Mob nqaij hlav endometrial

Endometrial cancer yog khees xawj uas pib hauv endometrium, txoj kab hauv tsev menyuam (lub tsev menyuam).

Endometrial cancer yog hom mob kheesxaws ntau tshaj ntawm uterine. Qhov tseeb ua kom mob cancer ntawm endometrial tsis paub. Ib theem kev sib luag ntawm cov tshuaj hormones estrogen kuj tuaj yeem ua lub luag haujlwm. Qhov no txhawb kev txhim kho ntawm kev tsim txoj hlua ntawm lub tsev menyuam. Qhov no tuaj yeem ua rau lub cev hla ntawm endometrium thiab mob qog ntshav.

Feem ntau ntawm cov mob qog nqaij hlav endometrial feem ntau tshwm sim thaum muaj hnub nyoog 60 txog 70 xyoo. Qee zaum muaj qee zaum kuj tshwm sim ua ntej hnub nyoog 40.

Cov xwm txheej hauv qab no ntsig txog koj cov tshuaj hormones ua rau koj muaj feem mob qog nqaij hlav endometrial:

• Kev kho tshuaj estrogen hloov kho yam tsis siv progesterone
• Keeb kwm ntawm endometrial polyps
• Lub sijhawm pheej tsis nyob hauv
• Tsis tau muaj menyuam
• Kev pham
• Mob ntshav qab zib
• Cov mob polycystic zes qe menyuam (PCOS)
• Pib kev coj khaub ncaws thaum tseem me (ua ntej hnub nyoog 12)
• Pib qaug lawm tom qab hnub nyoog 50
• Tamoxifen, yog ib hom tshuaj siv kho mob cancer mis

Cov poj niam nrog rau cov xwm txheej hauv qab no kuj zoo li yog qhov pheej hmoo siab rau mob qog nqaij hlav endometrial:

• Mob hnyuv lossis mob cancer mis
• Gallbladder muaj tus kab mob
• Ntshav siab

Cov tsos mob ntawm tus mob endometrial suav nrog:

• Txawv ntshav los hauv qhov chaw mos, nrog rau los ntshav ntawm ntu lossis nqaij lossis / los ntshav tom qab lawm
• Tshaj heev, ntev, lossis ntau ntu ntawm qhov chaw mos los ntshav tom qab hnub nyoog 40 xyoo
• Kev mob plab qis lossis mob plab ntswj

Thaum nyuam qhuav pib mob los, kuaj mob hu ua pelvic feem ntau ib txwm muaj.

• Hauv cov theem siab, tej zaum yuav muaj qhov hloov qhov loj, cov duab, los yog kev xav ntawm lub tsev menyuam lossis cov chaw nyob ib puag ncig.
• Pap smear (tuaj yeem ua rau lub sijhawm ua rau mob qog nqaij hlav endometrial, tab sis tsis kuaj nws)

Raws li koj cov tsos mob thiab lwm qhov kev tshawb pom, lwm yam kev kuaj mob kuj yuav xav tau. Qee qhov tuaj yeem ua tau hauv koj tus kws kho mob lub chaw haujlwm. Lwm qhov yuav ua tau ntawm tsev kho mob lossis chaw phais:

• Endometrial biopsy: Siv me me lossis nyias catheter (raj), cov nqaij yog coj los ntawm sab hauv tsev menyuam (endometrium). Lub hlwb raug kuaj hauv qab lub tshuab tsom kom pom seb puas muaj qhov txawv txav lossis qog nqaij hlav.
• Hysteroscopy: Cov twj zoo li lub koob yees duab nyias nyias tau nkag los ntawm lub paum thiab qhov qhib ntawm lub ncauj tsev menyuam. Nws ua rau tus kws kho mob pom sab hauv lub tsev menyuam.
• Ultrasound: Suab tsis tau siv los ua duab ntawm lub plab mog. Tus ultrasound yuav tuaj yeem ua plab lossis vaginally. Ib qho duab hluav taws xob tuaj yeem txiav txim siab yog tias hauv ob sab phlu ntawm lub tsev menyuam pom txawv txav lossis tuab.
• Sonohysterography: Kev tso dej tso rau hauv lub tsev me me los ntawm txoj hlab nyias nyias, thaum cov duab ntawm qhov paum yog qhov chaw ntawm lub tsev menyuam. Cov txheej txheem no yuav ua tau los txiav txim siab pom tias qhov twg txawv txav ntawm lub plab uterine uas yuav yog qhov qhia txog mob qog nqaij hlav.
• Magnetic resonance imaging (MRI): Hauv qhov ntsuas ntsuas no, cov hlau nplaum muaj zog yog siv los tsim cov duab ntawm cov khoom hauv nruab nrog.

Yog tias nrhiav tau mob qog, kev sim qhia qog yuav ntsuas seb tus mob cancer puas tau kis mus rau lwm qhov hauv lub cev. Qhov no hu ua staging.

Theem ntawm endometrial cancer yog:

• Theem 1: Mob qog noj tsuas yog nyob hauv tsev menyuam.
• Theem 2: Kab mob cancer yog nyob rau hauv tsev menyuam thiab ncauj tsev menyuam.
• Theem 3: Tus kabmob tau kis lwm qhov ntawm lub tsev menyuam, tabsis tsis dhau ntawm thaj chaw pelvis tseeb. Kab mob khees xaws muaj feem ua mob ua xais rau ntawm lub plab mog lossis ze rau ntawm aorta (txoj hlab ntshav loj hauv plab).
• Theem 4: Tus kabmob tau kis mus rau sab hauv sab hauv ntawm cov hnyuv, zais zis, plab, lossis lwm yam kabmob.

