Cervical Cancer yog ib yam kab mob loj heev, thiab cov txheeb cais ntawm cov neeg mob tau poob siab thiab nce zuj zus txhua xyoo. Tseem txaus ntshai thiab tshwm sim yog cov xwm txheej ntawm kev tshawb pom tus kab mob nyob rau theem lig - raws li ntau qhov chaw, cov txiaj ntsig ntawm qhov ntsuas sib txawv mus txog 50%, tab sis txawm nyob rau theem no tus kab mob tuaj yeem swb. Thiab qhov kev paub yooj yim tshaj plaws ntawm cov tsos mob sib txawv yuav pab kom muaj peev xwm ua tau zoo thiab tiv thaiv kev loj hlob ntawm tus kab mob.
Nws tuaj yeem xaus lus tias kev tuag ntawm cov poj niam muaj mob qog noj ntshav siab heev. Kev faib tawm ntawm WHO tau nthuav tawm hauv kab lus no.
Cervical cancer is a malignant tumor. Raws li cov txiaj ntsig ntawm histology, squamous cell carcinoma thiab adenocarcinoma yog qhov txawv (lub hauv paus ntawm neoplasm yog los ntawm glandular epithelium).
Cervical lesions lead in zaus ntawm tshwm sim ntawm tag nrho cov neoplasms ntawm poj niam lub cev.
Muaj qhov txuas ncaj qha ntawm kev muajpapillomavirus nyob rau hauv lub cev thiab muaj kev pheej hmoo ntawm oncopathology ntawm lub ncauj tsev menyuam. Tsis tas li ntawd, kev pheej hmoo ntawm kev mob qog noj ntshav ncaj qha nce ntau qhov kev hloov pauv ntawm cov neeg koom nrog kev sib deev thiab lub hnub nyoog nruab nrab ntawm cov poj niam (qhov siab tshaj plaws yog nyob nruab nrab ntawm 35 thiab 55 xyoo). Tam sim no, cov xwm txheej ntawm kev kuaj pom tus kab mob thaum muaj hnub nyoog yau tau dhau los ua ntau zaus.
Kev faib tawm: cov qauv
Txoj kev faib thoob ntiaj teb ntawm cov qog nqaij hlav malignant yog siv los cais cov qog noj ntshav hauv tsev menyuam. Nws yog hu ua TNM kev faib tawm. Kev faib tawm TNM ntawm kev mob qog noj ntshav hauv tsev menyuam tau txais kev pom zoo nyob rau hauv lub npe thoob ntiaj teb. Thiab FIGO yog lub koom haum thoob ntiaj teb ntawm obstetrics thiab gynecology. Tig mus rau kev faib cov qog nqaij hlav hauv tsev menyuam raws li TMN system, nws tsim nyog txiav txim siab tias T qhia txog qhov loj ntawm thawj neoplasm. N qhia txog qhov muaj cov qog ntshav qab zib, thiab M qhia tias muaj cov kab mob metastases.
TNM and FIGO
Kev faib tawm ntawm ncauj tsev menyuam los ntawm theem thiab FIGO yog raws li hauv qab no:
| Tx | Tsis muaj ntaub ntawv txaus los qhia meej qhov ntawm tus qog. |
| T0 | Pib qog hlav tsis tuaj yeem kuaj pom. |
| Tis | Intraepithelial carcinoma. FIGO theem 0 mob cancer. |
| T1 | qog nqaij hlav hauv lub ncauj tsev menyuam; 1 theem raws li FIGO. |
| T1a | Npaj hlav qog. FIGO theem 1a. |
| T1a1 | Sprout mus txog 3.0mm hauv ntaub thiab mus txog 7.0mm sab nraum. FIGO theem 1a1. |
| T1a2 | Invasion mus txog 5.0 mm, thiab mus txog 7.0 mm sab nraum. FIGO cervical cancer theem 1a2. |
| T1b | Clinically paub tseeb qhov mob tsuas yog rau lub ncauj tsev menyuam; microscopically, qhov mob loj dua ntawm qhov chaw tshaj T1A / 1A2 yog ua tau. FIGO Theem 1b. |
| T1b1 | qhov txhab ncav cuag 4 cm. FIGO theem 1b1. |
| T1b2 | Lesion ntau dua 4 cm. FIGO theem 1b1. |
| T2 | Cov qog kis dhau ntawm lub tsev menyuam, tsis muaj kev cuam tshuam ntawm phab ntsa ntawm lub plab thiab sab thib peb ntawm qhov chaw mos. FIGO theem 2 |
| T2a | Tsis muaj qhov thib ob foci ntawm kev faib tawm. FIGO theem 2a. |
| T2b | Nrog rau qhov thib ob foci ntawm cov txheej txheem qog. FIGO Theem 2b. |
| T3 | mob qog noj ntshav nrog cov qog nqaij hlav ntawm phab ntsa pelvic; qhov qis thib peb ntawm qhov chaw mos raug cuam tshuam, lub raum ua haujlwm tsis zoo. FIGO theem 3. |
