Ib yam kab mob insidious tshaj plaws hauv cov poj niam yog uterine sarcoma. Kev kwv yees ntawm lub neej hauv tus kab mob no txawv nyob ntawm theem ntawm cov txheej txheem pathological. Txawm li cas los xij, feem ntau nws poob siab. Qhov kev muaj sia nyob tsib xyoos nyob rau theem pib yog 47% ntawm txhua kis. Thaum kuaj pom tus kab mob oncological nyob rau theem plaub - tsuas yog 10%. Tsis tas yuav tham txog qhov muaj txiaj ntsig zoo txawm tias muaj kev kuaj mob raws sijhawm thiab kev kho mob muaj peev xwm.
Kev piav qhia tus kab mob
Uterine sarcoma yog ib qho tsis tshua muaj tab sis insidious pathology. Lub neoplasm yog tsim los ntawm cov ntsiab lus tsis txawv ntawm endometrium lossis myometrium. Mob qog noj ntshav tshwm sim hauv cov poj niam ntawm txhua lub hnub nyoog, suav nrog cov ntxhais hluas. Nws yog manifested los ntawm cyclic los ntshav, mob nyob rau hauv lub plab mog, general malaise. Sarcoma yog qhov nyuaj rau kev kuaj mob thaum pib ntawm txoj kev loj hlob. Cov lus teb rau lo lus nug ntawm kev rov ua tiav yog nyob ntawm theem ntawm cov txheej txheem pathological, hnub nyoog ntawm tus neeg mob thiab nws lub xeev kev noj qab haus huv. Tag nrho cov hom kab mob no yog yus muaj los ntawm ib tug high degree ntawm malignancy. Yog li ntawd, lawv nyuaj kho.
Cov qauv ntawm uterine sarcoma
Nyob ntawm qhov chaw ntawm cov kab mob malignant, cov kab mob hauv qab no yog qhov txawv:
- Leimiosarcoma yog cov qog loj tshaj plaws uas tuaj yeem ncav cuag txoj kab uas hla ntawm 5 cm. Nws tsim tshwj xeeb hauv cov nqaij mos ntawm myometrium.
- Endometrial stromal sarcoma tsim nyob rau hauv cov qauv kev txhawb nqa ntawm lub tsev menyuam, yog qhov tsis tshua muaj (tsuas yog 1% ntawm tag nrho cov kab mob malignant). Muaj ob pawg ntawm cov qog: qhov tsis zoo thiab tsis txawv. Hauv thawj kis, neoplasm xyaum ua haujlwm zoo rau lub neej, maj mam nce ntxiv. Cov qog tsis txawv txav yog nrog los ntawm kev noj qab haus huv tsis zoo, uas cuam tshuam rau tus neeg mob tus mob.
- Carcinosarcoma cov ntaub ntawv hauv endometrium.
Ntau tus neeg tsis meej pem ob kab mob: uterine sarcoma thiab mob qog noj ntshav. Qhov tseeb, cov no yog cov pathologies sib txawv kiag li. Cov qog nqaij hlav cancer yog tsim los ntawm cov ntsiab lus ntawm epithelium, thiab sarcomas cuam tshuam rau cov ntaub so ntswg xwb.
Ua rau mob qog noj ntshav
Uterine sarcoma yog hais txog pathologies ntawm complex etiology. Cov kws tshawb fawb tau muab tso rau ntau qhov kev piav qhia txog nws keeb kwm. Feem ntau ntawm lawv paub tseeb tias tus kab mob no tshwm sim nyob rau hauv kev cuam tshuam ntawm tag nrho cov pab pawg ntawm yam. Qhov no tej zaum yuav yog ib qho tsis ua haujlwm hauv cov tshuaj hormonal lossis ntau qhov kev raug mob ntawm lub tsev menyuam, kev ua haujlwm hauv plab tsis ua tiav, rho menyuam tawm, lossis lwm yam kev cuam tshuam.
Tus kab mob kuj tshwm sim tawm tsam keeb kwm ntawm cov teeb meem hauv kev loj hlob ntawm embryonic. Tsis muaj tsawg txaus ntshai yog qhov pathological proliferation ntawm cov ntaub so ntswgendometrium. Kev txhim kho ntawm pathology qee zaum ua rau kev kho tsis zoo ntawm qhov chaw, tshem tawm cov polyp lossis fusion ntawm ntau qhov tsim. Cov kab mob neuroendocrine yog lwm qhov ua rau sarcoma. Lub luag haujlwm tseem ceeb hauv cov xwm txheej predisposing yog muab rau cov cwj pwm phem, kev siv yeeb tshuaj. Cov kws kho mob yuav tsum tau ceeb toom rau qhov kev txiav tawm sai sai ntawm ovulation.
Leej twg txaus ntshai?
