Tubal cancer yog ib yam kab mob tsawg. Nws qhov kev nthuav dav yog nce mus txog 2% ntawm tag nrho cov qog nqaij hlav neoplasms ntawm lub cev xeeb tub. Qee lub sij hawm cov ntxhais hluas thiab cov poj niam cev xeeb tub hnov qhov kev kuaj mob zoo sib xws, tab sis feem ntau cov poj niam hnub nyoog 50 txog 62 xyoos yuav tsum tau nrog nws. Qhov kev cia siab rau kev rov zoo feem ntau yog nyob ntawm kev kuaj mob raws sij hawm thiab xaiv txoj kev kho kom zoo.
daim ntawv pov thawj kho mob
Cancer ntawm cov hlab ntsha hauv plab raws li ICD-10 muaj tus lej C57. Qhov no yog ib tug pathology, uas yog yus muaj los ntawm kev loj hlob ntawm ib tug malignant neoplasm. Feem ntau nws yog unilateral. Ob tog txheej txheem tsuas yog pom nyob rau hauv 30% ntawm cov neeg mob.
Kev txiav txim siab yam mob qog noj ntshav pab xaiv cov kev kho mob uas tsim nyog tshaj plaws. Los piav qhia txog theem ntawm cov txheej txheem oncological, TNM kev faib tawm ntawm cov qog nqaij hlav qog nqaij hlav yog siv. Nws yuav tau tham ntau yam hauv qab no.
Tseem muaj cov qauv thawj thiab theem nrab ntawm cov qog. Hauv qhov xwm txheej kawg, hais lusyog ib qho hematogenous lossis lymphogenous metastasis los ntawm lub ntsiab tseem ceeb, piv txwv li, los ntawm zes qe menyuam, tsev menyuam lossis plab. Thawj daim ntawv yeej ib txwm txhim kho ntawm nws tus kheej.
Histological kuaj ntawm qog tso cai rau peb paub qhov txawv ntawm cov hauv qab no:
- serous;
- endometrioid;
- clear cell;
- kev hloov pauv ntawm tes;
- tsis muaj qhov sib txawv.
Qhov laj thawj tseem ceeb
Qhov laj thawj tseem ceeb ntawm cov txheej txheem oncological yog kev hloov pauv ntawm cov cellular cov ntsiab lus nrog kev faib tawm siab. Nws tuaj yeem ua rau txo qis hauv kev tiv thaiv kab mob, kev puas tsuaj rau cov hlwb lossis cov noob. Qhov tshwm sim ntawm kev hloov pauv tshwm sim nce nrog lub hnub nyoog. Yog li ntawd, cov poj niam laus yeej ib txwm muaj kev pheej hmoo.
Kev tsim tawm ntawm cov mucous membranes kuj tseem ua tau raws li qhov cuam tshuam ntawm cov hauv qab no:
- cov txheej txheem inflammatory hauv plab hnyuv;
- kis kab mob / kab mob;
- kev puas tsuaj los yog tshuaj lom neeg (kev rho menyuam tawm, tshem tawm);
- irradiation;
- tus cwj pwm phem;
- ncua sij hawm raug rau cov carcinogens.
Cov kws tshawb fawb tau tswj xyuas lub luag haujlwm ncaj qha hauv qhov tshwm sim ntawm cov txheej txheem oncological ntawm tib neeg papillomavirus. Nws provokes mob qog noj ntshav ntawm zes qe menyuam, hlab ntsha, lub tsev menyuam thiab lub cev ntawm lub tsev menyuam. Ntau tshaj 80% ntawm cov pej xeem yog cov muaj tus kab mob no. Kev kis kab mob feem ntau tshwm sim los ntawm kev sib deev, feem ntau tsawg dua los ntawm cov tee dej.
