Lub zes qe menyuam yog lub cev tseem ceeb tshaj plaws ntawm cov poj niam cev xeeb tub, tab sis, hmoov tsis, lawv feem ntau raug rau ntau yam kab mob. Ntawm qhov feem ntau ua rau muaj kev phom sij rau lub neej - mob qog nqaij hlav (ovarian carcinoma). Raws li qhov kev hem thawj loj tshwm sim los ntawm cov kab mob zoo li no, txhua tus poj niam yuav tsum paub txog yam kab mob oncology li cas thiab nws cov tsos mob tshwm sim li cas.
Caus ntawm zes qe menyuam carcinoma
Raws li ntau hom kab mob oncological, mob qog noj ntshav ntawm zes qe menyuam tsis muaj qhov tsim kom pom tseeb. Txawm li cas los xij, nws tau pom tias muaj ntau qhov xwm txheej tuaj yeem ua rau muaj tus kabmob no.
Yog li cas ua rau tib neeg lub zes qe menyuam carcinoma?
Ua ntej tshaj, peb tab tom tham txog tus lej ntawm ovulation. Nws tau raug tsim los hais tias cov poj niam uas tsis tau yug los muaj feem ntau yuav kis tus kab mob no. Cov poj niam kuj suav nrog hauv pab pawg muaj kev pheej hmoouas muaj cev xeeb tub thaum ntxov (txog 12 xyoos) thiab lig menopause, uas yog, menopause tuaj tom qab 55-60 xyoo. Muaj ntau txoj kev xav hais tias ntau tus ovulations ua rau muaj kev cuam tshuam rau ntawm cov ntaub so ntswg ntawm zes qe menyuam epithelium, uas yuav tsum tau nyiaj ntau dhau lawm rov tsim dua. Qhov no ua rau muaj qhov nce ntawm qhov tshwm sim ntawm caj ces txawv txav hauv cov hlwb, uas ua rau cov tsos mob ntawm kev hloov pauv.
Lwm qhov kev pheej hmoo ntawm zes qe menyuam carcinoma yog los ntawm noob neej. Cov kev tshawb fawb qhia tau tias mob qog noj ntshav no muaj ntau dua rau cov poj niam uas nws niam cov txheeb ze kuj raug tus kab mob no.
Ib yam tseem ceeb uas ua rau muaj kev loj hlob ntawm carcinoma yog hnub nyoog. Cov qog nqaij hlav zes qe menyuam feem ntau pom thaum muaj hnub nyoog laus (txij tsib caug mus rau xya caum xyoo). Nyob rau hauv ntau txoj kev, qhov no yog ncaj qha ntsig txog qhov tseeb hais tias lub sij hawm no, uas yog hu ua premenopause, ib tug maj mam txo nyob rau hauv cov tshuaj hormones. Koj tsis tuaj yeem txo qis lwm yam xwm txheej uas, raws li kws kho mob, yog cov khoom siv thoob ntiaj teb rau ntau hom kab mob oncological.
Cov no suav nrog:
- Kev ntxhov siab tsis tu ncua nrog rau txo kev tiv thaiv.
- kev noj zaub mov tsis zoo ua ke nrog kev tsis muaj cov nroj tsuag fiber ntau hauv kev noj haus, nce cov tsiaj rog thiab lwm yam.
- Kev txhim kho ntawm beriberi thiab tus cwj pwm phem.
- Tus neeg mob rog rog lossis mob ntshav qab zib.
- Kev tawmkev ua neej nyob sedentary.
- Nyob rau qhov chaw phem.
- Kev ua haujlwm ntev ntawm cov khoom carcinogenic.
