Nyob rau hauv niaj hnub kev xyaum nyob rau hauv lub teb ntawm gynecology, ib xyoos ib zaug nce ntawm cov neeg mob uas kuaj pom muaj zes qe menyuam cystadenocarcinoma. Tus kab mob no qhia tias muaj cov qog nqaij hlav malignant uas tshwm sim ntawm qhov chaw ntawm lub epithelium. Nws raug xa mus rau cov kab mob feem ntau ntawm tag nrho cov kab mob epithelial uas twb muaj lawm. Cystadenocarcinoma yog ib hom qog nqaij hlav zes qe menyuam uas cuam tshuam rau cov neeg mob txhua hnub.
Hauv cov tshuaj niaj hnub no, ob hom mob qog noj ntshav tau txawv ib zaug: serous thiab mucinous. Xav txog lawv cov yam ntxwv.
Serous type
Cystadenocarcinoma ntawm zes qe menyuam hom serous tshwm sim ntawm rau caum feem pua ntawm cov neeg mob qog nqaij hlav malignant. Nyob rau hauv feem ntau, xws li ib tug kab mob yog tsim los ntawm kev hloov ntawm benign epithelial hlwb ntawm ib tug cystic tsim rau hauv ib tug unfavorable daim ntawv.
Nyob rau hauv cov neeg mob serous zes qe menyuam cystadenocarcinoma, kev loj hlob ntawm tus kab mob tshwm simsai, yog li nws sai sai ua metastases nyob rau hauv lwm yam kabmob. Cov tsos mob ntawm cov qog no ua rau nws tus kheej hnov thaum nws lub cev pib loj hlob mus rau qhov loj. Cov poj niam uas xav tias muaj kev hloov hauv lawv lub cev, tab sis tsis mus rau gynecologist rau lub sijhawm ntev, feem ntau coj qhov teeb meem mus rau theem kawg. Nrog rau tus kab mob no, cov tsos mob tshwm sim tsuas yog nyob rau theem tom qab thiab tshwm sim nws tus kheej hauv daim ntawv ntawm qhov mob tsis tu ncua hauv plab. Qhov mob no yog mob ntev thiab tsis thab tus poj niam ntau. Sij hawm dhau mus, qhov kev xav ntawm kev qaug zog tuaj yeem ntxiv rau lawv, muaj kev qaug zog ntawm lub cev.
Mucinous hom thiab nws cov tsos mob
Xav txog hom kab mob thib ob. Mucinous cystadenocarcinoma ntawm zes qe menyuam nyob rau hauv feem ntau yog yus muaj los ntawm ib tug asymptomatic chav kawm, yog li ntawd, nws yog pom nyob rau hauv ib tug lig theem, thaum mob tshwm sim nyob rau hauv lub plab mog thiab ascites tshwm. Feem ntau, cov poj niam yws yws txog kev ua haujlwm tsis zoo ntawm lub plab zom mov, uas yog nrog cem quav lossis plab zom mov, nrog rau kev xav tsis zoo nyob rau hauv qhov chaw ntawm lub cev. Nyob rau hauv ultrasound, lub mucinous neoplasm zoo li ib tug qog tsis sib xws. Tawm tsam keeb kwm ntawm palpation nyob rau hauv cov ntaub ntawv no, tus neeg mob hnov mob nyob rau hauv qhov chaw uas lub mucinous lub cev tau tsim. Raws li ib feem ntawm kev kuaj mob ntawm lub qhov quav, cov kws kho mob tuaj yeem hnov cov qog nqaij hlav.
Hom mob qog noj ntshav no txawv ntawm qhov chaw me me ntawm cov qog nqaij hlav tuaj yeem tshwm sim hauv cov tuab ntawm cov kab mob cystic lossis cov qog papillary.kev loj hlob ntawm cystic nto. Lub cev mucinous, raws li txoj cai, muaj cov ntsiab lus ntawm polymorphic ntawm hom atypical, nquag tsim cov papillary, glandular thiab lattice qauv. Nyob rau theem kawg ntawm hom mob qog noj ntshav, metastases cuam tshuam rau peritoneum, nrog rau cov ntshav thiab lymphatic hlab ntsha.
Papillary ovarian cystadenocarcinoma
Nws raug cais raws li theem nrab. Qhov no qhia tias nws yog tsim nyob rau ntawm qhov chaw ntawm ib tug benign tsim. Metastases tshwm sim tawm tsam keeb kwm ntawm kev sib kis ntawm cov qog nqaij hlav cancer nrog rau cov hlab ntsha.
Endometrioid cystadenocarcinoma: kev loj hlob nta
Endometrioid cystadenocarcinomas ntawm zes qe menyuam yog tsawg dua cystic tshaj cov serous thiab mucinous sawv daws yuav. Lawv qhov loj me txawv ntawm ob mus rau peb caug-tsib centimeters. Cov pob txha muaj qhov txawv txav nrog cov hemorrhages. Qhov nruab nrab hnub nyoog ntawm cov neeg mob yog tsib caug xyoo. Ascites thiab ntau yam implantation metastases tuaj yeem pom hauv thaj tsam plab, txawm li cas los xij, feem ntau, lawv tsis tshua muaj mob qog noj ntshav endometrioid dua li mob qog noj ntshav.
