mob qog nqaij hlav zes qe menyuam yog ib hom kab mob oncological hauv gynecology. Txhua xyoo, ntau dua 220 txhiab tus poj niam hnov qhov kev kuaj mob tsis txaus ntseeg, nrog rau feem ntau ntawm cov neeg tuag. Carcinoma feem ntau pom tau lig heev, vim tias tsis muaj cov tsos mob tshwj xeeb, thiab metastases tshwm sim ntxov. Nws yog vim li no thiaj li paub txog kab mob thiab kev kuaj xyuas tsis tu ncua yog qhov tseem ceeb.
Tumor nta
Ntau tshaj 70% ntawm cov qog ntawm zes qe menyuam yog cov neoplasms benign uas tuaj yeem tsis pom tau ntau xyoo thiab xyaum tsis ua rau muaj kev phom sij rau tus neeg mob noj qab haus huv. Tab sis qee zaum benign formations tuaj yeem degenerate mus rau hauv malignant sawv daws yuav. Qhov txawv ntawm cov qog no yog tias nws kis thoob plaws lub cev thiab ua rau tuag.
Nws yog ib qho tseem ceeb kom paub tias adenocarcinoma yog ib qho ntawm feem ntaucov qog ntawm cov poj niam gonads ntawm ib tug malignant xwm. Nws tsim los ntawm cov hlwb ntawm glandular epithelium, tuaj yeem cuam tshuam rau ob lub zes qe menyuam lossis tsuas yog ib qho xwb. Cov qog yog ib qho ntawm ntau lub chamber node nrog septa. Nws tuaj yeem tawg lub zes qe menyuam capsule thaum nws nce mus txog qhov loj me, thiab cov kabmob uas nyob sib ze. Hom mob qog noj ntshav no kuaj tau txhua lub hnub nyoog, tab sis muaj ntau dua rau cov poj niam tshaj plaub caug.
Ovarian adenocarcinoma yog tus cwj pwm los ntawm kev loj hlob sai. Nws tuaj yeem txav mus rau cov ntaub so ntswg nyob sib ze thiab ua rau cov metastasis thaum ntxov. Cov qog secretes co toxins uas ua rau tus neeg mob hnyav zuj zus thiab ua rau lub cev tiv thaiv kab mob. Nrog kev pab los ntawm cov txheej txheem tshwj xeeb, cov qog nqaij hlav tuaj yeem nkaum ntawm lub cev tiv thaiv kab mob.
Nws tseem yuav tsum tau hais tias adenocarcinoma yog ib yam kab mob oncological uas nyuaj rau paub vim yog cov qauv ntawm cov kabmob ntawm cov kabmob ntawm cov menyuam yaus. Kev cuam tshuam qhov kev kuaj mob yog tias nyob rau theem pib ntawm cov tsos mob qog noj ntshav yuav tsis tuaj yeem ua tiav. Tus kab mob no pib tshwm sim ntxov, tab sis kis mus rau hauv lub plab thiab cov qog nqaij hlav sai sai. Kev kuaj mob rau zes qe menyuam adenocarcinoma nyob ntawm lub sijhawm kho.
Vim txoj kev loj hlob
Cov tshuaj niaj hnub tsis paub meej qhov ua rau muaj kev mob qog noj ntshav, tab sis cov kws kho mob txheeb xyuas ntau yam uas cuam tshuam rau kev loj hlob ntawm pathology. Lub luag haujlwm tseem ceeb yog ua los ntawm kev tsis sib haum xeeb thiab kev muaj caj ces predisposition. Nws yuav tsis pab noj rog ntau,khoom noj khoom haus tsis zoo, ib puag ncig tsis zoo, raug ntau hom hluav taws xob, hnyav hnyav, tiv thaiv tsis muaj zog, haus cawv thiab haus luam yeeb. Yog tias lub zes qe menyuam loj zuj zus, qhov no yuav qhia tau tias kev loj hlob ntawm cov qog los yog ua rau muaj qhov tshwm sim.
Ua rau lub zes qe menyuam loj hauv cov poj niam feem ntau yog raws li hauv qab no:
- noj tshuaj hormonal (qhov ncauj contraceptives);
- hormonal imbalance;
- lub sijhawm lactation (vim yog qhov nce hauv cov ntsiab lus ntawm prolactin);
- kev ntxhov siab lossis kev nyuaj siab ntev;
- kev hloov pauv hauv lub cev hnyav;
- kab mob ntawm endocrine system;
- neoplasms ntawm ib tug malignant lossis benign xwm.
