom kab mob no:
- Intraepithelial squamous neoplasia yog hu ua dysplasia.
- Cervical carcinoma in situ (cancer in situ).
- Squamous cell carcinoma nrog me me nkag mus rau hauv cov txheej txheem ntawm epithelium.
- Squamous cell carcinoma ntawm lub ncauj tsev menyuam, uas kuj muaj nws ntau yam. Feem ntau hom yog keratinizing cancer, basaloid.
- Nonkeratinized carcinoma ntawm lub ncauj tsev menyuam kuj tuaj yeem txheeb xyuas.
Cov hom hauv qab no tsis tshua muaj:
- papillary;
- warty;
- squamous-transitional;
- lymphoepithelioma-zoo li.
Cov kab mob qog nqaij hlav los ntawm txheej txheej epithelial secreting yog cais raws li hauv qab no.
- Adenocarcinoma in situ (Cervical carcinoma in situ).
- Adenocarcinoma nrog cov yam ntxwv me me. Nws tseem hu ua microinvasive cervical carcinoma.
sib xyaw epithelioid neoplasms suav nrog:
- glandular squamous cell carcinoma;
- adenoid basal carcinoma;
- adenoid cystic carcinoma.
Adenocarcinoma tshwm sim:
- endometrioid;
- mucinous (plab hnyuv, endocervical, glandular-villous, cricoid);
- serous;
- clear cell;
- mesonephric.
Ntxiv rau, muaj cov hom kab mob neuroendocrine no:
- neuroendocrine loj cell carcinoma;
- carcinoid;
- mob qog noj ntshav me me;
- sarcoma;
- tsis muaj kab mob cancer.
Tus naj npawb ntawm cov kab mob malignant ntawm lub ncauj tsev menyuam yog histologically squamous (ntau dua 80%). Kwv yees li ntawm 17% ntawm cov neeg mob qog noj ntshav tau tsim adenocarcinoma thiab nws ua ke nrog squamous cell carcinoma. Hauv lwm qhov xwm txheej, lwm hom kab mob ntawm cov qog nqaij hlav no tau sau tseg.
Carcinoma cuam tshuam tsis yog xwblub tsev me nyuam kwj dej, tab sis kuj yog lub cev ntawm lub tsev menyuam. Raws li lub hauv paus ntsiab lus no, nws yog txoj cai los faib nws ua ob hom: mob qog noj ntshav ntawm lub tsev menyuam thiab mob qog noj ntshav ntawm lub ncauj tsev menyuam. Cervical carcinoma tsim ntau zaus ntau dua li cov qog nqaij hlav neoplasm ntawm lub tsev menyuam.
Txoj kev tshwm sim
Cov duab ntawm lub ncauj tsev menyuam tuaj yeem sib txawv ntawm qee txoj hauv kev:
- papillary daim ntawv, uas yog tus yam ntxwv los ntawm kev tsim ntawm papillae me me, me ntsis zoo li cauliflower;
- ib tug zoo li crater uas tshwm nyob rau hauv daim ntawv ntawm ib tug rwj npog nrog ib tug grey txheej.
Cervical cancer yog qhov txaus ntshai vim tias thawj theem yuav luag tsis muaj cov tsos mob tsis zoo, uas ua rau muaj kev sib kis sai ntawm cov txheej txheem pathological mus rau lwm yam kabmob.
Stages
Vim qhov kis ntawm cov qog nqaij hlav, cov theem hauv qab no ntawm cov qog nqaij hlav qog noj ntshav tau pom:
- 1 theem - tshwm sim ntawm cov qog nqaij hlav pathological;
- 2 theem - nkag mus ntawm cov qog nqaij hlav cancer rau hauv lub ncauj tsev menyuam;
- 3 theem - kev loj hlob ntawm neoplasm nyob rau hauv cov ntaub so ntswg periuterine, kev loj hlob ntawm thawj metastases;
- 4 theem - kev puas tsuaj rau cov kabmob nyob ze, uas pom ntau tus kabmob metastases.
Kev faib tawm
Metastases los ntawm lub ncauj tsev menyuam tuaj yeem kis tau raws li hauv qab no:
- lymphogenic;
- hematogenous;
- implantation.
Hom ntau tshaj plaws yog suav tias yog hematogenous, vim qhov mob feem ntau pomlymph node metastases. Tus naj npawb ntawm cov metastases nyob ntawm qhov chaw ntawm cov qog thawj, nrog rau qib ntawm nws qhov ntxeem tau thiab sib txawv.