Cov tsos mob tshwj xeeb
Ovarian cystadenocarcinoma nyob rau theem lig yog nrog los ntawm cov tsos mob hauv qab no:
- Kev muaj lub cev tsis tu ncua, uas cov uterine los ntshav ua ntau lossis tsawg.
- tsis ua haujlwm ntawm txoj hnyuv thiab zais zis.
- Nyob hauv plab ntim yam tsis muaj laj thawj.
- Lub sijhawm kub nce siab, tshwj xeeb tshaj yog yav tsaus ntuj.
- Poob poob vim cuam tshuam ntawm lub plab zom mov.
- Kev tsis zoo ntawm kev noj qab haus huv, uas tuaj yeem tshwm sim hauv daim ntawv ntawm kev qaug zog sai, qaug zog tas li, tsis txaus ntseeg, tsaug zog.
- Bleeding in menopause.
Txoj kev kuaj mob
Kev kuaj mob ua ntej ntawm zes qe menyuam cystadenocarcinoma yog los kuaj xyuas gynecological tag nrho nrog rau daim duab. Yog tias nws pom tias yav tas los tsim tau muaj qhov loj me lossis cuam tshuam rau lwm yam kabmob, ces tus neeg mob raug xa mus rau kev ntsuas thiab kuaj. Ib qho ntawm cov kev kuaj mob tseem ceeb yog transvaginal, transrectal lossis classical ultrasound. Nyob rau tib lub sijhawm, cov kws kho mob tshwj xeeb tuaj yeem tshawb pom hom neoplasm thiab nruj npaum li cas nws txuas nrog lub cev. Nyob rau hauv txoj kev tshawb no, nyob rau hauv feem ntau lub sij hawm, nws yog ib qhov ua tau kom pom kev sib kis ntawm pathogenic hlwb nyob rau hauv qhov chaw ntawm lub tsev menyuam thiab lub qhov quav.
Qee lub sij hawm ultrasound tsis tuaj yeem ua qhov kev kuaj mob kom raug. Tom qab ntawd cov txheej txheem hu ua paracentesis tau ua. Tus kws kho mob, nyob rau hauv cov tshuaj loog hauv zos, pierces qhov chaw mos thiab siv biomaterial los ntawm lub plab kab noj hniav. Cov nram qab no manipulations yog siv raws li kev kuaj mob ntxiv: puncture biopsy, MRI ntawm lub peritoneum, CT scan ntawm lub peritoneum kab mob, raws li zoo raws li lymphography.
Ib biopsy ntawm serous papillary cystadenocarcinoma ntawm zes qe menyuam muaj nyob rau hauv kev noj cov khoom, uas yog cov hlwb ntawm cov qog nqaij hlav. Tom qab ntawd cov khoom raug kuaj xyuas hauv lub tshuab ntsuas.
Tus txheej txheem ntawm lymphography ua rau nws muaj peev xwm tshawb nrhiav tib neeg lymphatic system. Qhov no yog qhov tseem ceeb heev, txij li cov qog nqaij hlav cancer kis tau zoo heev nrog cov qog ntshav. Ib feem tseem ceeb ntawm lawv yog khaws cia hauv cov qog ntshav, uas tuaj yeem kuaj pom siv txoj kev no.
Txoj kev raug tshaj plaws los txiav txim qhov loj ntawm cov qog hauv zes qe menyuam, nrog rau lawv qhov sib xws thiab qhov chaw meej, yog CT thiab MRI. Hauv kev kuaj mob qog noj ntshav, kuaj ntshav kuaj ntshav kuj tau siv dav, uas ua rau nws muaj peev xwm txheeb xyuas cov cim oncological thiab txiav txim siab lawv hom.
Txhawm rau txiav txim siab muaj cov qog nqaij hlav qog noj ntshav hauv zes qe menyuam thaum ntxov, Doppler xim daim phiaj siv dav siv. Thaum kuaj mob, CCD tso cai rau koj pom thiab ntsuas lub xeev ntawm cov ntshav ntws hauv cov hlab ntsha ntawm qhov tsim. Nyob rau hauv txoj kev no, nws muaj peev xwm txiav txim siab qhov tseeb ntawm hom pathology (benign lossis malignant) los ntawm kev suav vascularization.
Kev kho mob
Rau kev kho mob cystadenocarcinoma zoo, kev kho mob nyuaj ib txwm ua, uas suav nrog kev tshem tawm cov ntaub so ntswg cuam tshuam thiab kev tswj hwm tib lub sijhawm ntawm cov tshuaj (chemotherapy). Feem ntau, nrog rau theem siab ntawm oncology, nws yog ib qho tsim nyog los tshem tawm cov kab mob ntawm cov kab mob ntawm cov kab mob, nrog rau lub tsev me nyuam nrog appendages. Yog tias cov qog tau kis mus rau ib lub zes qe menyuam xwb, ces nws tshem tawm thiab kho tshuaj yuav txaus.