Ovarian o tuaj yeem ua tau rau cov menyuam ntxhais hnub nyoog 12-13 xyoos - qhov no yog ib qho tshwm sim uas tsis tas yuav kho. Qhov ua rau ntawm zes qe menyuam loj nyob rau hauv cov poj niam yog pathogenic microflora, cervical erosion los yog o ntawm appendix.
Ua kom muaj kev loj hlob ntawm adenocarcinoma tuaj yeem:
- uterine fibroids;
- tsis muaj menyuam lossis nquag cev xeeb tub thiab yug menyuam;
- ovarian dysfunction;
- kab mob ntawm endocrine system thiab hormonal ntshawv siab;
- uterine los ntshav;
- menstrual irregularities;
- rho menyuam thiab phais qhov chaw mos;
- menopause ntxov dhau los lig dhau lawm.
Qhov kev pheej hmoo ntawm kev tsim cov qog yuav nce ntxiv raws hnub nyoog. Nws ntseeg tau tias cov ntxhais uas tsis tau yug me nyuam yuav raug mob qog noj ntshav ntau dua. Thiab ib txhia txawm xav li ntawdua rau mob qog noj ntshav zes qe menyuam yog siv cov tshuaj pleev ib ce talc.
Kev faib kab mob
Ntau hom qog nqaij hlav raug cais raws li keeb kwm keeb kwm. Feem ntau hom mob qog noj ntshav yog serous zes qe menyuam adenocarcinoma, uas tau kuaj pom hauv 80% ntawm cov neeg mob. Qhov no yog ib hom mob qog noj ntshav. Cov qog nce mus txog qhov loj thiab feem ntau cuam tshuam rau ob lub zes qe menyuam. Metastases nyob rau hauv lub plab hnyuv kab mob yog pom nyob rau hauv thaum ntxov theem. Serous adenocarcinoma muaj cov neeg tuag coob heev.
Kwv yees li 10% ntawm cov neeg mob tau kuaj pom tias muaj endometrioid adenocarcinoma. Cov txheej txheem ntawm tus kab mob yog qeeb, lub pathology kuj kho tau zoo. Tib yam tshwm sim yog pom nyob rau hauv cov ntaub ntawv ntawm mucinous adenocarcinoma. Cov qog yog tus cwj pwm los ntawm qhov loj me thiab kev loj hlob sai. Feem ntau cuam tshuam tsuas yog ib qho ntawm zes qe menyuam.
Pale cell adenocarcinoma tsis tshua muaj (kuaj tsawg dua 1% ntawm cov neeg mob). Qhov no yog ib qho mob qog nqaij hlav loj heev uas ncav cuag qhov loj thiab ua rau cov metastasis thaum ntxov. Hom neoplasm no nyuaj rau kev kuaj mob. Feem ntau, cov qog nqaij hlav ntshiab tsuas cuam tshuam rau ib lub zes qe menyuam xwb. Kuj tseem muaj ib hom kev sib xyaw, uas muaj ntau hom kev kawm ua ke. Cais tawm undifferentiated adenocarcinoma.
Nyob ntawm qhov nyuaj ntawm cov txheej txheem ntawm tus kab mob, tsis zoo sib txawv adenocarcinoma raug cais tawm. Nyob rau hauv cov ntaub ntawv no, ib tug loj tus naj npawb ntawm cov qog nqaij hlav cancer tau kuaj pom, uas txawv heev ntawmnoj qab nyob zoo. Qhov no yog qhov tsis zoo ntawm qhov kev loj hlob ntawm tus kab mob. Nrog rau qhov sib txawv ntawm zes qe menyuam adenocarcinoma, cov qog nqaij hlav qog ua haujlwm tsis txawv ntawm qhov qub. Ib cov qog sib txawv me ntsis kuj txawv.
Raws li qhov sib txawv ntawm qhov sib txawv, muaj cov qog nqaij hlav malignant, adenocarcinoma ciam teb, zes qe menyuam sarcoma thiab mesodermal qog.
theem ntawm adenocarcinoma
theem mob qog noj ntshav tau txiav txim siab thaum kuaj thiab phais. Muaj plaub theem nyob rau hauv tag nrho:
- Thawj qhov cuam tshuam txog qhov pib ntawm kev loj hlob qog. Hauv qhov no, tsuas yog lub zes qe menyuam raug cuam tshuam, tsis muaj cov kua dej ntau ntxiv. Thaum pib, tus kab mob no tau kuaj pom hauv 23% ntawm cov neeg mob.
