Kev tuag ntau dhau los ntawm oncology yog qhov teeb meem tseem ceeb ntawm cov tshuaj niaj hnub. Txhua xyoo nws thov txog yim lab tib neeg lub neej. Piv txwv li, mob khees xaws ncauj tsev menyuam yog ib yam kab mob malignant uas nyob rau hauv peb ntawm cov neeg tuag los ntawm oncology ntawm cov poj niam cov pejxeem.
Kev kuaj mob no yog tsim los ntawm kwv yees li 7% ntawm cov poj niam hnub nyoog qis dua 30 thiab 16% - tshaj 70 xyoo. Hauv kwv yees li ib feem peb ntawm cov neeg mob, cov kab mob tau tshawb pom lig dhau lawm, thaum mob qog noj ntshav ntawm ncauj tsev menyuam.
Txawm li cas los xij, dhau peb xyoos dhau los, qhov xwm txheej ntawm cov pej xeem tau poob ib nrab. Txawm li cas los xij, kev tuag tseem nyob siab. Yog li ntawd, nws yog ib qho tseem ceeb kom paub qhov ua rau ntawm kev loj hlob ntawm tus kab mob, nws cov tsos mob, raws li zoo raws li cov kev kuaj mob thiab cov kev kho mob.
Kev txhim kho kab mob
Hauv yuav luag 100% ntawm cov neeg mob, qhov ua rau muaj qhov tshwm sim ntawm tib neeg papillomavirus hauv tus neeg mob lub cev. Txawm li cas los xij, txawm tias thaum tus poj niam kis tus kab mob, oncology tsis tas li txhim kho.
Muaj ntau yam uas tuaj yeem ua tauua ib tug impetus rau txoj kev loj hlob ntawm ib tug malignant txheej txheem. Cov no suav nrog:
- Ua kom muaj kev sib raug zoo nrog ntau tus neeg koom nrog tib lub sijhawm lossis hloov pauv ntau zaus.
- Ntau yam kab mob venereal.
- Muaj HIV lossis AIDS.
- Pib deev hluas dhau.
- Ntau yam yug nrog lub sijhawm luv ntawm lawv.
- Cov kab mob phem dhau los ntawm cov kab mob genitourinary.
- Ib zaub mov tsis txaus tsis muaj cov vitamins thiab minerals txaus.
- siv sijhawm ntev ntawm cov tshuaj tiv thaiv hormonal.
Nws tseem yuav tsum tau muab sau tseg tias kev pheej hmoo ntawm kev tsim cov qog nqaij hlav qog nqaij hlav ntau ntxiv hauv cov poj niam uas muaj kab mob xws li:
- Leukoplakia.
- Dysplasia.
- Cervical erosion.
Cov poj niam zoo li no yuav tsum tau ua tib zoo tshuaj xyuas los ntawm gynecologist.
Nyob ntawm kab mob
Cov kab mob no tuaj yeem faib tau raws li qib ntawm cov qog loj hlob.
- Non-invasive cancer. Ib qho malignant tsim nyob rau hauv tshwj xeeb txheej txheej ntawm lub epithelium, uas yog, cia nyob rau ntawm lub caj dab.
- Pre-invasive cancer. Cov qog nkag mus tob rau hauv cov ntaub so ntswg tsawg dua 5 hli.
- mob qog noj ntshav. Lub ncauj tsev menyuam muaj qhov tsim ntawm nws qhov chaw uas tau loj hlob mus rau qhov tob ntawm 5 mm lossis ntau dua. Hauv qhov no, nws tau mus txog qhov loj thiab tuaj yeem cuam tshuam rau lub tsev menyuam, qhov chaw mos, nrog rau lub zais zis thiab lub qhov quav.
Nyob hauv notsab xov xwm yuav tsom tshwj xeeb rau kev mob qog noj ntshav hauv ncauj tsev menyuam, ib daim duab ntawm cov tsos mob uas tuaj yeem pom hauv qab no. Qhov tseeb yog tias ib tug poj niam uas muaj tus kab mob no feem ntau txhawj xeeb txog qhov mob hauv plab plab.
Kev mob qog noj ntshav: tswvyim
Kev mob qog noj ntshav yog ib yam kab mob ntawm lub ncauj tsev menyuam nyob rau theem ob ntawm kev loj hlob ntawm malignant neoplasm.
Ntawd yog, thaum xub thawj, cov qog nqaij hlav cancer nyob rau ntawm cov ntaub so ntswg ntawm lub tsev menyuam. Yog tias tus kab mob tsis kuaj tau raws sijhawm thiab tsis muaj kev ntsuas los kho nws, cov hlwb nkag mus rau hauv cov ntaub so ntswg hauv tsev menyuam (parametria).