| T3a |
Qhov thib peb ntawm qhov chaw mos raug cuam tshuam yam tsis kis mus rau phab ntsa hauv plab thiab ua rau lub raum puas. FIGO Theem 3a. |
| T3b | Cov qog nkag mus rau phab ntsa ntawm lub plab mog thiab ua rau hydronephrosis ntawm lub raum. FIGO Theem 3b. |
| T4 | tso zis thiab / lossis qhov quav cuam tshuam; cov qog tuaj yeem ncav cuag lub plab me me. FIGO theem 4a. |
| M1 | Ntau thiab nyob deb metastases. FIGO Theem 4b. |
ICD classification
Cov kab lus hauv qab no nthuav tawm kev faib tawm ntawm ncauj tsev menyuam raws li ICD (International Classification of Diseases):
| C53 | Kev faib tawm dav dav rau malignant neoplasms ntawm lub ncauj tsev menyuam |
| C53.0 | Nyob hauv cheeb tsam ntawm lub ncauj tsev menyuam |
| C53.1 | Sab nraud cuam tshuam |
| C53.8 | Qhov txhab txuas ntxiv dhau lub ncauj tsev menyuam |
| C53.9 | Neoplasm ntawm thaj chaw tsis tau teev tseg |
Etiology
Predisposing factors for cervical cancer is:
HPV
Tus provocateur ntawm kev txhim kho qog noj ntshav yog tib neeg papillomavirus hom 16 thiab 18. Hauv yuav luag 80% ntawm cov neeg mob qog noj ntshav, cov hom kab mob no muaj nyob hauv lub cev ntawm poj niam. Hom kev kis tus kab mob no feem ntau yog kev sib deev. Feem ntau, txoj kev tiv thaiv kab mob tsis tuaj yeem lav 100% tiv thaivTus kab mob HPV.
HPV kis los ntawm kev sib deev tshwm sim hauv 75% ntawm cov neeg mob, tab sis lub cev tiv thaiv kab mob yog 90% muaj peev xwm tiv taus nws thiab ua kom puas sai sai. Thiab yog hais tias tus kab mob no tswj kom kov yeej lub cev tiv thaiv kab mob thiab nkag mus rau hauv lub cev, ib tug tsis tu ncua kab mob ntawm tus kab mob no tshwm sim, raws li los ntawm kev hloov nyob rau hauv lub epithelium ntawm lub ncauj tsev menyuam.
Raws li cov txiaj ntsig ntawm kev soj ntsuam, nws tuaj yeem xaus lus tias muaj ntau tshaj 10 tus neeg koom nrog kev sib deev hauv tus poj niam lub neej ua rau muaj kev pheej hmoo ntawm kev mob qog noj ntshav hauv tsev menyuam 3 zaug. Nws tseem tsim nyog sau cia tias cov poj niam uas muaj tus kab mob HPV tau lees paub tias lawv cov kev sib deev tsis tu ncua muaj ntau dua 20 kev sib deev hauv lawv lub neej, uas yog 5 npaug ntau dua li ib txwm txiv neej txoj cai lij choj.
daim duab kho mob
Kev phom sij ntawm tus kab mob nyob ntawm qhov tseeb tias thaum ntxov thiab theem tom ntej, cov tsos mob tsis tuaj, lossis lawv muaj, tab sis tus neeg tsis muab qhov tseem ceeb rau lawv. Tau ua rau qhov tsis xis nyob, tus neeg mob txiav txim siab lawv ib yam dab tsi zoo tib yam thiab tshwm sim ib ntus. Xav tias ib yam dab tsi tsis raug thiab txhawj xeeb, lawv feem ntau mus ntsib kws kho mob nrog cov tsos mob hauv qab no:
- Tus neeg mob yws yws ntawm qhov tsis xis nyob thiab mob hauv thaj chaw pelvic.
- Cov lus ceeb toom tsis cuam tshuam rau poj niam.
- Lub sijhawm thiab qhov xwm txheej ntawm kev coj khaub ncaws hloov pauv.
- Kab ntshav tom qab kuaj qhov chaw mos los ntawm gynecologist.
- Muaj mob thiab los ntshav thaum sib deev.
- Nyob qhov chaw mos los ntshav.
- Qhov tshwm sim los ntshav thaum lub sijhawmvagina tom qab menopause.
Cov tsos mob saum toj no yog qhov xwm txheej, qee qhov ntawm lawv tuaj yeem tsis tuaj, qee qhov tau hais ntau dua li lwm tus. Feem ntau, cov tsos mob zoo li no yog nrog los ntawm cov kab mob hauv qab no:
- Tus neeg mob sau ntawv sai sai thiab qaug zog.
- Kev ceeb toom poob ceeb thawj.
- Nyob ntev subfebrile mob.
- Kev kuaj ntshav qhia tias txo hemoglobin, ntshav ntshav thiab nce ESR.
