Endometrial cancer yog ib tus kab mob oncological heev ntawm qhov kev ua me nyuam. Pathology muaj keeb kwm latent, yog li nws tsis tshua tau kuaj nyob rau hauv cov theem thaum ntxov. Cia peb xav txog txhua yam kev mob kheesxaws ntawm qhov kev lag luam: cov tsos mob thiab cov tsos mob, ua rau, cov ntaub ntawv, cov lus qhia tseem ceeb ntawm txoj kev kho.
Endometrial cancer - yam yuav kis tau
Hauv cov neeg mob uas muaj kab mob endometrial, lub hnub nyoog ntau dua li 45-50 xyoo. Cov txheej txheem kev hloov ntawm cov kev hloov hauv cov qe ntshav ntawm lub uterine txheej yog cov txheej txheem txuam nrog menopause. Kev tuag ntawm kev tsim kho me nyuam yaus tsis dhau ib qho kab rau lub cev. Ntawm lwm qhov kev pheej hmoo yam tseem ceeb, cov kws kho mob txheeb xyuas xws li:
- mob ntawm kev ua mob hauv endocrine, metabolic kev ua ntawm lub cev - ntshav qab zib mellitus, rog;
- arterial hypertension;
- hormone-dependent ntshawv siab ntawm kev ua me nyuam deev - hyperestrogenism;
- hormone-nquag hlav ovarian hlav - Brenner tus qog nyob rau hauv txhua txhua thib tsib qub txuam nrog cancer;
- Stein-Levental syndrome - nrog rau kev mob kheesxaws endometrial hauv 30% ntawm tus neeg mob;
- kev tshuaj ntsuam genetic predisposition;
- ntxhov siab heredity - lub xub ntiag ntawm cov txheeb ze ze ntawm qog-xws li pathologies;
- qhov pib ntawm kev sib deev, tsis muaj nws;
- tsis muaj cev xeeb tub thiab yug me nyuam nyob rau hauv lub anamnesis;
- lig lawm (tom qab 55 xyoos);
- qhov tso cai ntawm hormone therapy (siv Tamoxifen).
Endometrial cancer - kev faib tawm
Raws li cov cim International International, qhov kawg ntawm kev qog nqaij hlav ntawm lub tsev menyuam tau muab faib ua cov ntaub ntawv hauv qab no:
- adenocarcinoma;
- tshem tawm cov kab mob adenocarcinoma;
- squamous cell carcinoma;
- glandular mob cancer;
- mucinous;
- mob ntshav;
- glandular-squamous;
- undifferentiated cancer.
Clear cell endometrial adenocarcinoma
Clearen adenocarcinoma ntawm lub cev yog tshwm sim ntau zaus dua lwm hom mob pathology. Rau hom kabmob kheesxaws no yog tus cwj pwm los ntawm qhov kuaj pom hauv cov cheeb tsam ntawm cov nqaij mos loj polyhedral epithelial hlwb. Nws yog feem ntau pom tias muaj cov kab mob hlwb uas tshwm sim hloov nrog cov ntsiab lus ntawm lub teeb ci-adenocarcinomas. Qee cov neeg ua haujlwm tshwj xeeb muaj cov kab mob pathologies thiab meson-fusion hlwb rau cov pab pawg no. Cov ntsiab lus nthuav tawm zoo li tus khau khau nrog lub kaus mom.
Endometrial carcinoma ntawm lub caj pas
Kev mob qog nqaij hlav qog ntawm lub paj hlwb ntawm lub ntiaj teb yog ib qho kev ntsuam xyuas uas ua rau cov hlwb glandular tau koom nrog rau hauv tus txheej txheem. Hauv kev xyaum, glandular adenocarcinoma cuam tshuam lub uterine kab noj hniav thiab tsev menyuam yaus kw. Hom kab mob khees xaws no li ntawm 70% ntawm tag nrho cov kev mob oncological, feem ntau pom muaj rau cov poj niam laus, tab sis kuj muaj nyob hauv cov neeg hluas.
Squamous cell carcinoma ntawm endometrium
Cov hlwv ntawm cov hlab ntaws ntawm lub tsev menyuam yog hais txog malignant neoplasms. Tus tsim ntawm lub qog yog los ntawm hlwb ntawm lub tiaj tus epithelium, uas tau txais ib tug txawv degree ntawm atypia. Nrog rau kev mob ntawm pathology nyob rau theem tom qab, lub hlwb hloov mus rau cheeb tsam ntawm lub tsev menyuam nkauj kwj. Nyob rau hauv xws li mob, oncology paub thaum lub sij hawm ib tug gynecological xeem. Vim yog tsis muaj cov duab tshwm sim tiag tiag, nws tsis pom nyob hauv cov theem thaum ntxov. Cov tsos mob tsis tshua muaj xws li:
- pelvic mob;
- kawg ntawm lub zais zis thiab qhov quav;
- spotting thiab leucorrhoea.