Lwm tus kab mob oncogenic yog tus kab mob herpes. Tej zaum nws yuav tsis tshwm sim rau lub sijhawm ntev. Txawm li cas los xij, nrog kev txo qisKev tiv thaiv kab mob ua rau muaj kev txhoj puab heev, ua rau mob qog noj ntshav ntawm lub cev xeeb tub.
daim duab kho mob
Cov tsos mob ntawm qog nqaij hlav qog nqaij hlav qog nqaij hlav tsuas tshwm sim thaum tus kab mob loj tuaj. Thaum pib, tus poj niam yuav yws txog cov teeb meem kev noj qab haus huv hauv qab no:
- serous lossis purulent tawm ntawm qhov chaw mos, nrog rau qhov kub hnyiab;
- pom cov xim av tawm sab nraum lub sijhawm ntawm kev coj khaub ncaws;
- mob paroxysmal hauv plab plab.
Hauv 70% ntawm cov neeg mob, cov tsos mob ntawm tus mob qog noj ntshav tsis tuaj. Lub pathology nws tus kheej feem ntau yog kuaj pom los ntawm lub sijhawm thaum kuaj gynecological lossis ultrasound rau lwm qhov laj thawj. Ntawm palpation nyob rau hauv cheeb tsam ntawm cov hlab ntsha fallopian, ib tug volumetric tsim yog zoo palpable. Cov pob no yog qhov sib xyaw ntawm exudate.
Cov tsos mob tshwm sim tau thiab tsis yog tshwj xeeb ntawm kev mob qog noj ntshav qog. Lawv manifest lawv tus kheej nyob rau hauv daim ntawv ntawm qaug zog, dav malaise, deterioration ntawm kev noj qab nyob zoo. Nyob rau theem tom qab, qhov nce hauv qhov kub thiab txias koom nrog lawv. Nyob rau hauv cov ntaub ntawv no, qhov mob nyob rau hauv lub cheeb tsam yuav mob siab heev, lub plab mog loj hlob. Kuj tseem muaj teeb meem tso zis, teeb meem nrog plab hnyuv patency.
Cov kauj ruam hauv cov txheej txheem ntws
Raws li International Classification of Diseases (ICD), kab mob qog noj ntshav tau muab faib ua 4 theem:
- Kuv theem. Mob qog noj ntshav yog nyob ntawm qhov chaw ntawm txoj hlab ntshav.
- II theem. Lub neoplasm nyob rau hauv ib los yogob leeg leeg, tab sis twb txuas mus rau zes qe menyuam los yog cov ntaub so ntswg pelvic.
- III theem. Muaj qhov mob ntawm tsuas yog ib lossis ob txoj hlab ntsha hauv plab, plab hnyuv. Muaj peev xwm metastasis rau cov qog nqaij hlav inguinal lossis iliac.
- IV theem. Thaum kuaj, metastases pom nyob rau hauv cov qog ntshav nyob deb.
Kev txiav txim siab ntawm theem ntawm pathology tso cai rau koj xaiv txoj kev kho mob zoo tshaj plaws.
Txoj kev kuaj mob
Vim tias tsis muaj cov cim qhia pom tseeb ntawm kev mob qog noj ntshav hauv lub cev thaum pib, cov neeg mob nrhiav kev pab kho mob lig. Kev kuaj mob ntawm cov txheej txheem pathological yog complex. Nws suav nrog kev kawm txog daim duab kho mob, kuaj thiab ntsuas cov txheej txheem.
Tom qab kuaj xyuas ntawm lub rooj zaum gynecological, tus poj niam raug kuaj cytological ntawm smears los ntawm qhov chaw mos thiab lub ncauj tsev menyuam. Txawm li cas los xij, siv txoj kev no, cov kab mob pathological tuaj yeem kuaj pom tsuas yog hauv 23% ntawm cov neeg mob. Qhov tseeb ntawm kev soj ntsuam cytological ua rau muaj qhov piv txwv ntawm cov khoom siv roj ntsha uas siv cov swab tshwj xeeb. Nws muab tso rau hauv qhov chaw mos tau ob peb teev.
