Hmoov tsis zoo, hauv ob peb lub xyoo dhau los, cov poj niam uas tsim cov qog nqaij hlav cancer tau nce ntau. Ib qho ntawm feem ntau hom yog mob qog noj ntshav endometrial. Vim li cas nws thiaj txaus ntshai? Cov theem kev loj hlob, kev kho mob thiab txoj hauv kev yuav rov qab los yuav tau tham ntxiv tom ntej.
Problem description
mob qog noj ntshav endometrial yog cov qog nqaij hlav uas tshwm sim los ntawm kev loj hlob ntawm cov qog nqaij hlav hauv lub tsev menyuam. Feem ntau, cov kab mob no cuam tshuam rau cov poj niam tom qab 45 xyoo. Hom mob qog noj ntshav no teb tau zoo rau kev kho mob, tshwj xeeb tshaj yog tias nws cov tsos mob tau kuaj pom thaum ntxov ntawm kev loj hlob.
Yog vim li cas thiaj pom
Hnub no, cov tshuaj tseem ceeb tsis muaj cov ntaub ntawv tseeb txog qhov ua rau mob qog noj ntshav. Txawm li cas los xij, muaj ntau yam uas tsim nyog rau qhov pom ntawm neoplasms:
- kab mob ntawm kev ua me nyuam, suav nrog kev mob, uas tus poj niam ntsib thoob plaws hauv nws lub neej;
- kev coj khaub ncaws tsis zoo;
- siv cov tshuaj uas muaj cov tshuaj estrogen;
- genetic predisposition (piv txwv li, yog tias muaj cov poj niam hauv tsev neeg mob qog noj ntshav, ces lawv cov txheeb ze muaj kev pheej hmoo);
- kev sib deev promiscuous, uas tuaj yeem ua rau STDs;
- ncua kev sib deev abstinence;
- lig cev xeeb tub (tom qab 30);
- rho menyuam thiab lwm yam kev ua haujlwm gynecological uas cuam tshuam nrog kev tshem tawm ntawm lub tsev menyuam, xws li kev cuam tshuam nyias thiab ua rau cov endometrium, yog li ua rau cov txheej txheem malignant;
- thaum ntxov menopause (qis dua 50);
- pib ua cev qhev (ua ntej 12 xyoos);
- muaj keeb kwm mob ntshav qab zib;
- overweight;
- kab mob ntawm lub cev tiv thaiv kab mob;
- tsis muaj lossis kho tsis raws sijhawm ntawm cov kab mob gynecological.
Ntxiv rau, cov kws kho mob nco ntsoov tias cov poj niam uas tsis muaj menyuam, nrog rau cov neeg mob hyperplasia, tus kab mob uas tsis yog qog nqaij hlav, tab sis provokes kev loj hlob ntawm endometrial hlwb, muaj kev pheej hmoo.
Ntau yam ntawm pathology
Muaj ob yam tseem ceeb ntawm uterine endometrial cancer:
- Cov tshuaj hormone-dependant tshwm sim hauv 70% ntawm tag nrho cov mob. Neoplasms tuaj yeem tshwm sim ntawm qib siab ntawm cov tshuaj estrogen. Raws li txoj cai, hyperplasia tuaj yeem tshwm sim ua ntej qhov no. Hormonal tsis ua haujlwm kuj tuaj yeem tsim nrog cov kab mob inflammatory ntawm zes qe menyuam, nrog rau keeb kwm ntawmLwm hom mob qog noj ntshav, feem ntau hauv lub mis.
- Kev mob qog noj ntshav endometrial tsim nyob rau hauv rooj plaub ntawm cov kab mob endocrine uas cuam tshuam nws txoj haujlwm. Hom kab mob no feem ntau raug rau cov poj niam tom qab 60 xyoo nrog atrophy ntawm cov ntaub so ntswg endometrial los yog kev tiv thaiv ntawm lub cev. Kev mob qog noj ntshav tsis muaj peev xwm kho tau nrog cov tshuaj hormonal; tshem tawm cov kab mob hauv nruab nrog cev feem ntau qhia, vim tias qhov kev pheej hmoo ntawm metastasis mus rau lwm lub cev yog siab.