Gynecologists tab tom sim ua kom pom cov poj niam los tiv thaiv sarcoma, vim nws tsis tshua muaj heev los kho cov kab mob no. Ua ntej tshaj plaws, nws tau qhia rau cov neeg uas tau suav nrog hauv qhov hu ua pawg pheej hmoo. Cov no yog poj niam:
- polycystic zes qe menyuam (tus kab mob provokes hormonal tsis txaus);
- mob cancer mis;
- tsis tau yug;
- lig menopausal survivors (menopause tom qab 50 xyoo).
Hereditary predisposition plays lub luag haujlwm loj hauv qhov teeb meem no. Nws raug pom zoo los saib xyuas lub xeev kev noj qab haus huv nrog kev saib xyuas tshwj xeeb rau cov poj niam tom qab 40 xyoo, uas nws cov txheeb ze tau kuaj pom muaj kab mob qog, suav nrog uterine sarcoma.
Symptoms and signs of disease
Ntau zaus, sarcoma yog hu ua ib tug ntsiag to pathology, txij li thaum tsis muaj cov cim qhia pom tseeb ntawm nws thaum pib ntawm txoj kev loj hlob. Cov poj niam tsis maj mus nrhiav kev pab los ntawm kws kho mob, pom qhov mob hnyav dua li kev ntxhov siab lossis mob hnyav dua. Txawm tias nyob rau theem siab, sarcoma yuav tsis tshwm sim. Cov tsos mob tshwm sim, txuas ntxiv qhov loj me lossis zais nws tus kheej li fibromyoma.
Raws li tus kab mob no zuj zus thiab nyob ntawm qhov chaw tshwj xeeb ntawm cov txheej txheem pathological, muaj kev ua txhaum ntawm kev coj khaub ncaws. Cov poj niam yws yws ntawm qhov mob hauv plab hauv plab, copious tawm nrog cov ntxhiab tsw. Qab los kuj ploj mus, daim tawv nqaij kis ib tug yellowish tint. Cov kev hloov pauv tau pom meej hauv kev kuaj ntshav.
Kev tshwm sim lig ntawm sarcoma ua rau muaj ntshav tsis txaus, tsis muaj zog thiab ascites. Raws li qhov tshwm sim ntawm metastasis, pleurisy tsim nyob rau hauv lub ntsws, thiab jaundice tsim nyob rau hauv daim siab. Kev nkag mus ntawm cov hlwb malignant rau hauv tus txha nraub qaum yog nrog los ntawm qhov pom ntawm qhov mob hauv nws ntau ntu.
Ntau zaus, thaum kuaj gynecological rau kev tiv thaiv, kws kho mob kuaj xyuas "sarcoma ntawm lub tsev menyuam." Cov cim qhia tias qhov pib ntawm cov txheej txheem pathological yuav tsis tuaj. Xws li kev sib xyaw ua ke ntawm cov xwm txheej suav hais tias ua tiav, txij li kev kho mob raws sij hawm ua rau muaj kev pheej hmoo ntawm qhov tshwm sim zoo. Gynecologists tsis tu ncua nco ntsoov txog qhov tseem ceeb ntawm kev kuaj mob raws sij hawm ntawm cov poj niam tom qab 40 xyoo, tshwj xeeb tshaj yog ua ntej pib ntawm cev xeeb tub.
theem ntawm kev loj hlob ntawm sarcoma
Tus kab mob no tshwm sim los ntawm kev loj hlob qeeb.
- Thaum pib, sarcoma yog ib qho qog me me. Tej zaum nws yuav txwv rau cov mucous lossis cov leeg nqaij.
- Nyob rau theem ob, cov qog loj tuaj, tab sis tsis mus dhau lub cev ntawm lub tsev menyuam. Tseem muaj ib feemorgan infiltration.
- Nyob rau theem peb, cov neoplasm loj hlob mus rau hauv lub tsev menyuam, tab sis tseem nyob hauv lub plab me me. Qee zaum muaj metastasis rau zes qe menyuam, cov qog ntshav hauv cheeb tsam. Nyob rau theem no, tus kab mob ntawm uterine sarcoma pib tshwm sim cov tsos mob, yog tias lawv tsis tuaj txog rau lub sijhawm ntawd.
- theem plaub yog lub sijhawm ntawm cov qog nqaij hlav thiab tsim cov metastases. Cov kab mob thib ob txuas mus rau txhua qhov ntawm cov kab mob hauv nruab nrog cev, cuam tshuam rau lub ntsws thiab cov pob txha pob txha.