Txoj kev kuaj mob tshaj plaws yog kev tshuaj xyuas ntawm oncomarker CA-125. Nws yog ib tug natural protein uas tso tawm rau hauv cov hlab ntsha los ntawm qog cov ntsiab lus. Kev nce hauv cov ntsiab lus ntawm CA-125 hauv cov ntshav ntawm theem I thiab II ntawm mob qog noj ntshav tau pom hauv 68% ntawm cov neeg mob. Hauv theem III lossis IV, daim duab no yog 95%. Ib qho kev nce me ntsis hauv qhov ntsuas noua tau nrog endometriosis thiab thaum cev xeeb tub.
kuaj ultrasound nyob rau hauv cov ntaub ntawv ntawm mob qog noj ntshav ntawm cov hlab ntsha fallopian yog suav tias yog cov ntaub ntawv tseem ceeb. Nws tso cai rau koj txheeb xyuas qhov neoplasm, ntsuas qee qhov ntawm nws cov yam ntxwv. Ultrasound nrog Doppler daim ntawv qhia tau lees paub tias yog cov ntaub ntawv ntau dua. Nrog nws cov kev pab, nws yog ib txwm muaj peev xwm mus ntes pathological ntshav txaus, signaling ib malignant neoplasm. Txoj kev kuaj mob no yog siv txawm tias cov poj niam rog rog.
Computed tomography kuj suav hais tias yog cov ntaub ntawv yog tias xav tias oncology. Nws yog ib qho kev soj ntsuam ntxaws ntawm cov kab mob hauv plab. Txawm li cas los xij, tus nqi siab thiab raug hluav taws xob ntau ua rau CT ib txoj kev kuaj xyuas tsawg. Nws txoj kev pab yog siv rau hauv cov xwm txheej tshwj xeeb, piv txwv li, nrog cov ntsiab lus nug.
Txoj Kev Kho Mob
Cov kab mob no tsis tshua muaj neeg. Yog li ntawd, ib qho kev kho mob ib leeg tsis tau tsim. Tag nrho cov kev kho mob raug txo kom tshem tawm cov neoplasm, tiv thaiv kev rov tshwm sim thiab metastasis. Rau lub hom phiaj no, kev phais thiab kws khomob tau siv niaj hnub no. Txhua txoj kev tau piav qhia hauv qab no.
Surgery
Radical kev kho mob qog nqaij hlav qog nqaij hlav qog noj ntshav cuam tshuam nrog kev tshem tawm tsis yog cov kabmob cuam tshuam nkaus xwb, tab sis extirpation. Nyob rau hauv tas li ntawd, nyob rau hauv lub general tshuaj loog, lub tsev menyuam nrog appendages thiab cov lymph nodes raug excised. Yog tias nws tsis tuaj yeem lees paub qhov mob ntawm neoplasm, kev cuam tshuam ntawm lub cev yog ua. Kuj rau nws pabsiv los kho cov tub ntxhais hluas uas xav sim lub luag haujlwm ntawm tus niam yav tom ntej.
Thaum lub sijhawm ua haujlwm, kev tshuaj xyuas ntawm lub plab kab noj hniav, ntxuav los ntawm peritoneum, kuaj ntshav ntawm cov qog ntshav nyob deb tau ua tiav. Tom qab kuaj histological, tus kws kho mob txiav txim siab ntxiv cov tswv yim: rov ua haujlwm lossis kho hluav taws xob.
Yog tias muaj kev txwv tsis pub phais lossis lig nrhiav kev kho mob, pom zoo kho cov tsos mob. Tus neeg mob tau muab tshuaj tua kab mob uas pab kom txo tau qhov mob. Qhov tshwm sim tuag nyob rau theem kawg tshwm sim hauv ob peb lub hlis thiab tsis nyob ntawm qhov kev loj hlob ntawm neoplasm.
Kev tswj cov tshuaj khomob
Tubal cancer yog qhov nyuaj rau kev kuaj mob thaum ntxov. Kev kho phais feem ntau tsis muaj txiaj ntsig. Yog li ntawd, txhua tus neeg mob tau muab tshuaj kho ua ke, tsis hais txog theem ntawm pathology.
Cov txheej txheem kho mob suav nrog kev sib xyaw ntawm "Cyclophosphamide" nrog cov tshuaj uas muaj platinum hauv lawv cov muaj pes tsawg leeg ("Cisplastin", "Carbolplastin"). Ib nrab lossis txawm tias ua tiav ntawm cov qog nrog cov kev kho mob zoo li no tau pom nyob rau hauv 53-92% ntawm cov neeg mob, thiab tsib xyoos kev ciaj sia yog 51%. Yog tias cov neoplasm tsis pom qhov zoo tshwm sim rau cov tshuaj nrog platinum, lawv raug hloov nrog cov tshuaj los ntawm pawg taxane. Txawm li cas los xij, nyob rau hauv cov ntaub ntawv no, tus nqi ciaj sia nyob tsib xyoos yog kwv yees li 30%.