Nrog daim ntawv no mob qog noj ntshav, lub ncauj tsev menyuam yog hyperemic, thickened thiab loj.
Nquag, lub ncauj tsev menyuam yog them nrog cov ntaub so ntswg epithelial, muaj cov hlwb ntawm cov qauv tiaj tus. Thaum raug rau tej yam tsis zoo, lawv degeneration mus rau malignant cov ntaub ntawv yog ua tau. Cov duab no yuav txawv.
- Qee zaum, cov qog nqaij hlav qog noj ntshav muaj peev xwm tsim tau lub npe hu ua "mob qog noj ntshav" - thaj chaw muaj keratinization. Thiab ces tus kab mob no yuav hu ua keratinizing carcinoma.
- Peb yuav tham txog invasive squamous cell nonkeratinizing cervical cancer nyob rau hauv cov ntaub ntawv uas malignant hlwb tsis muaj peev xwm tsim tej cheeb tsam.
Tsis muaj ib tus poj niam sawv cev tiv thaiv kab mob no. Piv txwv li, invasive squamous cell carcinoma ntawm lub ncauj tsev menyuam tuaj yeem tshwm sim thaum cev xeeb tub. Yog li ntawd, pawg poj niam no yog tshuaj xyuas tshwj xeeb yog ua tib zoo.
Txhua tus poj niam cev xeeb tub yog kuaj los ntawm gynecologist yam tsawg kawg ob zaug hauv cuaj lub hlis, uas siv kev tshuaj ntsuam rau oncocytology, uas kawm txog cov ntsiab lus ntawm lub ncauj tsev menyuam epithelium thiab cov qauv ntawm nws cov hlwb.
Nws tsim nyog sau cia tias tej zaum yuav muaj kab mob hauv ncauj tsev menyuam thiab cov ntaub ntawv intraepithelial. Nyob rau hauv cov ntaub ntawv no, lub malignant tsim yog cia li pib mus tob rau hauv lub ncauj tsev menyuam cov ntaub so ntswg. Qhov thib ob lub npe yog preinvasive cervical cancer.
Symptoms
Raws li lwm yam kab mob oncological, nyob rau theem pib, tus poj niam tuaj yeem hnov zoo tag nrho. Txawm li cas los xij, qee zaum muaj cov tsos mob xws li:
- qaug zog,
- txo qis qab los noj mov,
- ua npaws yam tsis muaj mob khaub thuas.
Nrog mob qog noj ntshav hauv ncauj tsev menyuam, cov tsos mob tau tshaj tawm, vim tias cov qog nqaij hlav zuj zus thiab qhov no tsis tuaj yeem ua tsis tau tab sis ua tsis tiav hauv cov kabmob thiab cov kab ke ntawm lub cev, ua rau qee yam cim qhia ntawm tus kabmob, xws li:
- Npaj paug qhov chaw mos uas muaj ntxhiab tsw thiab muaj cov ntshav tawg.
- Ntxhais chaw mos tsw.
- Cov ntshav zoo li poj niam cev xeeb tub nyob nruab nrab ntawm lub voj voog, tom qab kev sib deev lossis kev kuaj mob gynecological (tshwj xeeb tshaj yog nyob rau hauv cov kab mob squamous cell nonkeratinizing cervical cancer).
- Mob thaum tso zis lossis tso zis.
- Thaum fistulas tshwm sim nyob rau hauv cov phab ntsa ntawm qhov chaw mos, fragments ntawm cov quav yuav tshwm sim nyob rau hauv cov zis.
Kev kuaj kab mob
Btshuaj, muaj ntau txoj hauv kev los tshuaj xyuas tus poj niam rau cov qog nqaij hlav hauv lub ncauj tsev menyuam, txawm li cas los xij, txhawm rau kuaj xyuas qhov tseeb thiab zaum kawg, nws yog ib qho tsim nyog yuav tsum tau ua ntau yam kev ntsuam xyuas, suav nrog kev sim kuaj thiab cov txheej txheem kuaj mob.
Cov txheej txheem zoo tshaj plaws ntawm kev ntsuas yog colposcopy, histology, tomography ntawm ntau yam kabmob. Cia peb xav txog txhua txoj hauv kev kom ntxaws ntxiv.
Colposcopy
Ib txoj kev kuaj mob uas tus kws kho mob tshuaj xyuas cov phab ntsa ntawm qhov chaw mos thiab lub ncauj tsev menyuam siv lub cuab yeej tshwj xeeb - colposcope. Nws yog lub koob yees duab uas muaj peev xwm ua kom pom cov duab mus txog 20 npaug, thiab lub teeb ci.
Thaum tus txheej txheem, tus kws tshaj lij tshuaj xyuas cov xim ntawm nws, lawv qhov tsos, muaj qhov txhab, lawv qhov xwm txheej, qhov loj me thiab thaj tsam ntawm kev kawm, yog tias muaj.