Symptoms
Nrog rau qhov tshwm sim ntawm zes qe menyuam carcinoma hauv cov poj niam, tso zis tso quav thiab nws qhov nce tuaj yeem ua tau. Tsis tas li ntawd, cov txheej txheem defecation yuav cuam tshuam rau keeb kwm yav dhau los ntawm kev nce hauv qhov loj ntawm cov qog, uas nyob rau pem hauv ntej lossis tom qab lub tsev menyuam. Nws kuj tseem muaj peev xwm hais tias qhov kev hloov ntawm lub siab lub ntsws ntawm tus poj niam nrog rau cov kab mob neurological, mob taub hau, plab zom mov, poob phaus, qaug zog, apathy, kub taub hau, poob phaus thiab o ntawm extremities. Txawm li cas los xij, feem ntau, cov tsos mob no yuav qhia tau tias mob qog noj ntshav tau nyob rau theem siab heev.
Nws tsim nyog sau cia tias qhov tshwm sim no tsis tshua muaj tshwm sim rau cov neeg mob uas muaj tus kab mob loj heev xws li zes qe menyuam carcinoma. Qhov no feem ntau yog txuam nrog kev qaug zog lossis ua haujlwm ntau dhau. Nyob rau theem tom ntej, cov kua dej sib sau hauv lub hauv siab kuj tseem tsis tau txiav tawm, uas ua rau ua tsis taus pa. Ntawm lwm cov kev tshwm sim uas tau pom nyob rau hauv zes qe menyuam carcinoma, nws yuav tsum tau sau tseg:
- Kev txhim kho ntawm pleurisy thiab o ntawm extremities.
- Cov tsos mob ntawm lymphostasis thiab plab hnyuv obstruction.
- Qhov muaj qhov nce ntawm ESR hauv cov ntshav.
- Tshav uterine los ntshav tsis cuam tshuam rau kev coj khaub ncaws.
Yog li, mob qog noj ntshav zes qe menyuam thaum ntxov tsis muaj qhov tshwj xeeb. Thiab nws qhov feem ntau yuav nrhiav tau kev xaiv yog tsis tu ncuaKev kuaj mob los ntawm gynecologist.
Serous carcinoma
Cov qog nqaij hlav zes qe menyuam muaj feem ntau ntawm cov qog nqaij hlav malignant uas tsim los ntawm cov epithelium. Ntawd yog, cov qog tshwm sim los ntawm cov ntaub so ntswg epithelial uas tau yug los. Txog niaj hnub no, cov laj thawj ntawm cov txheej txheem no tseem tsis tau pom. Muaj peb txoj kev xav muab los ntawm oncologists:
- Cov qog nqaij hlav zes qe menyuam yog tsim los ntawm qhov sib koom ua ke ntawm epithelium, uas yog, cov ntaub so ntswg uas nyob rau ntawm lub zes qe menyuam tau yug dua tshiab.
- Ib qog tuaj yeem tsim los ntawm cov khoom seem ntawm qhov chaw mos ntawm cov khoom nruab nrog cev sab laug tom qab cov qauv nruab nrog cev tsim hauv poj niam lub cev.
- Kev muaj tus kabmob epithelium nkag mus rau zes qe menyuam los ntawm cov hlab ntsha los yog los ntawm lub tsev menyuam.
Tam sim no, muaj ntau ntau yam ntawm cov kab mob no:
- Tshuaj ntawm serous papillary zes qe menyuam carcinoma.
- Kev txhim kho ntawm adenofibroma.
- Kev tsim cov papillary carcinoma.
- Qhov tshwm sim ntawm papillary-type serous cystoma.
Ntau hom mob qog noj ntshav tau kho nrog tshuaj tshwj xeeb.
Dab tsi yog endometrioid ovarian carcinoma?
Qhov tshwm sim ntawm endometrioid zes qe menyuam qog noj ntshav feem ntau cuam tshuam nrog endometriosis. Hom kab mob no suav nrog 10% ntawm lwm cov qog nqaij hlav epithelial. Nws feem ntau pom muaj nyob rau hauv cov poj niam hnub nyoog 50-60 xyoo. Hauv 15-20% ntawm cov neeg mob, endometrioid zes qe menyuam cancertxuam nrog mob qog noj ntshav endometrial. Lub neoplasm muaj ntau qhov sib txuam ntawm cov qog oval thiab tubular, cov qauv villous, thiab kev loj hlob ntawm spindle hlwb. Feem ntau muaj foci ntawm necrosis thiab hemorrhage. Cancer cuam tshuam rau ob lub zes qe menyuam hauv 17% ntawm cov neeg mob.