- theem thib ob yog qhov tshwm sim los ntawm metastases ntawm zes qe menyuam qog noj ntshav mus rau lub plab hauv plab thiab cov kua dej ntau ntxiv. Tus kab mob no tau kuaj pom hauv 13% ntawm cov neeg mob.
- Nyob rau theem thib peb, metastases txog li ob centimeters nyob rau hauv txoj kab uas hla tau kuaj pom nyob rau hauv lub plab kab noj hniav, thiab cov qog nqaij hlav kuj raug cuam tshuam. Feem ntau, zes qe menyuam adenocarcinoma raug kuaj pom nyob rau theem thib peb (hauv 47% ntawm cov neeg mob).
- theem plaub yog tus yam ntxwv los ntawm metastases thoob plaws hauv lub cev. Pom nyob rau hauv 17% ntawm cov neeg mob.
Yog tias tus kab mob tau kuaj pom thawj zaug, qhov kev ciaj sia nce mus txog 85-90%, qhov thib ob - 70-73%, qhov thib peb - kwv yees li 20-30%. Thaum kawg, qhov ciaj sia taus nce mus txog 1-5%. Cov neeg mob feem ntau tuag vim metastases hauv hlwb, ntsws, pob txha thiab siab.
daim duab kho mob
Nyob rau theem pib ntawm cov tsos mobTxawm tias muaj qhov sib txawv tsis zoo ntawm adenocarcinoma tuaj yeem tsis tuaj. Cov cim qhia ntawm mob qog noj ntshav tau yuam kev rau lwm yam kev mob, yog li kws kho mob kuaj tsis raug.
Cov tsos mob tseem ceeb ntawm tus kab mob gonadal yog:
- ntshav hnyav thaum cev xeeb tub thiab mob;
- mob plab zom mov;
- mob hauv plab hauv plab, uas hnyav zuj zus thaum cov qog loj tuaj;
- ntau cov qog nqaij hlav;
- mob tom qab kev sib deev;
- qaug zog thiab kev xav ntawm qhov tsis muaj zog.
Nrog rau qhov loj ntawm cov qog, lub plab yuav nce ntxiv. Qee cov tsos mob zoo ib yam li qhov pib ntawm lub cev tsis muaj zog, uas yog vim li cas cov poj niam yuam kev ua rau lawv tsis muaj hnub nyoog, ploj mus rau lub sijhawm muaj txiaj ntsig thaum kho tau zoo tshaj plaws.
Txoj kev kuaj mob
Kev kuaj mob pib nrog kev kuaj mob gynecological. Tus kws kho mob gynecologist tuaj yeem pom qhov kev txiav txim siab ntawm cov kab mob hauv nruab nrog cev, xav tias lawv loj tuaj. Yog tias xav tias mob qog noj ntshav, lawv yuav raug xa mus rau kev sab laj nrog kws kho mob oncogynecologist.
Txhawm rau kom paub meej qhov kev kuaj mob, ultrasound diagnostics tau qhia, uas yog ua los ntawm kev siv lub ntsuas tshwj xeeb los ntawm qhov chaw mos. Tus txheej txheem yuav txiav txim siab qhov loj thiab qhov xwm txheej ntawm cov qog, tab sis yuav tsis lees paub nws qhov malignancy.
Koj tuaj yeem xav tias tus kab mob nrog zes qe menyuam loj. Qhov no tuaj yeem paub tseeb los ntawm ultrasound. Tus neeg mob tuaj yeem txiav txim siab cov ntaub ntawv ntawm kev kawm ntawm nws tus kheej. Qhov loj me me ntawm zes qe menyuam hauv cov poj niam yog raws li hauv qab no:
- depth - ntawm 1.6 txog 2.2 cm;
- ntev - los ntawm 2 txog 3.7 cm;
- ntim - los ntawm 4 txog 10 cubic centimeters;
- qhov siab - ntawm 1.8 txog 3 cm.
Qhov ntau thiab tsawg yuav txawv nyob ntawm theem ntawm lub voj voog thiab lub xeev ntawm lub cev tag nrho. Kev sib txawv ntawm cov qauv hauv qhov loj ntawm zes qe menyuam hauv cov poj niam tsis yog ib txwm qhia ncaj qha rau oncology.