Txhua yam no tso cai:
- Ntsuas qhov dav dav ntawm cov poj niam qhov chaw mos cov kab mob thiab qhov chaw mos microflora
- Txhim kho qhov tsim (benign lossis malignant).
- Siv lub swab thiab biopsy rau kev kawm ntxiv ntawm cell tsim.
Histological tsom xam (biopsy)
Xav txog txoj hauv kev tseem ceeb hauv kev kuaj mob qog noj ntshav hauv ncauj tsev menyuam. Yog tsis muaj nws, tus kws kho mob tsis tuaj yeem kuaj qhov tseeb, tab sis tsuas yog qhia txog kev txhim kho tus kab mob.
Siv lub scalpel, tus kws tshaj lij yuav siv cov ntaub so ntswg tsis zoo nrog rau thaj chaw noj qab haus huv. Tom qab uas tau txaisCov khoom raug tshuaj xyuas kom meej nyob rau hauv ib lub tshuab microscope. Raws li cov txiaj ntsig ntawm kev tshuaj ntsuam, tau txiav txim siab.
Nrog kev soj ntsuam histological zoo, tsis muaj qhov tsis ntseeg tias tus neeg mob muaj mob qog noj ntshav. Txawm li cas los xij, hauv kev xyaum muaj cov xwm txheej thaum qhov tshwm sim ntawm oncology tsis zoo, tab sis muaj cov tsos mob ntawm kev mob qog noj ntshav.
Nyob rau hauv rooj plaub no, txawm hais tias qhov kev kuaj ntshav tsis tau lees paub tias muaj cov kab mob malignant, tus kws kho mob oncologist tau sau tshuaj tiv thaiv kab mob rau tus neeg mob. Qhov tshwm sim tsis zoo nyob rau hauv qhov no tsuas yog qhia tias cov kab mob phem tsis tau nkag mus rau hauv cov ntaub so ntswg uas tau coj mus rau hauv lub cev nqaij daim tawv.
Kom tsis txhob muaj cov xwm txheej zoo li no hauv oncological gynecology, txoj kev siv tshuaj biopsy yog nce ntxiv siv cov gelatin tshwj xeeb lossis cellulose daim txhuam cev, uas ua tau zoo ntes cov hlwb epithelial, suav nrog cov malignant. Tom qab ntawd daim txhuam cev tau kho nrog 10% formalin tov, kos rau hauv paraffin thiab tshuaj xyuas hauv lub tshuab ntsuas.
Ntau hom tomography
Magnetic resonance imaging (MRI) ntawm lub plab hnyuv siab raum yog siv. Txoj kev no muab lub tswv yim tseeb tshaj plaws ntawm qhov xwm txheej ntawm cov qog, nws qhov loj me, qhov kev cuam tshuam ntawm kev cuam tshuam, kev hloov mus rau cov kab mob sib ze. Yog li ntawd, thaum kuaj pom tus kab mob uas kab lus no tau mob siab rau, nws yog qhov zoo dua los ua nws dua li kev suav tomography (CT).
Nyob rau hauv rooj plaub ntawm kev tshawb pom ntawm kev tsim ntawm theem nrab malignant foci (metastases) hauv cov qog ntshav, nws muaj peev xwm ua tau suav tomography ntawm lub plab kab noj hniav, nrog rau qhov chaw retroperitoneal. Hauv qhov noqhov tseeb ntawm qhov kev tshwm sim ntawm ob txoj kev no yog tib yam.
Positron emission tomography (PET lossis PT-CT). Nws yog txoj kev tshiab tshaj plaws thiab zoo tshaj plaws rau kev kuaj mob ntau yam kab mob malignant. Cervical cancer yog tsis muaj kev zam. Piv txwv li, txoj kev tuaj yeem tshawb pom txawm tias kev kawm nyob rau theem ntxov ntawm nws txoj kev loj hlob, txawm tias ua ntej cov tsos mob tshwm sim thawj zaug. PET tseem muab lub tswv yim ntawm kev txhim kho cov kab mob metastatic thiab lawv cov ciam teb nrog qhov tseeb ntawm ib millimeter.
Kev kho mob
Muaj ntau ntau txoj kev kho mob rau mob qog noj ntshav hauv ncauj tsev menyuam. Ib yam li lwm yam mob qog noj ntshav, muaj peb txoj hauv kev tseem ceeb.
Surgery
Txoj kev tseem ceeb ntawm kev kho cov qog yog kev phais kom excise ib malignant tsim.
Ua ntej kev ua haujlwm, nws yog qhov yuav tsum tau sau ntawv raug rau cov hluav taws xob gamma rays, uas cuam tshuam rau cov hlwb tsis zoo, ua rau lawv puas tsuaj. Qhov no tuaj yeem ua rau txo qhov loj ntawm cov qog, nrog rau qhov txo qis ntawm nws qhov kev ua phem.