Epithelial carcinoma
mob qog nqaij hlav Epithelial yog tsim los ntawm mesothelium, uas yog, los ntawm cov epithelium nyob rau saum npoo ntawm zes qe menyuam. Feem ntau cov tsiaj no cuam tshuam rau ib lub zes qe menyuam thiab tsis tshua muaj peev xwm hloov mus rau qhov sib txawv. Cov qog nyob rau hauv cov ntaub ntawv no mus qeeb heev thiab yog li ntawd nyuaj heev rau kev kuaj mob. Raws li kev txheeb cais, xya caum-tsib feem pua ntawm cov neeg mob kawm txog lawv cov kab mob tsuas yog nyob rau theem lig, thaum kev kho mob nyuaj heev. Kev mob qog nqaij hlav epithelial feem ntau tshwm sim hauv cov neeg mob uas muaj hnub nyoog tsib caug xyoo. Nws ua nrog rau qhov zoo tshaj plaws.
Mucinous carcinoma ntawm zes qe menyuam
Cov kab mob carcinoma no tau kuaj pom ntau dua ntawm cov neeg mob uas muaj mob lossis mob uterine fibroids, muaj ectopic cev xeeb tub, lossis muaj kev mob ntawm cov kab mob. Feem ntau, tawm tsam keeb kwm ntawm kev loj hlob ntawm cov qog no, cov neeg mob tsis pom muaj kev hloov pauv hauv kev coj khaub ncaws. Ntawm cov tsos mob tseem ceeb yog:
- Npaj plab ntim.
- mob plab hauv plab.
- tso zis ntau zaus.
Nyob ntawm theem ntawm tus kab mob, cov tsos mob tuaj yeem tshwm sim lossis ploj mus, nrog rau qhov hnyav zuj zus.
Clear cell carcinoma
hom mob qog noj ntshav no tsawg heev. Feem ntau, cov qog nqaij hlav qog ua ke nrog qhov muaj endometriosis hauv tus poj niam. Cov kws kho mob tsis paub meej tias dab tsi ua rau pom tseeb cell carcinoma ntawm zes qe menyuam, tab sis lawv qhia tias hom kab mob no feem ntau tshwm sim los ntawm Müllerian epithelium. Feem ntau, mob qog noj ntshav ntawm daim ntawv no cuam tshuam tsuas yog ib lub zes qe menyuam xwb. Nyob rau hauv tsos, lub qog yuav zoo li ib tug cyst. Nws muaj peev xwm metastasize sai heev, nyob rau hauv kev sib txuas nrog qhov no, qhov kev cia siab rau kev kho mob qog noj ntshav yog qhov tsis txaus ntseeg. Clear cell carcinoma feem ntau tsim nrog adenofibroma.
Diagnosis
Ib txheej txheej ntawm kev kuaj mob qog noj ntshav ntawm zes qe menyuam suav nrog kev ua lub cev, nrog rau kev tshuaj ntsuam xyuas thiab kuaj gynecological. Kev lees paub ntawm cov qog tuaj yeem ua tiav nyob rau hauv cov txheej txheem ntawm palpation ntawm lub plab mog. Kev soj ntsuam gynecological ua rau nws muaj peev xwm txheeb xyuas qhov muaj ob sab ntawm zes qe menyuam neoplasm, tab sis tsis muab kev nkag siab meej txog qib kev zoo. Los ntawm txoj kev kuaj rectovaginal, kev cuam tshuam ntawm zes qe menyuam qog noj ntshav tau txiav txim siab. Ovarian carcinoma kuj tuaj yeem pom ntawm ultrasound.