MRI thiab CT scans tau ua kom tau cov duab los txheeb xyuas cov metastases hauv lwm lub cev. Kev kuaj ntshav biopsy yog ua raws li kev qhia CT. Qhov tsis zoo ntawm txoj kev yog qhov xav tau los qhia qhov sib txawv, uas tuaj yeem ua rau muaj kev phom sij.
Histology, laparoscopy, cov ntaub so ntswg biopsy thiab kua puncture ntawm lub plab kab noj hniav kuj tau qhia rau kev kuaj mob. Tus kws kho mob yuav sau ib qho kev kuaj ntshav dav dav thiab kawm txog cov cim qog.
Kev kuaj ntshav yuav pab txiav txim siab qhov xwm txheej ntawm neoplasm. Thaum lub sij hawm tus txheej txheem, ib tug qauv raug coj mus kuaj thiab soj ntsuam nyob rau hauv lub microscope.
Laparoscopy cuam tshuam nrog kev tshuaj xyuas lub peritoneum los ntawm ib lub cuab yeej tshwj xeeb uas tau ntxig los ntawm kev phais hauv plab. Cov duab yog pauv mus rau lub monitor. Tus txheej txheem tso cai rau koj los ntsuas qhov tshwm sim ntawm cov qog, theem, qhov xwm txheej tag nrho.
Nrog kev tshawb pom ntxov ntawm zes qe menyuam adenocarcinoma, qhov kev cia siab tuaj yeem ua tau zoo. Nyob rau theem pib, kev tshem tawm ntawm cov qog yog qhia, thaum nws tseem tsis tau metastasized. Kev tshem tawm ntawm zes qe menyuam nyob rau hauv cov poj niam yog nqa tawm kom tus kab mob tsis kis. Nyob rau theem ob, lub neej expectancy raug txo kom tsawg. Tom qab cov tsos mob ntawm metastases nyob rau hauv tsib xyoosTsuas yog 10% ntawm cov neeg mob muaj sia nyob, thiab cov neeg mob uas nws txiav txim siab tsis kam phais nyob ntawm ib mus rau peb xyoos.
Kev kho mob ntawm adenocarcinoma
Kev kho mob feem ntau yog qhia los ntawm kev phais. Thaum muaj kev cuam tshuam, kev tshem tawm ntawm zes qe menyuam hauv cov poj niam yog ua. Lawv tuaj yeem txiav lub tsev menyuam thiab cov appendages yog tias lawv tseem cuam tshuam. Tab sis feem ntau cov kws phais neeg sim tshem tawm cov neoplasm nkaus xwb kom tus poj niam muaj peev xwm muaj menyuam yav tom ntej. Ua ntej qhov kev cuam tshuam, ib chav kawm ntawm chemotherapy yog muab los txo cov qog. Tib txoj kev yog siv tom qab phais yog tias cov qog nqaij hlav cancer tseem nyob.
Lub ntsiab ntawm txoj kev yog kev siv cov co toxins thiab tshuaj lom uas muaj kev cuam tshuam rau cov qog nqaij hlav malignant. Tau kawg, nrog rau kev kawm, tag nrho lub cev raug kev txom nyem.
Kev phais yuav raug contraindicated. Hauv qhov no, chemotherapy yog siv los ua qhov tseem ceeb. Qee zaum, cov txheej txheem tsis xav tau, tab sis tsuas yog pab nrog kev teem caij ua haujlwm. Nrog rau qhov sib txawv ntawm adenoma, piv txwv li, qhov ciaj sia taus tom qab kev cuam tshuam yog 95%. Cov tactics ntawm kev kho mob nyob ntawm ntau yam: qhov tam sim no tus neeg mob thiab lub hnub nyoog, theem thiab loj ntawm cov qog, muaj metastases. Tom qab ua haujlwm, yuav tsum tau saib xyuas tas li. Txhawm rau tiv thaiv kev rov tshwm sim, ultrasound thiab kuaj ntshav rau cov cim qog nqaij hlav tsis tu ncua.