Ua ntej ua haujlwm, qhov loj ntawm cov qog thiab nws thaj tsam yuav tsum tau kawm txhawm rau txhawm rau muaj lub tswv yim ntawm txoj haujlwm uas yuav tsum tau ua thiab xaiv kev kho mob tactics
Nyob ntawm qhov no, xaiv qee hom kev cuam tshuam kev phais. Yog tias tsuas yog txiav lub ncauj tsev menyuam tuaj yeem muab tshem tawm, ces nws raug tshem tawm siv ib qho ntawm cov hauv qab no:
- Laser.
- Radiosurgical.
- YUltrasonic.
- Ntxhais muaj riam.
- Cryosurgery.
Yog tias cov qog tau kis mus rau cov kabmob uas nyob sib ze, nws muaj peev xwm ua tau cov kev phais hauv qab no, nyob ntawm qhov ntsuas ntawm txoj haujlwm yuav tsum ua:
- Tshem tawm lub ncauj tsev menyuam nrog rau daim ntawv lo, zes qe menyuam thiab cov hlab.
- Tshem tawm ntawm lub ncauj tsev menyuam nrog rau cov cim, cov qog ntshav thiab ib feem ntawm qhov chaw mos.
Irradiation Therapy
Ntxiv rau qhov ua rau kev phais mob, txoj kev no tuaj yeem siv los ua kev kho mob qog noj ntshav thawj zaug.
Kev kho hluav taws xob tshwj xeeb yog siv tau zoo hauv thawj ob theem. Nrog kev mob qog noj ntshav hauv tsev menyuam, ntxiv rau nws, raws li txoj cai, lawv kuj siv tshuaj khomob. Kev sib xyaw ua ke ntawm ob txoj kev no yog qhov tseem ceeb tshwj xeeb rau cov neeg mob qog noj ntshav tsis tuaj yeem, nrog rau cov poj niam ua haujlwm txhawm rau tiv thaiv kev rov tshwm sim dua.
Tshuaj khomob
tuaj yeem siv tau rau txhua theem ntawm tus kab mob, nrog rau ua ntej kev phais. Cov tshuaj npaj muaj cov tshuaj tiv thaiv kab mob thiab tuaj yeem txo qhov loj ntawm cov qog, tiv thaiv lossis nres cov txheej txheem ntawm metastasis. Nws tseem yog qhov tseem ceeb ntawm kev kho mob rau cov poj niam uas muaj mob qog noj ntshav hauv ncauj tsev menyuam, nrog rau cov neeg mob uas muaj theem plaub, thaum qhov mob qog nqaij hlav tsis ua haujlwm thiab muaj ntau yam metastases.
Cov tshuaj siv ntau tshaj plaws rau kev mob qog noj ntshav hauv tsev menyuam yog Cisplatin, Fluorouracil, Vincristine, Ifosfamide thiab lwm yam. Tshwj xeeb yog lawv sivcuam tshuam rau kev mob qog noj ntshav hauv ncauj tsev menyuam.
Survival forecast
Kev muaj tus kab mob qog nqaij hlav ntawm lub caj dab yog ib yam kab mob loj uas, nrog rau kev kuaj mob lig thiab kho tsis tau sijhawm, tuaj yeem coj tus poj niam txoj sia.
Yog li, yog tias kev kuaj mob qog noj ntshav ntawm thawj lossis theem thib ob yog 78% thiab 57%, feem, tom qab ntawd nrog kev mob qog noj ntshav hauv tsev menyuam, qhov kev cia siab tsawg dua. Tom qab tag nrho, thaum cov qog tau loj hlob tob txaus, nws pib metastasize mus rau qhov ze tshaj plaws thiab cais cov kabmob. Yog li ntawd, qhov ciaj sia taus yog 31% nyob rau theem thib peb thiab tsuas yog 7.8% nyob rau hauv plaub.
Yog li, tag nrho feem pua ntawm cov neeg muaj txoj sia nyob ntawm cov neeg mob nrog cov kab mob no, qhov ciaj sia taus yog me ntsis ntau dua li ib nrab (55%).
Zoo kawg
Kev mob khees xaws ncauj tsev menyuam yog ib yam kab mob loj uas feem ntau kuaj pom lig heev. Txawm hais tias muaj ntau txoj kev kuaj mob, muaj ntau txoj hauv kev kho rau cov kab mob no, qhov ciaj sia taus tseem tsis siab heev. Yog li ntawd, txhawm rau zam txoj hmoo ntawm ntau tus poj niam, ib tus yuav tsum tsis tu ncua mus kuaj los ntawm gynecologist, nrog rau kev kuaj kom tsim nyog.