Tshuaj kho mob yuav luag ib txwm nrog los ntawm kev phiv. Piv txwv li, cov neeg mob muajpoob phaus, daim tawv nqaij ua pob khaus, plab hnyuv, qaug zog. Tsis tas li ntawd, muaj kev cuam tshuam ntawm cov pob txha pob txha. Cov xwm txheej no ploj mus ntawm lawv tus kheej tom qab tso tseg txoj kev kho.
Kev ntsuas kom rov zoo
Kev kuaj mob rau cov qog nqaij hlav qog noj ntshav yog txiav txim siab los ntawm feem pua ntawm kev muaj sia nyob tom qab kev kho mob rau 5 xyoos. Thaum tsis muaj kev kho ua ke, daim duab no yog 35%, thiab nyob rau hauv cov ntaub ntawv ntawm thawj theem ntawm tus kab mob - 70%. Tom qab ua haujlwm thiab noj cov tshuaj khomob, qhov muaj sia nyob tsib xyoos rau theem I-II yog 100%, rau theem III - tsis ntau tshaj 28%.
Kev kuaj mob feem ntau txiav txim siab los ntawm kev noj qab haus huv ntawm tus neeg mob, tus yam ntxwv ntawm nws lub cev thiab hom qog nws tus kheej. Nrog rau qhov no pathology, cov mob ntawm relapse tsis raug cais tawm. Ua tsaug rau txoj kev loj hlob ntawm cov tshuaj, yuav luag txhua theem, nws muaj peev xwm mus cuag ib tug neeg lub neej. Txawm li cas los xij, qhov no tsis siv rau theem kawg, vim tias qhov no tus neeg mob twb tau tuag lawm.
Puas muaj menyuam?
Thaum muaj kev puas tsuaj rau txoj hlab ntaws, qhov tshwm sim ntawm cev xeeb tub yog qhov tsawg heev. Qhov tshaj plaws yog tias cov txheej txheem pathological ua txhaum lub tubal patency vim qhov txhaws ntawm nws cov lumen nrog lub neoplasm thiab tsim cov txheej txheem nplaum. Nrog kev mob ob sab, nws tsis tuaj yeem xeeb menyuam ntawm koj tus kheej.
Txoj Kev Tiv Thaiv
Txoj kev tshwj xeeb los tiv thaiv kev mob qog noj ntshav hauv tsev menyuamcev tsis muaj. Kev tiv thaiv tus kab mob los ntawm cov qauv kev cai pom zoo rau txhua yam kab mob oncological. Ntawm lawv yog cov hauv qab no:
- ua raws li tsoomfwv txoj haujlwm thiab so;
- khoom noj kom raug;
- exclusion of stressful xwm;
- muab tus cwj pwm phem;
- kev ua neej nyob.
Raws li qee tus kws kho mob, qhov tsis muaj qhov ua rau muaj kev tiv thaiv kab mob qog noj ntshav. Yog li ntawd, cov kws tshaj lij qhia txog kev kho mob raws sij hawm ntawm cov kab mob inflammatory uas cuam tshuam rau cov kab mob ntawm cov kab mob hauv lub cev. Tsis tas li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau siv cov tshuaj tiv thaiv kab mob thaum lub sij hawm sib deev kom tshem tawm txoj kev pheej hmoo ntawm kev cog lus STI. Ib qho kev ntsuas tseem ceeb ntawm kev tiv thaiv yog kev kuaj mob raws sij hawm los ntawm gynecologist. Nws yog ib qho tsim nyog yuav tsum tau npaj ua ntej kev xeeb tub ntawm tus menyuam txhawm rau txhawm rau tshem tawm qhov kev pheej hmoo ntawm kev xeeb tub tsis xav tau.
Ua raws li cov lus qhia saum toj no thiab kev ceev faj tuaj yeem txo qhov kev pheej hmoo ntawm kev txhim kho oncopathology.