Ntxiv thiab, tus kws kho mob muab cov lus pom zoo rau tus neeg mob txog kev ua neej. Koj yuav tsum tso tus cwj pwm phem thiab ua tib zoo saib xyuas koj txoj kev noj qab haus huv, vim tias lub cev tsis muaj zog heev. Kev kho mob raws sij hawm ntawm tag nrho cov kab mob concomitant yog qhov tseem ceeb. Khoom noj khoom haus rau adenocarcinoma ntawm zes qe menyuam yuav tsum ua kom tiav. Daim ntawv qhia zaub mov feem ntau pom zoo rau cov poj niam.
kev kho mob phais
Feem ntau, cov qog tau kuaj pom thaum nws tau loj hlob lawm. Hauv qhov no, kev tshem tawm ntawm zes qe menyuam yog qhia, tejzaum nws ua ke nrog lub tsev menyuam thiab appendages. Qee zaum tsuas yog ib feem ntawm cov qog raug tshem tawm kom txo nws cov ntim. Yog tias tsis muaj ntau tshaj 1 cm ntawm neoplasm tseem nyob tom qab kev cuam tshuam, ces qhov kev cuam tshuam yog hu ua kev pom zoo. Qee lub sij hawm oncology cuam tshuam rau cov kabmob uas nyob sib ze, xws li lub gallbladder, ib feem ntawm lub plab lossis daim siab. Hauv qhov no, cov kabmob no yuav tsum tau muab tshem tawm.
Tom qab tshem cov kab mob hauv qhov chaw mos, tus poj niam yuav tsis muaj menyuam ntxiv lawm yav tom ntej. Nrog rau qhov mob unilateral, kuaj pom nyob rau hauv cov theem thaum ntxov, nws muaj peev xwm khaws cia cov menyuam muaj nuj nqi. Kev phais mob laparoscopic tsawg dua. Thaum muaj kev cuam tshuam zoo li no, cov ntshav poob qis tsawg, lub sijhawm rov ua haujlwm tom qab yog luv heev, thiab yuav tsis muaj qhov caws pliav loj ntawm lub cev. Tab sis txoj kev no tsuas yog siv yog tias cov qog tau kuaj pom thaum pib ntawm txoj kev loj hlob. Txwv tsis pub, yuav tsum muaj kev phais ntau.
khoom noj kom raug rau oncology
Txawm kom txo tau qhov tsis zoo ntawm kev kho mob qog noj ntshav ntawm lub cev, tus neeg mob yuav tsum noj kom zoo. Txhawm rau rov qab muaj zog, koj tuaj yeem qhia zib mu rau hauv kev noj haus (yog tias tsis muaj kev fab tshuaj rau cov khoom lag luam muv), txiv ntoo, noj cov vitamins complexes.
Nws yog qhov yuav tsum tau cais tawm ntawm cov ntawv qhia zaub mov ib yam nkausfatty thiab nqaij cov zaub mov, haus luam yeeb nqaij, txuj lom thiab marinades, refined roj. Qab zib thiab ntsev yuav tsum txwv.
Txiv txiv hmab txiv ntoo thiab zaub tshiab, nplej, nqaij ntshiv, legumes, ntses tais. Nws yog ib qho tseem ceeb rau normalize qhov hnyav, tso tus cwj pwm phem, xyuas kom tsis muaj kev ntxhov siab thiab so zoo, thiab ua raws li tsoomfwv.
tiv thaiv kab mob
Kev tiv thaiv txhua yam mob qog noj ntshav cuam tshuam nrog kev cais tawm ntawm cov yam ntxwv uas yuav cuam tshuam rau kev loj hlob ntawm tus kab mob. Nws yog ib qho tsim nyog yuav tsum normalize qhov hnyav, tso tseg tag nrho cov cwj pwm phem, zam kev ntxhov siab thiab noj kom raug. Yuav tsum zam kom txhob kis tau thaum twg los tau.
Nws yog ib qho tseem ceeb los saib xyuas koj txoj kev noj qab haus huv thiab kho txhua yam kab mob raws sijhawm. Yog tias koj muaj cov tsos mob txaus ntshai (nws yuav tsum nco ntsoov tias cov tsos mob thaum ntxov ntawm mob qog noj ntshav zoo ib yam li qhov pib ntawm lub cev tsis muaj zog), koj yuav tsum sab laj nrog kws kho mob tam sim ntawd, tsis tas ncua kev mus ntsib tom qab. Lub luag haujlwm tseem ceeb sib npaug yog ua los ntawm kev xaiv ntawm tus kws tshaj lij uas twb tau ua tiav kev ua haujlwm nrog kev kuaj mob zoo sib xws. Nws yog ib qho tseem ceeb uas tus kws kho mob tuaj yeem ua haujlwm tau zoo.