Txoj kev kuaj mob
Kev kuaj pom ntawm sarcoma nyob rau theem pib feem ntau nyuaj vim tsis muaj cov tsos mob pom tseeb. Ntawm kev sab laj thawj zaug, tus kws kho mob gynecologist qhia meej txog anamnesis thiab cov ntaub ntawv ntsig txog ntawm cov kab mob oncological pathologies nyob rau tom ntej ntawm cov txheeb ze. Kev ntsuam xyuas gynecological tso cai rau koj txheeb xyuas qhov kev hloov pauv ntawm cov xim ntawm lub ncauj tsev menyuam, txhawm rau txheeb xyuas cov tsos mob ntawm neoplasm. Tom qab ntawd ib tug xov tooj ntawm kev kuaj thiab kho vajtse raug muab tshuaj (kev kuaj ntshav, CT, MRI, hysteroscopy thiab ultrasound ntawm lub cev nqaij daim tawv).
Kev kuaj mob sib txawv ntawm uterine sarcoma tso cai kom tsis suav cov kab mob nrog cov duab kho mob zoo sib xws. Cov no muaj xws li qog ntawm zes qe menyuam, benign formations ntawm qhov chaw mos kab mob, endometrial polyps. Kev lees paub ntawm qhov kev kuaj mob zaum kawg yog ua tsis tau yam tsis muaj kev kuaj ntshav biopsy. Thaum lub sijhawm ua haujlwm no, cov qog nqaij hlav raug kuaj hauv chav kuaj.
Metastases hauv sarcoma
Lub neoplasm tuaj yeem cuam tshuam cov metastases nrog rau cov ntshav ntws, nrog rau loj hlob mus rau hauv cov kabmob uas nyob ib sab. Nws tshwm sim li caskev sib kis ntawm malignant ntsiab? Sarcoma cuam tshuam nws cov khoom mus rau hauv cov ntshav, los ntawm qhov chaw uas lawv nkag mus rau hauv lub ntsws thiab lub cev pob txha, sab nraud genitalia. Nyob rau hauv cov ntaub ntawv no, feem ntau cov lesion cuam tshuam rau sab laug ntawm lub ntsws. Malignant hlwb feem ntau nkag mus rau hauv cov appendages. Qhov teeb meem no feem ntau pom nyob rau hauv kev kuaj mob ntawm endometrial sarcoma ntawm lub tsev menyuam. Metastases tsiv mus nyob thoob plaws lub cev, uas tuaj yeem ua rau tuag ntxov.
xaiv kev kho mob
Hauv kev kho mob, ntau txoj hauv kev ntawm kev kho mob ntawm uterine sarcoma yog siv. Feem ntau, cov neeg mob tau muab kev xaiv ua ke, uas suav nrog kev phais thiab chemoradiotherapy. Kev ua haujlwm yog nqa tawm tsuas yog nyob rau thawj theem ntawm cov txheej txheem pathological. Nws tso cai rau koj los txiav txim siab txog theem ntawm tus kab mob thiab ua kom tshem tawm cov neoplasm. Tus nqi ntawm kev cuam tshuam nyob ntawm qhov chaw ntawm lub qog thiab nws qhov loj. Qhov zoo tshaj plaws, lub tsev menyuam nrog appendages raug tshem tawm, thiab qhov phem tshaj, tag nrho cov kabmob uas nyob ib sab raug tshem tawm. Nyob rau hauv cov ntaub ntawv siab heev, tsuas yog ib qho kev phais yuav tsis txaus. Raws li qhov teeb meem ntawm kev kho hluav taws xob, hnub no nws yog ib qho kev xaiv zoo tshaj plaws rau kev tawm tsam tus kab mob ntawm lub tsev menyuam sarcoma. Qhov kev kwv yees nyob rau hauv rooj plaub no kuj yuav poob siab. Nws raug sau tseg los tua cov qog nqaij hlav qog noj ntshav.
Tshuaj khomob
Cov kev qhia tshuaj khomob rau lub tsev menyuam sarcoma koom nrog kev siv tshuaj anthracyclines ("Idarubicin", "Doskorubicin", "Epirubicin"). Cov no yog cov tshuaj tiv thaiv kab mob qog noj ntshav. Tam sim noNyob rau tib lub sijhawm, cov kws kho mob tshwj xeeb tau kawm txog cov txiaj ntsig ntawm cov tshuaj Ifosfamide, nws siv ob qho tib si hauv kev kho mob monotherapy thiab ua ke nrog lwm cov tshuaj. Nrog rau kev siv tshuaj khomob, kev ua haujlwm zoo tau pom hauv 30% ntawm cov neeg mob.
Kev siv cov kev kho mob ua ke tau zoo dua, tab sis nws muaj ntau yam kev phiv. Kev ua haujlwm zoo yog pom los ntawm kev kho nrog Docetaxel thiab Gemcitabine. Nws feem ntau yog rov siv dua rau kev rov qab los.