Nyob rau hauv rooj plaub thaum cov txheej txheem pathological dhau mus rau lub ncauj tsev menyuam, qhov tshwm sim ntawm kev tsim cov metastases nce ntau zaus. Nyob rau hauv cov xwm txheej zoo li no, cov qog nqaij hlav qog nyob hauv lub plab pelvis raug kev puas tsuaj. Rau txoj kev hematogenous, kev puas tsuaj rau daim siab, cov pob txha thiab lub ntsws ua tus yam ntxwv.
Txoj kev cog qoob loo yog tus cwj pwm los ntawm kev nkag mus ntawm cov qog hlwb rau hauv lub plab kab noj hniav. Tom qab ntawd, cov hlab ntsha thiab zes qe menyuam raug cuam tshuam.
Symptoms
Nyob rau theem pib, muaj cov qog nqaij hlav squamous cell carcinoma ntawm lub ncauj tsev menyuam yuav tsis tshwm sim nws tus kheej li cas. Tom qab ntawd, cov txheej txheem oncological tshwm sim nws tus kheej hauv daim ntawv ntawm peb cov tsos mob tseem ceeb:
- Qhov tshwm sim ntawm qhov tshwm sim ntawm uterine los ntshav, uas tsis yog vim kev coj khaub ncaws. Ntshav tuaj yeem tso tawm ntawm qhov chaw mos ib zaug lossis ob peb zaug. Nyob rau theem siab, los ntshav yuav tshwm sim tom qab kev sib deev, kev kuaj los ntawm gynecologist, lossis kev tawm dag zog lub cev. Yog tias cov ntshav tso tawm ntawm lub tsev menyuam thaum lub sijhawm cev xeeb tub, qhov no yog qhov yuav luag tsis pom tseeb ntawm kev loj hlob ntawm carcinoma.
- Tshwj xeeb tawm, leucorrhoea, uas tej zaum yuav pob tshab lossis muaj xim liab. Feem ntau, xws li tso zis yog nrog los ntawm cov ntshav impurities.
- mob siab. Qhov tshwm sim ntawm qhov mob qhia tau hais tias cov qog oncological tau loj hlob heev. Qhov no txhais tau hais tias metastases tau pib cuam tshuam rau cov qog nqaij hlav, thiab lawv tso siab rau cov paj hlwb. Qhov no yuav ua rau mob hauv plab plab. Kev mob tuaj yeem yog kev cog lus zoo li, tsis sib xws lossis tas li. Cov tsos mob ntawm lub ncauj tsev menyuam feem ntau yog vim li cas thiaj li mus ntsib tus kws kho mob sai.
Hmoov tsis zoo, nws feem ntau tshwm sim tias cov poj niam mus ntsib kws kho mob lig dhau lawm, tom qab kev txhim kho ntawm qhov mob hnyav, uas ua rau cov theem kawg ntawm lub ncauj tsev menyuam, uas nyuaj rau kho.
Diagnosis
Qhov kev kuaj mob yog suav tias yog qhov tseem ceeb tshaj plaws hauv kev kho mob qog noj ntshav (carcinoma), txij li lub sijhawm no tus kws kho mob tshwj xeeb xaiv cov kev kho mob uas tsim nyog tshaj plaws. Cov txheej txheem no yog cuam tshuam los ntawm lub hnub nyoog ntawm tus neeg mob, theem ntawm kev loj hlob ntawm pathology, localization ntawm malignant neoplasm, nws cov qauv thiab hom.
Cov qog nqaij hlav oncological hauv cov ntaub so ntswg ntawm lub ncauj tsev menyuam tuaj yeem kuaj pom los ntawm tus kws kho mob gynecologist thaum kuaj. Feem ntau qhov no tshwm sim thaum lub sij hawm colposcopy, thaum tus saib pom tau meej meej pom cov kev hloov uas tshwm sim ntawm cov mucous membrane.
Cov txheej txheem kuaj mob, raws li txoj cai, pib nrog kev kuaj pom ntawm tus poj niam los ntawm tus kws kho mob gynecologist, uas tom qab ntawd coj tus neeg mob mus rau cov txheej txheem ntsuas, kuaj thiab kho vajtse. Ntawm lawv nws yuav tsum tau sau tseg:
- kev tshuaj ntsuam;
- colposcopy;
- biopsy;
- hysteroscopy;
- ultrasound;
- cystoscopy thiab rectoscopy;
- kuaj HPV;
- kawm txog qhov muaj cov qog nqaij hlav;
- CT lossis MRI.
Rau qhov kev kuaj pom tseeb, kev kuaj ntshav yog qhov yuav tsum tau ua. Cov txheej txheem no suav nrog pncturing ib qho me me ntawm cov ntaub so ntswg. Tom qab ntawd, kev soj ntsuam histological lossis cytological yog ua, uas yuav pab txiav txim seb hom mob qog noj ntshav thiab theem ntawm cov txheej txheem oncological.