Ua tsaug rau transvaginal echography thiab xam tomography ntawm lub plab me me, lub ntim ntim ntawm cov duab tsis sib xws uas tsis muaj cov tshuaj ntsiav meej nrog lub tuberous contour thiab kuaj pom cov qauv tsis sib xws. Ua tsaug rau qhov kev tshawb fawb no, nws qhov loj me kuj tau kwv yees nrog rau qib ntawm kev nthuav dav. Ua ib qho kev kuaj mob laparoscopy rau zes qe menyuam carcinoma yog tsim nyog rau biopsy thiabkev txiav txim siab ntawm histotype ntawm cov qog tsim. Tsis tas li ntawd, cov txheej txheem no yog siv los sau cov tshuaj peritoneal txhawm rau ua qhov kev tshawb fawb cytological. Hauv qee qhov xwm txheej, tau txais cov kua dej ascitic ua tau vim yog qhov chaw mos ntawm qhov chaw mos fornix.
Nyob rau hauv cov ntaub ntawv ntawm kev xav tias mob qog noj ntshav ntawm zes qe menyuam, txoj kev tshawb fawb ntawm cov qog thiab cov cim cim muaj feem xyuam. Txhawm rau tshem tawm thawj foci lossis metastases ntawm carcinoma hauv cov kab mob nyob deb, cov kev kuaj hauv qab no tau ua tiav:
- Ua mammography thiab x-rays ntsws.
- Irrigoscopy thiab ultrasound kuaj ntawm thaj tsam plab, kab noj hniav thiab cov thyroid caj pas.
- Sigmoidoscopy, cystoscopy.
Kev kho mob
Kev xaiv cov kev kho mob nyob rau hauv lub xub ntiag ntawm papillary zes qe menyuam carcinoma yog txiav txim siab mus rau hauv tus account theem ntawm cov txheej txheem pathological, cov qauv ntawm cov qog thiab rhiab heev ntawm cov keeb kwm uas twb muaj lawm rau hluav taws xob thiab tshuaj kho mob. Kev kho mob qog noj ntshav zes qe menyuam ua ke ua ke nrog kev phais mob (piv txwv li panhysterectomy) nrog kev siv xov tooj cua thiab kev kho mob polychemotherapy.
Kev kho mob ntawm zes qe menyuam carcinoma ntawm qib thib ib thiab thib ob yog ua kom tshem tawm lub tsev menyuam nrog kev txiav ntawm qhov ntau dua omentum thiab adnexectomy. Hauv cov neeg laus thiab cov neeg mob debilitated, nws muaj peev xwm mus rau supravaginal amputation ntawm lub tsev menyuam, thiab, ntxiv rau, mus rau subtotal resection ntawm lub omentum. Thaum lub sijhawm ua haujlwm, nws yog ib qho tsim nyog yuav tau ua qhov kev kho dua ntawm cov kab mob paraortal lymph node nrog nws cov haujlwm histologicalkev tshawb fawb. Yog hais tias tus neeg mob muaj lub thib peb los yog plaub theem, cytoreductive kev cuam tshuam yog ua, uas yog coj mus rau lub siab tshaj plaws tshem tawm ntawm lub qog loj ua ntej chemotherapy. Nyob rau hauv lub xub ntiag ntawm ib tug inoperable txheej txheem, cov kws kho mob feem ntau txwv lawv tus kheej mus rau ib tug biopsy ntawm qog nqaij hlav.
Polychemotherapy rau zes qe menyuam carcinoma yog ua nyob rau hauv lub postoperative los yog preoperative theem. Feem ntau txoj hauv kev no yog kev kho mob ywj pheej tiv thaiv keeb kwm yav dhau los ntawm cov txheej txheem malignant. Ua polychemotherapy (nrog kev pab los ntawm platinum npaj, chlorethylamines thiab taxanes) ua rau nws muaj peev xwm mus suppress lub mitosis ntawm qog hlwb. Cov kev mob tshwm sim tseem ceeb ntawm cytostatics yog xeev siab nrog rau ntuav, nephrotoxicity, thiab kev nyuaj siab hematopoietic. Kev kho hluav taws xob rau kev mob qog noj ntshav ntawm zes qe menyuam tsuas yog ua tau zoo xwb.