Nyob ntawm hom mob qog noj ntshav, xaiv txoj kev kho kom raug.
Kev tshwm sim ntawm tus kab mob
Cov tsos mob ntawm cov qog nqaij hlav endometrial loj hlob zuj zus, nyob ntawm theem ntawm tus kab mob. Tsis tas li ntawd, lawv qhov kev siv zog yog nyob ntawm qhov muaj lossis tsis muaj kev sib txuam ntawm cov kab mob genitourinary. Hmoov tsis zoo, nyob rau hauv thawj theem, cov tsos mob thiab cov tsos mob ntawm uterine endometrial cancer tsis yog tshwj xeeb, vim hais tias ib tug poj niam yuav tsis muab ntau qhov tseem ceeb rau lawv. Nov yog tus kab mob insidiousness.
Cov tsos mob ntawm tus kab mob muaj xws li cov tsos mob hauv qab no:
- atypical menstruation (ntau dhau los lossis hnyav, ntev lossis luv dua li ib txwm, tsis muaj sijhawm);
- mob hauv plab plab uas tshwm sim tsis muaj laj thawj;
- teeb meem nrog tso zis (lawv mob, ntshav txhaws, nyuaj);
- quav quav (cem quav lossis plab);
- tawm qhov chaw mos uas muaj ntxhiab tsw thiab atypicalxim.
Nyob rau theem tom ntej, qhov mob mob tuaj yeem nce nrog kev nqa hnyav, lub neej zoo, thaum cev xeeb tub. Cov kev mob tshwm sim kuj maj mam deteriorating - qab los noj mov ploj, ib tug mob ntawm daim tawv nqaij tone tshwm, tus poj niam yog sai poob ceeb thawj, ntev tsam plab, cem quav, tsis muaj zog, tsaug zog thiab ib tug nyiam ua hauj lwm ntau heev txawm tias me ntsis exertion.
theem kab mob
Kev loj hlob ntawm pathology tshwm sim maj mam. Txhua theem ntawm kev mob qog noj ntshav endometrial muaj nws tus yam ntxwv thiab cov yam ntxwv:
- Nyob rau theem 1, tsis muaj cov tsos mob tshwm sim uas tuaj yeem txheeb xyuas qhov muaj qog. Lub neoplasm nws tus kheej yog me me thiab tsis ncav cuag lub uterine kab noj hniav. Tsis tas li ntawd, kev ua tsis tiav ntawm lub voj voog txhua hli tau sau tseg, thiab feem ntau tus poj niam poob lub peev xwm xeeb tub.
- Theem 2 yog qhov tshwm sim ntawm cov qog loj hlob sab nraud ntawm lub tsev menyuam thiab kev puas tsuaj rau cov mucous ntawm lub caj dab ntawm lub cev. Ib tug poj niam yuav muaj cov tsos mob ntawm uterine endometrial cancer raws li pom thaum lub sij hawm kev sib deev kev sib deev, ib tug tsis tsim nyog deterioration nyob rau hauv kev noj qab nyob zoo, mob nyob rau hauv lub plab mog, thiab poob ntawm qab los noj mov. Feem ntau, cov kev tshwm sim no yog me me, yog li ib tug poj niam yuav tsis xyuam xim rau lawv. Tus kws kho mob gynecologist tuaj yeem kuaj pom cov qog thaum lub sijhawm kuaj.
- Nyob rau theem 3, cov tsos mob thiab cov tsos mob ntawm cov qog nqaij hlav endometrial pom tau ntau dua. Thaum lub sijhawm no, cov qog tuaj yeem kis mus rau cov kabmob hauv plab hnyuv - zes qe menyuam, cov hlab ntsha hauv plab. Nyob ntawmNyob rau theem ntawm tus kab mob no, tej zaum yuav muaj me me foci ntawm metastasis nyob ze ntawm lub cev thiab cov pob txha.