Iron-squamous cell carcinoma ntawm endometrium
Iron-squamous cell carcinoma ntawm cov ntaub so ntswg endometrial yog ib daim ntawv txawv ntawm pathology. Ib qho txawv ntawm nws yog qhov muaj cov qog uas muaj lub qauv dimorphic. Cov khoom sib dhos thiab cov kab glandular muaj nyob rau hauv xws li formations. Raws li txoj cai, squamous cell predominates li glandular. Daim ntawv no ntawm endometrial cancer khov kho rau 4% ntawm tag nrho cov mob ntawm pathology. Nws muaj ntau dua rau cov poj niam laus dua 55 xyoos, nyob rau hauv ib zaug hauv cov hluas.
Hauv kev sib piv nrog lwm cov adenocarcinomas, glandular squamous cell carcinoma muaj qhov sib txawv me ntsis. Vim hais tias ntawm cov qauv no, cov qog feem ntau tau txais kev txhoj puab heev. Macroscopically, tsis tas siv cov khoom siv nrog kev loj hlob, daim ntawv no tsis txawv ntawm lwm cov adenocarcinomas. Outwardly tsa li polypoid los yog tsim kom muaj kab mob. Txiav txim siab rau daim ntawv ntawm pathology yog nqa tawm ntawm lub siab me me, kev xav txog qhov txawv ntawm kev sib txawv ntawm cov khoom ib leeg.
Serous endometrial cancer
Mob ntshav khov heev muaj npe rau ib pawg loj ntawm epithelial neoplasms. Pathology yog tsim los ntawm kev hloov kho lossis lub hlwb dej ntawm cov ntaub so ntswg epithelial. Hauv qhov no, feem ntau nws tsis yooj yim los tsim kom tau qhov keeb kwm ntawm xws li. Daim ntawv no yog tus ciav qis, thiab pom thaum tus poj niam kuaj rau lub voj voog, qhov kev ua me nyuam. Cov cwj pwm ntawm endometrial cancer ntawm daim ntawv no yog qhov nyuaj rau kev kuaj mob rau tus poj niam nws tus kheej.
Mucinous Cancer
Hom kab mob oncology no yog cov kab mob loj ntawm cov hlwb uas muaj cov cytoplasmic intrinsic hauv lawv tus kheej. Daim ntawv no ntawm pathology nyiaj rau 10% ntawm tag nrho cov mob ntawm oncology ntawm uterus lub cev. Ib qho txawv ntawm qhov neoplasm yog qhov sib txawv ntawm cov qog cov ntsiab lus, uas yog kev pom zoo los ntawm kev kuaj mob ultrasound thiab ntxiv microscopy ntawm cov ntaub so ntswg. Mucinous cancer feem ntau yog kho los ntawm cov kws kho mob vim yog kev noj cov tshuaj synthetic gestagens.
Endometrial cancer ntawm lub tsev menyuam - cov tsos mob thiab cov cim
Thaum endometrial cancer mob, cov tsos mob ntawm pathology tshwm sim tom qab ntev. Cov neeg mob feem ntau tsis yws txog thaum lub sijhawm ntawm lub neoplasm. Qhov no piav qhia qhov kev mob tshwm sim heev ntawm tus kab mob nyob hauv chav kawm ntawm kev tshawb nrhiav qhov txawv txav hauv kev ua me nyuam. Cov tsos mob tseem ceeb uas qhia tias khees xaws yog kev mob ntshav qab zib.
Cov dej ntws tawm no tsis muaj kev sib txuas nrog kev coj khaub ncaws. Lawv yog cov uas tsis tau sib thooj, feem ntau yog nrog ib tus menyuam yaus, uas dag ntxias cov neeg mob. Cov poj niam lawv tus kheej tau noj haus cov kab mob rau lub hli tshwj xeeb thiab sab laj nrog ib tus kws kho mob tsuas yog tom qab rov ua dua qub. Kev kuaj tus mob sib txawv pab tsim los tsim qhov tseeb ntawm ntshav tawm - mob cancer ntawm lub uterine endometrium.