Kab Mob kheesxaws kuj tau piav raws li qeb 1, 2, lossis 3. Qib 1 yog qhov muaj kev ntxhov siab tsawg tshaj plaws, thiab qeb 3 yog qhov muaj txhoj puab heev. Kev txhoj puab heev txhais tau hais tias tus kabmob loj tuaj thiab kis ceev ceev.

Cov kev kho mob suav nrog:

• Kev phais mob
• Kev siv hluav taws xob
• Kws khomob

Kev phais mob kom tshem tawm lub tsev me me (hysterectomy) tuaj yeem ua rau cov poj niam uas muaj mob qog nqaij hlav thaum ntxov. Tus kws kho mob yuav tuaj yeem tshem cov hlab thiab zes qe menyuam.

Kev phais mob ua ke nrog kev ntsuas hluav taws xob yog lwm txoj kev kho mob. Nws yog feem ntau siv rau cov poj niam nrog:

• Kab mob theem 1 uas muaj feem yuav muaj rov qab los, tau kis rau cov qog ntshav, lossis qib 2 lossis 3
• Theem 2 tus kab mob

Kev siv tshuaj kho mob los yog kev kho tshuaj hormonal tuaj yeem txiav txim siab nyob rau qee kis, feem ntau yog rau cov neeg mob theem 3 thiab 4.

Koj tuaj yeem daws kev ntxhov siab ntawm kev muaj mob los ntawm kev koom nrog pawg pab txhawb mob qog noj ntshav. Faib qhia rau lwm tus uas muaj kev paub thiab teeb meem ntau yam tuaj yeem pab koj tsis txhob xav tias yog ib leeg.

Kab mob endometrial feem ntau kuaj tau thaum ntxov.

Yog hais tias mob cancer tsis kis, 95% ntawm cov poj niam muaj sia nyob tom qab 5 xyoos. Yog hais tias mob cancer tau kis mus rau cov kabmob sib txawv, kwv yees li 25% ntawm cov pojniam tseem muaj sia nyob tom qab 5 xyoos.

Teeb meem yuav suav nrog ib qho hauv qab no:

• Kev mob ntshav vim ntshav poob (ua ntej kuaj mob)
• Perforation (qhov) ntawm lub tsev me nyuam, uas yuav tshwm sim thaum lub hnub D thiab C lossis endometrial biopsy
• Teeb meem los ntawm kev phais mob, hluav taws xob, thiab kev siv tshuaj kho

Hu mus teem sijhawm nrog koj tus kws khomob yog koj muaj tej yam hauv qab no:

• Ib qho kev los ntshav lossis ntshav uas tshwm sim tom qab qhov pib lawm
• Los ntshav lossis los ntshav tom qab sib deev lossis douching
• Los ntshav ntev tshaj 7 hnub
• Ib hlis mus ncig tsis xwm yeem uas muaj ob zaug ib hlis
• Kev tso tawm tshiab tom qab lub cev yuav pib
• Pelvic mob lossis mob ntswj uas tsis ploj mus

Nws tsis muaj qhov tshuaj ntsuam zoo rau kev kuaj qog nqaij hlav endometrial (uterine).

Cov poj niam uas muaj feem yuav mob qog nqaij hlav cancer yuav tsum tau ua raws lawv cov kws kho mob. Qhov no suav nrog cov pojniam tabtom noj:

• Estrogen hloov kho tsis siv tshuaj kho progesterone
• Tamoxifen ntau dua 2 xyoos

Feem ntau kuaj plab, Pap smears, qhov chaw mos ntawm qhov chaw mos, thiab kuaj cov qog nqaij hlav hauv koj lub cev tej zaum yuav xav txog qee yam.

Txoj kev pheej hmoo rau mob qog nqaij hlav endometrial yog txo los ntawm:

• Tswj lub cev hnyav
• Siv tshuaj tiv thaiv kom tsis pub muaj menyuam rau ntau xyoo

Endometrial adenocarcinoma; Kev kho mob hauv tsev me adenocarcinoma; Kev mob raum; Adenocarcinoma - endometrium; Adenocarcinoma - tsev menyuam; Cancer - uterine; Kab Mob Cancer - endometrial; Uterine corpus mob cancer

• Hysterectomy - plab - tso tawm
• Hysterectomy - laparoscopic - kev tso tawm
• Hysterectomy - chaw mos - tso tawm
• Pelvic radiation - paug

• Pelvic laparoscopy
• Poj niam deev aub
• D thiab C
• Endometrial me me
• Hysterectomy
• Uterus
• Mob nqaij hlav endometrial

Armstrong DK. Gynecologic cov qog nqaij hlav. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 189.

Boggess JF, Kilgore JE, Tran A-Q. Uterine cancer. Hauv: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical OncologyCov. 6 tus ed. Philadelphia, PA: Elsevier; 2020: chap 85.

Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Kab mob qog nqaij hlav cancer. Kev Looj MemCov. 2016; 387 (10023): 1094-1108. PMID: 26354523 pubmed.ncbi.nlm.nih.gov/26354523/.

Lub koom haum Cancer National website. Endometrial kev kho mob qog noj ntshav (PDQ) -Txoj kev noj qab haus huv tshaj tawm. www.cancer.gov/types/uterine/hp/endometrial-txuj-pdq. Hloov kho thaum Lub Kaum Ob Hlis 17, 2019. Nkag mus Lub Peb Hlis 24, 2020.

Lub Tebchaws National Comprehensive Cancer Network lub vev xaib. NCCN kev soj ntsuam kev coj ua hauv oncology (Cov txheej txheem NCCN): kev siv lub tsev menyuam. Daim Ntawv 1.2020. www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Hloov kho thaum Lub Peb Hlis 6, 2020. Nkag mus rau Lub Peb Hlis 24, 2020.