- Nyob rau theem 4 ntawm endometrial cancer ntawm lub tsev menyuam, cov neoplasm cuam tshuam rau lub plab hauv plab - qhov quav, zais zis, qhov chaw mos, tso zis. Cov qog nqaij hlav cancer kis thoob plaws hauv lub cev, yog li metastases tuaj yeem tshwm sim hauv ib qho khoom nruab nrog cev. Cov cim qhia ntawm kev mob qog noj ntshav endometrial nyob rau theem kawg tau tshaj tawm thiab cuam tshuam lub neej ib txwm muaj ntawm tus poj niam.
Ciaj sia nyob ncaj qha nyob ntawm theem ntawm tus kab mob uas tau pib kho. Yog li, piv txwv li, nyob rau theem 1 lossis 2 ntawm kev mob qog noj ntshav, qhov kev mob tshwm sim tau zoo dua li ntawm theem 3 thiab 4 ntawm kev puas tsuaj rau lub cev.
Kev kis mob qog noj ntshav
Thaum 3rd theem ntawm kev loj hlob ntawm tus kab mob, metastases pib tshwm sim hauv cov kabmob uas nyob sib ze. Qhov no tuaj yeem tshwm sim ntau txoj hauv kev:
- Txoj kev lymphogenic cuam tshuam nrog kev sib kis ntawm cov qog nqaij hlav cancer los ntawm cov qog ntshav. Tib lub sijhawm, lawv loj tuaj thiab ua rau mob thaum kov.
- Txoj kev hematogenous tau sau tseg thaum cov qog nqaij hlav qog nqaij hlav nkag mus rau hauv cov hlab ntsha thiab kis mus rau nws thoob plaws lub cev. Nyob rau tib lub sijhawm, cov kab mob pathogenic tuaj yeem nyob hauv txhua yam hauv nruab nrog cev lossis cov pob txha thiab pib rov ua dua.
- Implantation metastasis cuam tshuam nrog kev loj hlob ntawm neoplasm rau hauv cov kabmob uas nyob ze, nrog rau cov pob txha thiab cov ntaub so ntswg adipose.
Hmoov tsis zoo, cov theem ntawm mob qog noj ntshav uas tshwm sim los ntawm qhov muaj cov metastases hauvlwm yam kabmob, kho tsis tau. Kev kho mob hauv cov xwm txheej zoo li no yog txhawm rau txo qhov mob mob, nrog rau kev ua kom qeeb ntawm kev faib cov qog nqaij hlav cancer thiab kev sib kis ntawm cov kab mob metastases hauv cov kab mob noj qab haus huv.
Cov khoom ua rau metastasis
Qhov kev pheej hmoo ntawm cov qog nqaij hlav qog nqaij hlav kis mus rau lwm lub cev tsis yog nyob ntawm theem ntawm tus kab mob nkaus xwb, tab sis kuj nyob rau lub sijhawm zoo li no:
- localization ntawm neoplasm hauv lub cev;
- poj niam lub hnub nyoog (tus neeg mob laus dua, qhov yuav ua rau metastases ntau dua);
- degree ntawm neoplasm sib txawv (muaj cov qog los ntawm cov hlwb sib txawv uas muaj ntau dua lossis qis dua ntawm kev tsim tawm).
Cov no thiab lwm yam uas yuav cuam tshuam rau kev kho mob qog noj ntshav tau raug tshawb xyuas hauv kev sim tshuaj.
Kev kuaj kab mob
Nws yog ib qho tseem ceeb heev kom tsis txhob tsis quav ntsej cov kev ntsuam xyuas tsis tu ncua los ntawm kws kho mob gynecologist, vim tsuas yog ib tus kws tshaj lij tuaj yeem kuaj mob qog noj ntshav hauv thawj theem ntawm tus kab mob. Kev kuaj mob qog noj ntshav endometrial muaj cov haujlwm hauv qab no:
- Kev tshawb fawb kho mob uas tus neeg mob yuav tsum piav qhia meej txog cov lus tsis txaus siab thiab tshaj tawm lub sijhawm ntawm cov tsos mob tsis zoo, yog tias muaj. Tsis tas li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau muab cov ncauj lus qhia ntxaws txog kev coj khaub ncaws rau tus poj niam - nws tsis tu ncua, mob, abundance, ntev.