Raws li cov kab mob pathology loj hlob tuaj, txoj kev mob tshwm sim loj tuaj. Ntawm lwm cov cim qhia ntawm xws li ib tug kab mob raws li endometrial mob cancer, nws yog qhov yuav tsum tau paub qhov txawv:
- Cov tsos ntawm cov dawb yog ib txoj kev tawm ntawm lub qhov chaw mos. Ntawd thaum tus qog hlob. Txaus siab nyob rau hauv lub uterine kab noj ntawm cov kua qaub li, ua rau mob siab heev nyob rau hauv lub plab mog, rub tawm tus cwj pwm.
- Purulent discharge los ntawm qhov chaw mos. Kev ua txhaum ntawm kev tawm ntawm leucorrhea tuaj yeem ua rau raug tus kab mob, ua rau muaj kev tsim pyometers - ib qho kua paug hauv lub uterine kab noj hniav. Tus poj niam tib lub sij hawm kho qhov tsos ntawm qhov mob ntawm qhov tawg, qhov nce ntawm lub cev kub, qhov kev puas tsuaj nyob rau hauv txhua yam zoo.
- Kev hnov mob ntawm lub cev - tshwm thaum muaj tus kab mob pathological, kis mus rau hauv pelvic kab noj hniav. Nrog txoj kev loj hlob sai ntawm lub qog, muaj compression ntawm txoj hnyuv, muaj kev mob nkeeg hauv cheeb tsam chaw lumbar.
- Kev ua txhaum ntawm txoj kev tso zis thiab kev defecation. Qhov loj loj ntawm tus thawj tumor provokes cov tsos mob ntawm cov tsos mob ntxiv (mob nrog tso zis, defecation, tenesmus - tsis muaj tseeb, mob siab heev kom khaus).
- Kev ua txhaum ntawm txoj kev coj khaub ncaws - ncua sij hawm, ncua, ua kom ntshav ntws nce ntxiv. Feem ntau yog txuam nrog hormonal hloov hauv tus neeg mob lub cev.
Endometrial cancer - theem
Raws li cov kev mob tshwm sim thiab qhov teeb meem no, cov theem hauv qab ntawm endometrial cancer ntawm lub tsev menyuam tau txawv, raws li kev cais ntawm International Federation of Obstetrics thiab Gynecologists (FIGO):
1. Zoom theem (0) - muaj qhov atypical endometrial hyperplasia, uas yog thawj theem ntawm oncology.
2. Thawj theem - lub qog tsis dhau mus lub cev ntawm lub tsev menyuam (IA-C). Nws txais yuav qhov txawv:
- Cov theem ntawm cov kab mob - cov qog tsis kis hauv, nws tsuas yog ib txheej ntawm epithelium;
- Nyob rau theem - Tus npag ntawm lub pob zeb muaj kev koom tes hauv cov txheej txheem pathological, thiab tsis txog ntawm nws qhov chaw nruab nrab;
- Cov kab mob ІС theem - carcinoma sprouts ib nrab ntawm cov npag npag thiab tob, tab sis tsis mus txog serosa.
2. Qhov thib ob theem tau muab faib ua:
- IB TUG - tsuas yog cov qog kis;
- Huab cua theem - muaj kev txawv txav.
3. Qhov thib peb theem - cancer ntawm endometrium yoojyim ciam teb ntawm lub cev, tab sis tsis mus dhau lub me pelvis. Raws li cov kev soj ntsuam, qhov theem no tau muab faib ua:
- IB TUG - carcinoma sprouts serous membrane los yog cuam tshuam cov khoom siv;
- YEEJ - yog tus cwj pwm ntawm cov tsos mob ntawm cov kab mob hauv cov kab mob uas nyob ib sab.
4. Qib plaub:
- cov qog tuaj yeem mus rau hauv lub zais zis los yog qhov quav - IVA.
- qhov zoo li ntawm cov metastases nyob sab nraum lub me pelvis - IVB.
Endometrial cancer - mob
Muaj cov cim qhia txog kev mob qog nqaij hlav ntawm lub tsev menyuam yog qhia txog kev kuaj xyuas tus neeg mob. Rau lub hom phiaj ntawm qhov no:
- qhov chaw mos ultrasound ntawm pelvic plab hnyuv siab raum;
- hysterocervicoscopy - scraping cov ntaub so ntswg thiab ncauj tsev menyuam rau ntxiv microscopy;
- echography ntawm plab me me kabmob;
- kuaj txoj hnyuv ;
- cystoscopy.