Huab cua
Qhov kev mob tshwm sim rau zes qe menyuam carcinoma feem ntau tsis yog nyob ntawm theem ntawm pathology, tab sis kuj nyob ntawm hom mob qog noj ntshav. Tsis tas li ntawd, nws kuj nyob ntawm lub hnub nyoog ntawm tus neeg mob. Muaj tseeb tiag, nws yuav tsum tau hais tias, piv nrog rau lwm yam kab mob oncological ntawm cov poj niam cev xeeb tub, qhov ua rau ntawm zes qe menyuam malignancies yog heev aggression, thiab prognosis nyob rau hauv lub xub ntiag ntawm tus kab mob no kuj tsis zoo. Txawm tias muaj kev kho mob txaus nyob rau theem kawg, tag nrho cov ciaj sia tsis ntau tshaj kaum feem pua.
Yog tias peb siv cov txiaj ntsig ntawm kev phais mob rau txhua theem thiabhom mob qog noj ntshav ntawm zes qe menyuam, nws tsim nyog hais tias qhov muaj sia nyob ib xyoos yog rau caum-peb feem pua. Qhov kev muaj sia nyob peb xyoos yog plaub caug-ib feem pua. Qhov kev muaj sia nyob tsib xyoos yog peb caug-tsib feem pua. Hais txog kev muaj sia nyob tsib xyoos rau ntau theem, cov txheeb cais muaj raws li hauv qab no:
- Nyob rau theem pib - xya caum tsib feem pua.
- Nyob rau theem ob - rau caum feem pua.
- Thib Peb - nees nkaum tsib feem pua.
- Nyob rau theem plaub - kaum feem pua.
Dhau li ntawm theem ntawm pathology, qhov kev kuaj mob kuj nyob ntawm hom carcinoma. Serous thiab mucinous variants feem ntau yog yooj yim rau kev kho thiab muaj ib tug zoo prognosis dua undifferentiated sawv daws yuav. Nyob rau hauv lub xub ntiag ntawm ib tug stromal qog, prognosis rau thawj theem ntawm tus kab mob yog feem ntau cuaj caum-tsib feem pua, thiab nyob rau hauv lub xub ntiag ntawm cov kab mob cell carcinomas, cuaj caum-yim. Rau theem thib peb ntawm tus kab mob nrog cov qog stromal, qhov ciaj sia taus yuav siab tshaj rau caum-tsib feem pua. Tsis tas li ntawd, qhov kev kwv yees tau cuam tshuam nrog cov teeb meem tshwm sim hauv tus neeg mob. Piv txwv li, lub xub ntiag ntawm ascites txo qis tus nqi ciaj sia tag nrho.
Reviews
Hauv kev tshuaj xyuas, tib neeg sau tias mob qog noj ntshav ntawm zes qe menyuam (carcinoma) yog ib yam kab mob loj heev rau cov poj niam, uas yog qhov txaus ntshai heev rau lawv lub neej. Raws li kws kho mob hais txog cov kab mob pathology, kev kho mob feem ntau nyob ntawm theem ntawm tus kab mob thiab cov yam ntxwv ntawm lub cev ntawm tus neeg mob.
Cov kws kho mob tshwj xeeb hais tias cov qog nqaij hlav zes qe menyuam tsis yog yuav tsum tau ua nrog. Nws yog ib qho tseem ceeb heev rau txhua tus poj niam kom tsis tu ncua los ntawm gynecologist,kom txo tau qhov kev pheej hmoo ntawm kev txom nyem los ntawm tus kab mob no. Qhov no muaj tseeb tshwj xeeb rau cov poj niam hnub nyoog plaub caug tsib.