Yuav ua li cas lwm yam tshuaj siv rau kev kuaj mob ntawm "uterine sarcoma"? Kev kho mob nrog cov tshuaj hormonal yog tsim nyog tsuas yog nrog cov qib qis ntawm malignancy ntawm neoplasm.
Huab cua
Qhov kev tshwm sim ntawm uterine sarcoma yog dab tsi? Cov duab ntawm cov neeg mob uas tau tswj kom ciaj sia tus kab mob insidious no txhawb kev cia siab. Txawm li cas los xij, feem ntau, qhov tshwm sim ntawm pathology yog qhov tsis zoo, qhov tshwm sim ntawm kev rov tshwm sim yog siab. Cov txheeb cais hais li cas txog qhov no?
Nrog rau kev kuaj mob raws sij hawm ntawm cov qog thiab phais, qhov tshwm sim ntawm kev rov tshwm sim yog 65%. Yog tias kuaj pom sarcoma nyob rau theem tom qab, qhov muaj feem ntawm kev rov tshwm sim ntawm cov txheej txheem pathological yog 90%. Raws li txoj cai, lub neej expectancy ntawm tus neeg mob tom qab phais yog 2 xyoo. Cov ntaub ntawv pov thawj pom tau tias muaj sia nyob tsib xyoos tom qab kev kho mob sarcoma tsuas yog pom hauv 40% ntawm cov neeg mob xwb.
Nyob ntawm theem ntawm tus kab mob, daim duab no yuav zoo li no:
- thawj theem - 47%;
- theem thib ob - 44%;
- thib peb - 40%;
- theem plaub - 10%.
Txawm li cas los xij, qhov noTsuas yog cov ntaub ntawv los ntawm kev tshawb fawb thaum lub sijhawm cov kws tshawb fawb tau sau cov xwm txheej ntawm qhov txiaj ntsig zoo tom qab kev kho mob uterine sarcoma. Nws yog ib qho nyuaj hais tias ntev npaum li cas cov neeg mob uas muaj tus kab mob no nyob. Thaum teb cov lus nug no, nws yog ib qho tsim nyog yuav tsum paub txog theem ntawm tus kab mob, kev kho mob, thiab cov neeg mob rov qab los. Tsuas yog cov sarcomas uas tsim los ntawm fibromatous nodes yog tus cwj pwm los ntawm kev kawm zoo. Thiab nyob rau hauv rooj plaub no, yuav tsum tau kuaj xyuas thiab kho raws sijhawm.
ntsuas kev tiv thaiv
Yuav ua li cas tiv thaiv tus kab mob txaus ntshai no? Ua ntej tshaj plaws, cov kws tshaj lij pom zoo kom kuaj xyuas gynecological txhua xyoo. Nws tseem yog ib qho tsim nyog yuav tau ua raws li tus kws kho mob cov ntawv sau rau hauv kev kho mob ntawm "poj niam", tshwj xeeb tshaj yog muaj feem xyuam rau cov tshuaj hormonal. Lub luag haujlwm tshwj xeeb hauv kev tiv thaiv yog muab rau qhov teeb meem ntawm cev xeeb tub. Cov kws kho mob tsis pom zoo kom ncua kev npaj tus menyuam. Yog tias vim li cas koj tsis xav sim lub luag haujlwm ntawm leej niam, koj yuav tsum siv cov tshuaj tiv thaiv thiab tsis txhob rho menyuam tawm. Nws yog tsis yooj yim sua tsis hais txog kev noj zaub mov kom raug. Kev noj zaub mov yuav tsum muaj cov zaub tshiab thiab txiv hmab txiv ntoo. Thiab tus nqi ntawm cov tsiaj rog yog zoo dua los txwv. Muab tus cwj pwm tsis zoo, siv sijhawm ntau sab nraum zoov thiab ua si kis las.
Zoo kawg
Kev saib xyuas ntawm cov kws tshawb fawb thiab kws kho mob tseem nyiam los ntawm cov kab mob tsis tshua muaj xws li uterine sarcoma. Kev kwv yees ntawm lub neej nrog tus kab mob no tsis tuaj yeem kwv yees. Txawm hais tias sarcoma tsis tshua muajkab mob, nws muaj nyob rau hauv cov npe ntawm aggressive malignant neoplasms. Txawm tias muaj kev kho mob raws sij hawm thiab muaj peev xwm, ib tus tsis tuaj yeem cia siab rau qhov zoo. Pathology tuaj yeem tshwm sim hauv cov poj niam ntawm txhua lub hnub nyoog. Yog tias koj pom cov tsos mob txawv txawv thiab tsis xis nyob, koj yuav tsum sab laj nrog kws kho mob. Nws tseem zoo dua los mus kuaj kev tiv thaiv txhua xyoo. Noj qab nyob zoo!