Endometrial cancer ntawm ultrasound
Endometrial cancer ntawm ultrasound, cov cim qhia ntawm uas tau piav qhia saum toj no, tuaj yeem kuaj tau los ntawm cov keeb kwm ntawm cov keeb kwm ntawm transvaginal. Nyob rau hauv txoj kev tshawb no, tus kws kho mob pom txog qhov sib npaug los yog tsis zoo. Cov hlab ntsha me me tau nce lub cev thiab homogeneous qauv. Hauv qhov no, cov kab mob ntawm tus qog no feem ntau txawm tias (nrog rau qhov infiltration, cov npoo hloov). Cov acoustic conductivity ntawm cov qog cov ntaub ntawv muaj cov nyhuv acoustic, uas ua rau cov teeb liab echo. Thiaj li cov kws kho mob kuaj endometrial cancer ntawm lub tsev menyuam, cov tsos mob ntawm cov uas kuj muaj tseeb los ntawm cov kev ntsuam xyuas.
Endometrial cancer - oncomarkers
Onkomarkery - biologically active tshuaj, synthesized nyob rau hauv ib qho cancer cell. Lawv muaj feem xyuam ntawm cov protein molecule uas muaj lipid thiab carbohydrate nrog. Cov npiv zuj zus yog tsim nyob ntawm seb cov txheej txheem ntawm cov kab mob pathological, cov peculiarities ntawm tus qauv ntawm lub qog. Ib txhia lawv nkag mus rau hauv cov ntshav, uas lawv tau kuaj pom nrog kev pab ntawm kev tshawb nrhiav. Los tshawb nrhiav pom kab mob cancer rau me me, cov neeg mob tau muab rau cov qia cov hlab ntsha nram qab no:
- squamous cell carcinoma antigen (SCCA);
- CA 125;
- mob cancer-embryonic antigen (CEA);
- cancer marker CA 27-29.
Endometrial cancer - kev kho mob
Thaum peb kawm txog qhov kev nyuaj siab heev, thawj lo lus nug ntawm cov neeg mob: txawm tias yuav kho los yog tsis mob endometrial cancer. Cov kws kho mob tham txog kev rov qab tau. Lub txiaj ntsim tau zoo yog nyob ntawm seb hom pathology, qhov mob ntawm tus kab mob, theem. Cov kev kho mob nram qab no yog siv los kho:
- phais txoj kev;
- kev kho hluav taws xob ;
- chemotherapy ;
- hormonotherapy.
Qhov kev xaiv ntawm txoj kev kho mob yog nyob ntawm ntau yam. Thaum xaiv txoj kev kho cov tshuaj kho mob, cov hauv qab no raug muab xam rau hauv cov account:
- theem ntawm tus kab mob;
- qog loj;
- keeb kwm ntawm cov keeb kwm;
- degree txawv;
- tob ntawm cov kab mob;
- kis ntawm lub qog tshaj li lub cev.
Ntawm cov kev no, phais siv ntau zaus dua lwm tus. Nws thiaj li ua rau tus kab mob qoob loo endometrial dua. Thaum lub sij hawm ua hauj lwm, cov kws kho mob tsis tsuas yog tshem tawm cov ntaub so ntswg los ntawm cov khoom, tab sis kuj tshawb xyuas cov neeg nyob ze. Kev phais staging muaj xws li:
- kev hloov kho ntawm cov kab mob plab;
- kev kuaj qog cov qog nqaij hlav qog;
- Kev soj ntsuam ntawm cytological ntawm ib cov qauv nqaij.
Raws li cov txiaj ntsim tau los thaum lub sij hawm tshuaj ntsuam xyuas, kev txiav txim siab raug ua raws li cov kev ua haujlwm:
- qhov tso tawm ntawm lub tsev menyuam (ua tiav hlo tshem tawm) nrog kev ntxiv;
- radical extirpation ntawm lub tsev menyuam nrog mob hnyuv thiab lymphadenectomy - tshem tawm ntawm lub tsev menyuam nrog rau cov qog ntshav hauv lub cev.
Endometrial cancer - kev mob
Txiav txim siab thaum twv seb qhov tshwm sim ntawm tus kab mob yog:
- theem ntawm pathology;
- hnub nyoog;
- qhov tob ntawm kev hloov;
- degree txawv;
- tumor loj.
Ib qho kev txiav txim siab yog cov metastases ntawm endometrial cancer, uas yog nyob hauv cov qog ntawm cov qog. Nws tau raug tsim tawm tias, txij li qhov kev ntsuam xyuas ntawm kev mob qog nqaij hlav ntawm thawj theem pib, 82% ntawm cov neeg mob nyob tsib xyoos lossis ntau dua. Thaum kuaj pom tus kab mob hauv ob theem, thiab txoj kev tswj hwm txoj kev kho, 65% ntawm tag nrho cov neeg mob nyob ntau tshaj tsib xyoos. Hauv 25% ntawm cov neeg mob pathology, kev mob ntawm tus kab mob nrog ib qho kev tsim muaj qhov tsis zoo raug cim tseg.