Tus kab mob txaus ntshai ntau dua thiab nyuaj rau qhov kev kawm thiab qhov tshwm sim ntawm tus kab mob, cov tsos mob tsawg dua nyob rau hauv tus neeg mob keeb kwm - nws nrhiav kev pab los ntawm cov kws kho mob tshwj xeeb thaum cov qog tau pib hauv lub cev thiab pib ua kom puas tsuaj. nyhuv. Kev kuaj mob lig thiab kev kho mob ntev ua rau qhov kev cia siab ntawm kev rov zoo.
Nws tshwm sim: pathogenesis
Hauv peb lub cev muaj cov txheej txheem zoo kawg nkaus ntawm kev rov ua dua tshiab ntawm tes hu ua apoptosis. Hauv tib neeg lub cev, qhov nruab nrab, kwv yees li 60-70 billion hlwb tuag txhua hnub, lawv tau hloov kho tshiab. Yog hais tias cov hlwb tuag tsis raug tshem tawm ntawm lub cev, tsis absorbed los ntawm cov neeg nyob sib ze tshiab thiab khaws cia, qhov no ua rau intoxication ntawm lub cev, mus rau kev loj hlob ntawm ib tug inflammatory tshuaj. Raws li qhov tshwm sim ntawm kev puas tsuaj rau apoptosis, ib puag ncig zoo rau kev tshwm sim ntawm cov qog nqaij hlav malignant. P53 Rb noob muaj nyob rau hauv lub cev, uas yog lub luag hauj lwm rau kev sib ntaus tawm tsam kev tsim ntawm lub ncauj tsev menyuam. Thaum tib neeg papillomavirus tshwm nyob rau hauv lub cev, cov noob nothaiv los ntawm cov kab mob kis kab mob. Tom qab ntawd cov qog nqaij hlav qog nqaij hlav pib ua kom nquag plias thiab tswj tsis tau faib. Tib neeg papillomavirus rhuav tshem lub cev tiv thaiv kab mob, yog li ua rau muaj kev pheej hmoo thiab mob qog noj ntshav.
Kev faib tawm ntawm ncauj tsev menyuam: histology
Kev tshuaj xyuas gynecological tsis tu ncua yuav tsum yog qhov yuav tsum tau ua: tus kws tshaj lij muaj peev xwm sau tau txhua yam kev sib txawv ntawm cov qauv, txawm tias muaj cov tsos mob tshem tawm thiab cov kab mob latent. Ces nws yuav xa tus neeg mob mus tshawb fawb ntxiv.
Cov txheej txheem kuaj mob tshaj plaws yog colposcopy thiab kuaj cytological ntawm cov khoom. Tus kws kho mob tshwj xeeb cais cov theem ntawm mob qog noj ntshav raws li cov txiaj ntsig ntawm histology. Kev kho mob ntxiv nyob ntawm qhov no.
Kev kho mob
Txoj hauv kev rau kev kho mob qog noj ntshav yuav tsum yog tus kheej thiab nyuaj. Cov txheej txheem txheej txheem yog ua kev phais, thiab tom qab ntawd xaiv cov tshuaj khomob lossis kev kho hluav taws xob, raws li txoj cai, lawv cov kev sib xyaw ua ke txhawm rau txhim kho cov txiaj ntsig ntawm kev kho mob nrog kev saib xyuas kev tiv thaiv kab mob.
Kev Tiv Thaiv
Puas muaj peev xwm tiv thaiv koj tus kheej ntawm kev txhim kho tus kab mob no?
Kev txhaj tshuaj tiv thaiv kab mob papillomavirus pom tias muaj txiaj ntsig zoo. Lub hnub nyoog zoo thiab tsim nyog rau nws qhov kev siv yog hnub nyoog ntawm 13-15 xyoo. Tam sim no, qee lub tebchaws kuj tau qhia txog kev txhaj tshuaj tiv thaiv rau cov tub hluas thaum hnub nyoog laus.lub sij hawm.
Nrog qhov kev mob khees xaws ncauj tsev menyuam zuj zus, kev tiv thaiv tib neeg papillomavirus kis yog qhov tseem ceeb.
Nws tseem ceeb heev uas yuav tsum saib xyuas kev nyiam huv ntawm kev sib deev - lub sijhawm luv luv ua rau muaj kev phom sij txaus ntshai, kev kis kab mob yog fraught nrog cov teeb meem loj mus ntev. Zoo li banal cov lus pom zoo rau kev tswj lub neej noj qab haus huv thiab txiav luam yeeb yog qhov tseem ceeb heev. Lawv yuav tsum tau coj mus rau hauv tus account. Nws yuav tsum yog ib feem tseem ceeb ntawm lub neej - tsis yog tsuas yog tiv thaiv koj tus kheej los ntawm tus kab mob HPV, tab sis kom muaj kev noj qab haus huv zoo dua, ua kom lub neej ntev thiab nws qhov zoo.
Kev kuaj gynecological tsis tu ncua thiab ultrasounds, Pap smears ib xyoos ib zaug, thiab mloog koj lub cev thiab ua tib zoo saib xyuas cov kab mob uas tsis yog tshwj xeeb thiab cov tsos mob txawv txawv yog qhov tseem ceeb.