Cervical carcinoma treatment
Kev kuaj mob ntxov yog qhov tseem ceeb rau kev kho kom zoo. Txhawm rau ua qhov no, nws yog qhov tsim nyog rau kev tiv thaiv kev kuaj mob ultrasound ntawm tus neeg mob ib ntus thiab kuaj ntshav kuaj, uas yuav pab txiav txim siab txog oncology thaum lub sijhawm carcinoma asymptomatic.
Lub hom phiaj tseem ceeb ntawm kev kho mob yog:
- tshem tawm ntawm cov kab mob malignant neoplasm;
- Kev tiv thaiv ntawm metastasis thiab qog rov ua dua.
Txoj Kev Kho Mob
Cervical carcinoma feem ntau yog kho los ntawm txoj kev kho nyuaj, uas suav nrog txoj kev kho mob, phais thiab hluav taws xob. Cov peev txheej ntawm lawv siv tsuas yog txiav txim siab los ntawm theem ntawm cov txheej txheem mob qog noj ntshav thiab cov peculiarities ntawm chav kawm ntawm pathology.
Txoj kev kho mob tau sau tseg rau txhua tus neeg mob ib tus zuj zus, suav nrog kev siv ntawm kev loj hlob ntawm carcinoma. Kev mus pw hauv tsev kho mob ntawm tus neeg mob yuav tsum tau ua rau lub koom haum ntawm kev kho kom raug. Thaum kho nyob rau hauv xyoo tas los noNws tau raug pov thawj tias kev siv cov kev phais mob thiab kev kho mob muaj txiaj ntsig ntau dua li kev kho hluav taws xob.
Kev phais mob feem ntau yog siv los tshem tawm cov kab mob hauv lub ncauj tsev menyuam. Nws dhau los ua lub hauv paus rau kev kho ua ke.
Laparotomy
Ntxiv rau, laparotomy yog siv los kho tus mob qog noj ntshav no. Nws qhov ntim feem ntau yog nyob ntawm qhov ntsuas tseem ceeb ntawm carcinoma thiab hnub nyoog ntawm tus neeg mob. Yog hais tias tus kab mob yog nyob rau hauv thawj theem, tus poj niam tsuas yog tshem tawm lub tsev menyuam nrog appendages. Hauv cov theem tom qab, cov qog ntshav qab zib kuj raug tshem tawm.
Kev kho hluav taws xob yog siv rau kev kho ua ke nrog cov txheej txheem oncological siab heev. Rau qhov no, ionizing rays yog siv, uas lub ncauj tsev menyuam epithelium yog rhiab heev. Cov txheej txheem no yog siv tom qab laparotomy. Qhov chaw mos, thaj chaw pelvic, nrog rau thaj tsam ntawm kev loj hlob ntawm metastasis tau ua tiav.
Kev kho hluav taws xob tau muab tshuaj raws li tus kheej tus yam ntxwv ntawm tus neeg mob, nrog rau kev kwv yees kom rov zoo.
kev kho mob
Tshuaj kho mob qog noj ntshav kuj suav nrog kev siv tshuaj hormone kho thiab tshuaj khomob, tab sis cov txheej txheem zoo li no tau sau ntau ntawm lawv tus kheej. Ntau zaus lawv tau siv rau hauv kev kho mob tom qab tshem tawm cov kab mob hauv lub cev.
Txawm li cas los xij, tsis zoo li kev kho tshuaj, tshuaj hormonal tuaj yeem siv rau lawv tus kheej.kev kho mob. Kev kho mob yuav tsum tau ua nyob rau hauv ob theem. Thaum pib, kev kho mob oncology yuav tsum xaus. Nyob rau theem ob, tus poj niam txoj kev coj khaub ncaws rov qab. Txhawm rau ua qhov no, thawj ob peb lub hlis, lub voj voog yog tsim tawm, uas cov tshuaj hormonal tau muab rau tus neeg mob.
Huab cua
Tom qab kev phais mob carcinoma, qhov kev muaj sia nyob tsib xyoos yog kwv yees li 45-87%.
Kev kuaj mob rau uterine carcinoma yog qhov zoo tshaj plaws nyob rau hauv cov xwm txheej uas kuaj pom cov kab mob nyob rau theem pib ntawm kev loj hlob (kwv yees li 80%). Tsuas yog 5% ntawm cov neeg mob uas muaj theem plaub muaj sia nyob.
Yog tias cov kab mob hnyav dua los ntawm kev rov ua dua, tsuas yog ib feem peb ntawm cov neeg mob muaj sia nyob tom qab kev phais.