Metastases rau lwm lub cev yuav xav taukev phais mob plab loj. Txhawm rau tiv thaiv qhov no, nws raug nquahu kom mus ntsib kws kho mob tsis tu ncua, nrog rau kho tag nrho cov kab mob gynecological hauv lub sijhawm, tshem tawm cov qog tsis txaus ntseeg nrog zes qe menyuam.
Stages
Raws li cov ntaub ntawv kho mob qhia, hmoov tsis zoo, cov poj niam uas, thaum thawj qhov tsis xis nyob tshwm sim hauv zes qe menyuam lossis lwm yam kabmob hauv plab, nrog kws kho mob, twb muaj III-IV theem ntawm qog noj ntshav. Tus naj npawb ntawm cov neeg mob no yog 74.7%. Qhov no qhia tau tias qhov pib ntawm kev loj hlob ntawm tus kab mob kis mus yam tsis muaj tsos mob dab tsi.
Xav seb yuav mob qog noj ntshav zes qe menyuam li cas. Tag nrho muaj plaub theem. Thawj peb muaj tsab ntawv gradation (A, B thiab C), uas qhia tias kev loj hlob sai npaum li cas.
theem:
Nyob ib.
- I A - Ib lub zes qe menyuam raug cuam tshuam, tab sis tsis muaj ascites (kua dej txuam nrog).
- I B - twb cuam tshuam ob lub zes qe menyuam, tab sis tsis muaj ascites.
- I C - qog ntawm zes qe menyuam thiab ascites.
Second.
- II A - cuam tshuam uterus thiab hlab ntsha.
- II B - pelvic tissue cuam tshuam.
- II C - qog ntawm zes qe menyuam thiab ascites.
Nyob rau hauv serous cystadenocarcinoma ntawm zes qe menyuam, theem 3 muab faib ua:
- III A qhia pom tias muaj cov kab mob tsis zoo nyob sab nraud ntawm lub plab sab hauv lub peritoneum.
- III B txhais tau hais tias cov kab mob pathogenic tshwm sim sab nraum lub plab mog thiab muaj txog li ob centimeters ntawm txoj kab uas hla.
- III C metastases muaj nyob hauvperitoneum nrog lub cheeb ntawm ntau tshaj ob centimeters los yog nyob rau hauv lub regional nodes.
IV - ntau lub zos thiab nyob deb metastases.
Huab cua
Lub neej expectancy nyob rau hauv zes qe menyuam cystadenocarcinoma, raws li nyob rau hauv ib tug xov tooj ntawm lwm yam oncological formations, ncaj qha nyob ntawm theem ntawm tus kab mob thaum lub sij hawm ntawm nws nrhiav pom. Yog tias cov qog tau pom thiab tshem tawm sai sai ntawm thawj theem, tom qab ntawd txog li 90% ntawm cov neeg mob muaj lub sijhawm zoo rov qab los (lub neej expectancy yog ntau tshaj 5 xyoos). Tsis tas li ntawd xwb, cov neeg mob uas muaj hnub nyoog tseem me me tuaj yeem xeeb tub thiab nqa tau tus menyuam noj qab nyob zoo.
Yog kev kho mob pib thaum tus kab mob nyob rau theem thib ob ntawm txoj kev loj hlob, feem pua ntawm kev muaj sia nyob tshaj 5 xyoos yog los ntawm 70 txog 73%.
Thaum kuaj pom mob qog nqaij hlav zes qe menyuam nyob rau theem thib peb, qhov ciaj sia taus yog los ntawm 40 txog 59%. Qhov kev pom zoo tshaj plaws rau hom mob qog noj ntshav nrog lub cim A.
Txawm li cas los xij, cov neeg mob qog noj ntshav hauv qib plaub muaj txoj hauv kev. Raws li kev txheeb cais, ntawm lawv tau tswj kom nyob 5 xyoo thiab ntau dua 17%. Raws li cov kws kho mob, cov xwm txheej ntawm tus neeg mob, lub zog ntawm nws txoj kev tiv thaiv, thiab tus cwj pwm zoo cuam tshuam rau qhov tshwm sim.
Kev Tiv Thaiv
Qhov ua rau ntawm txhua yam mob qog noj ntshav, suav nrog zes qe menyuam cystadenocarcinoma, tsis tau tsim muaj tseeb. Yog li ntawd, tsis muaj cov lus pom zoo rau kev tiv thaiv. Raws li kev ntsuas uas pab txheeb xyuas cov qog ntawm thawj theem, cov kws tshaj lij pom zoo kom mus ntsib kws kho hniav tsis tu ncua (tsawg kawg ob zaug hauv ib xyoos).
Vim tias muaj ntau tus mob qog noj ntshav yog los ntawm noob neej, cov poj niam uas muaj tsev neeg keeb kwm ntawm tus kab mob yuav tsum tsis yog kuaj xwb tab sis kuj kuaj cov cim qog nqaij hlav tsawg kawg ib xyoos ib zaug.