- Kev soj ntsuam ntawm tus neeg mob cov ntaub ntawv gynecological muab cov ntaub ntawv hais txog cov kab mob gynecological yav dhau los, kev yug menyuam thiab lwm yam uas tuaj yeem cuam tshuam qhov tshwm sim ntawm qog.
- Gynecologicalkuaj ntawm lub rooj zaum nrog palpation ntawm sab nraud thiab sab hauv ntawm qhov chaw mos thiab, tshwj xeeb tshaj yog, lub ncauj tsev menyuam.
- Transvaginal ultrasound pab txheeb xyuas qhov neoplasm, ntsuas nws tus mob thiab qhov loj me, nrog rau nws qhov chaw.
- Biopsy rau kev kuaj xyuas cov ntaub so ntswg ntawm lub tsev menyuam. Nws yog noj nrog kev pab los ntawm ib tug aspirator, uas yog muab tso rau hauv lub uterine kab noj hniav thiab nqus ib feem ntawm lub endometrium ntawm lub cev.
- Hysteroscopy - ib qho kev ntsuam xyuas sab hauv ntawm lub xeev ntawm lub tsev menyuam uas siv lub hysteroscope - ib qho khoom siv hauv daim ntawv ntawm lub raj nruj lossis mos nrog lub lens kaw lus thiab lub teeb pom kev ntawm qhov kawg. Cov cuab yeej tau muab tso rau hauv lub uterine kab noj hniav, uas tso cai rau tus kws kho mob los tshuaj xyuas lub cev kom ntxaws los ntawm sab hauv. Cov cuab yeej no tseem tso cai rau koj los koom nrog cov endometrium cuam tshuam rau kev tshawb fawb ntxiv.
- Kev tshawb fawb fluorescent ua rau nws tuaj yeem kuaj pom tus neoplasm nyob rau theem pib. Txhawm rau ua qhov no, cov tshuaj fluorescent yog txhaj rau hauv lub uterine kab noj hniav. Cov qog nqaij hlav cancer nquag nqus nws thiab pom rau tus kws kho mob.
- Computer los yog magnetic resonance imaging, nrog rau X-rays raug sau nyob rau hauv cov ntaub ntawv ntawm suspicion ntawm metastasis mus rau lwm yam hauv nruab nrog cev.
Ntxiv rau, cov poj niam uas xav tias mob qog noj ntshav ntawm lub tsev menyuam yuav tsum tau kuaj ntshav lossis tso zis rau cov qog nqaij hlav.
YUterine Cancer Therapy
Nyob ntawm seb qhov kev loj hlob ntawm tus kab mob, kev kho mob sib txawv. Cov txheej txheem nyuaj feem ntau siv:
- Kev cuam tshuam kev phais uas cuam tshuam nrog kev tshem tawm ntawm lub tsev menyuam. Qee zaum, lub cevtshem tawm nrog rau cov appendages thiab cov qog nqaij hlav, yog tias lawv cuam tshuam los ntawm kev hloov pauv qog noj ntshav. Txog niaj hnub no, rau kev kho mob qog noj ntshav endometrial thaum ntxov, laparoscopy yog siv, uas tsis tshua muaj mob. Txawm li cas los xij, nrog rau thaj tsam loj ntawm lub cev puas tsuaj, kev ua haujlwm hauv plab yog qhov tsim nyog, uas yog ua los ntawm kev txiav lub plab kab noj hniav.
- Radiotherapy cuam tshuam cov nyhuv ntawm ionizing hluav taws xob ntawm thaj tsam ntawm kev kis mob qog noj ntshav. Nws yog feem ntau siv ua ke nrog kev phais. Yog tias qhov kev tshem tawm tsis xav tau rau ib qho laj thawj, ces nws tuaj yeem siv brachytherapy - cog cov hluav taws xob rau hauv cov qog. Qhov no txo qis kev kis mus rau lwm yam kabmob.
- Tshuaj khomob yog suav tias yog kev kho mob ntau tshaj plaws rau mob qog noj ntshav ntawm txhua yam. Nws yog siv nyob rau hauv cov mob cancer thoob plaws. Cov tshuaj siv ntau tshaj plaws ntawm cov tshuaj xws li cisplatin, doxorubicin, cyclophosphamide. Hmoov tsis zoo, cov txheej txheem no muaj ntau yam kev mob tshwm sim: alopecia (ntsiav tshuaj), osteoporosis, xeev siab, ntuav, raws plab.
- Kev kho tshuaj hormone yog qhia thaum pom cov tshuaj hormones progesterone hauv cov qog. Cov kev kho mob zoo li no raug xaiv los ntawm tus kws kho mob oncologist. Nws qhov zoo dua yog qhov tsis muaj kev phiv. Txawm li cas los xij, yog tias cov qog tsis teb rau cov tshuaj hormones, kev kho mob zoo li no tsis muaj txiaj ntsig.
Cov tsos mob ntawm uterine endometrial cancer tuaj yeem ua rau lub neej tsis zoo, yog tias tsis ua rau nws luv. Yog vim li ntawd nws thiaj tseem ceebpib kho thaum pib, thaum tus kab mob no kis tau mus rau kev kho kom tiav.
Huab cua
Qhov kev pheej hmoo ntawm kev kho mob qog noj ntshav kom tiav yog nyob ntawm theem ntawm tus kab mob, nrog rau cov txheej txheem kho mob kom raug. Cov ciaj sia taus ntawm cov qog nqaij hlav sib txawv heev (tsim cov hlwb uas tsis zoo li loj hlob sai) yog li 95%, thiab rau cov qog tsis sib txawv (cov qia hlwb tsis zoo uas faib sai heev) tsuas yog 18%. Hom neoplasm yog txiav txim siab nyob rau theem kuaj mob.
Hmoov tsis zoo, nyob rau theem 4 mob qog noj ntshav, qhov ciaj sia taus tsawg kawg nkaus, thiab txhua yam kev kho mob tau nqis los tswj tus neeg mob tus mob, txo cov tsos mob ntawm tus mob qog noj ntshav endometrial, nrog rau kev ua kom qeeb ntawm kev faib cov qog nqaij hlav cancer thiab metastasis rau lwm yam hauv nruab nrog cev.
Hauv peb xyoos tom qab qhov kawg ntawm kev kho mob, txhua tus neeg mob, yam tsis muaj kev zam, yuav tsum tau kuaj xyuas tiav ob zaug hauv ib xyoos, uas suav nrog kev kuaj mob gynecological, kuaj ultrasound, x-rays, kuaj zis thiab ntshav. Qhov no yog qhov tsim nyog los tshem tawm qhov rov tshwm sim ntawm tus kab mob lossis nws qhov kev tshawb pom raws sijhawm.
Tiv thaiv kab mob
Hmoov tsis zoo, niaj hnub no tsis muaj txoj hauv kev uas tuaj yeem tshem tawm tag nrho qhov muaj peev xwm ntawm kev tsim cov qog nqaij hlav malignant. Txawm li cas los xij, muaj qee yam uas tuaj yeem txo qhov tshwm sim:
- tswj qhov hnyav thiab tiv thaiv kev rog dhau.
- Txhob tus cwj pwm phem xws lihaus luam yeeb thiab haus cawv.
- Kev kho mob tsis tu ncua thiab tiv thaiv lawv txoj kev loj hlob.
- kho raws sijhawm rau cov teeb meem gynecological.
Kev tiv thaiv ib ntus suav nrog kev tshawb pom ntxov ntawm cov qog nqaij hlav thiab xaiv txoj kev kho kom raug.
