Umhlaza wesifo se-Endometrial yisifo sesifo se-incological senkqubo yokuzala. I-Pathology inemvelaphi evulekileyo, ngoko ke ayifumaneki kakhulu kwiimeko zokuqala. Makhe siqwalasele ngokubanzi umhlaza we-endometrium: iimpawu kunye nempawu, izizathu, iifom, izikhokelo eziphambili zonyango.
Umdlavuza we-Endometrial - iingozi
Kwizigulane zomhlaza wesifo se-endometrial, ubudala budlula iminyaka engama-45 ukuya kuma-50. Indlela yokuqala yokuguqulwa kwesakhiwo kwiiseli zobuncwane be-uterine yiinkqubo ezinxulumene nokuqeda umva. Ukuqedwa kwenkqubo yokuzala akudluli ngaphandle komzila womzimba. Phakathi kwezinye izinto ezinobungozi, oogqirha bajonga iimeko ezifana nale:
- iziphazamiso zenkqubo ye-endocrine, iinkqubo zesisombululo somzimba - isifo sikashukela, ukukhuluphala;
- ngxinzelelo lwegazi;
- izifo ezixhomekeke kwiHommone kwinkqubo yokuzala - i-hyperestrogenism;
- izidumbu ze-ovarian ezisebenza nge-hormones - i-tumor ye-Brenner kuyo yonke into yesihlanu ihamba nomhlaza;
- I-Stein-Levental syndrome - ihlanganiswe nomdlavuza we-endometriya kwi-30% yamatyala;
- imfuza;
- ububele obunzima - ubuhlobo bezondlo ezifuphiweyo ze-pathologies ezinjenge-tumor;
- ukuqala kokuqala kwesenzo sezesondo, ukungabi naso;
- ukungabikho kokukhulelwa nokubeletha kwi-anamnesis;
- ekupheleni komyeni (emva kweminyaka engama-55);
- kwinqanaba le-hormone therapy (esebenzisa iTamoxifen).
Umdlavuza we-Endometrial - udidi
Ngokutsho kwe-Histological International Classification, umdlavuza we-endometrial we-uterus uhlukaniswe kwiifom ezilandelayo:
- adenocarcinoma;
- kucace i-cell adenocarcinoma;
- squamous cell carcinoma;
- nomhlaza wesifo;
- mucinous;
- umhlaza wesifo;
- i-squirous-squamous;
- umhlaza ongenasiphelo.
Sula i-cell endometrial adenocarcinoma
Kucacisa i-cell adenocarcinoma kwenzeka kaninzi kunezinye iindlela zokugula. Ngolu hlobo lomhlaza lubonakaliswa nobukho kwiindawo ezichaphazelekayo zezicubu ezinkulu ze-polyhedral ze-cell epithelial. Ngokuqhelekileyo kubonakala ukuba ubukho beeseli eziqhelekileyo zenzeka ngokunye kunye nezinto ezinokukhanya-i-cell adenocarcinomas. Ezinye iingcali zithi i-pathologies kunye ne-meson-fusion cells kule qela. Ezi zinto zingaphandle zifana nesihlangu esikhwameni sinentsimbi.
I-endometrial carcinoma ye-gland
Umhlaza wesibeletho we-endometrium yi-pathology apho iiseli ezincinci zibandakanyeka kwinkqubo. Ngokwenza oko, i-adenocarcinoma ye-glandular iyathintela i-uterine cavity kunye nomngcingo wesibeleko. Olu hlobo lomhlaza lubhalisela malunga ne-70% yazo zonke iinkqubo ze-oncological, ngokuqhelekileyo zifunyanwe ngabafazi abasebekhulile, kodwa ziyafumaneka kubantu abatsha.
I-Squamous cell carcinoma ye-endometrium
I-Squamous cell carcinoma yesibindi ibhekisela kwiimpawu ezimbi ezimbi. Ukubunjwa kwe-tumor kuvela kwiiseli ze-epithelium eplatili, ezithe zafumana iqondo elihlukile le-atypia. Ngokuqhubela phambili kwentsholongwane kwizigaba ezizayo, iiseli ziya kutshintshela kwingingqi yomsele womlomo wesibeleko. Kwiimeko ezinjalo, i-oncology ifunyaniswa ngexesha lokuhlolwa kwegazi. Ngenxa yokungabikho komfanekiso ocacileyo weklinikhi, ayifumaneki kumanyathelo okuqala. Izimpawu ezinqabileyo zentsholongwane ziquka:
- intlungu;
- ukungasebenzi kwebladder and rectum;
- ukuphawula kunye nokugqithisa.
I-Iron-squamous cell carcinoma ye-endometrium
I-iron-squamous cell carcinoma yeethambo ze-endometriyari yindlela ehlukeneyo yokugula. Isici esahlukileyo sawo kukho ubuhlungu obunesakhiwo se dimorphic. Izakhi ze-Squamous kunye ne-glandular zikhoyo kwiinkalo ezinjalo. Njengomthetho, i-cell squamous ibangelwa ngaphezu kwe-glandular. Le fom yomdlavuza we-endometrial i-4% yazo zonke iimeko zokugula. Kuqhelekileyo kubasetyhini abadala kuneminyaka engama-55, kwiimeko ezinye zenzeka kubantu abatsha.
Xa kuthelekiswa namanye adenocarcinomas, i-squlandous cell squamous ine-differentiation ephantsi. Ngenxa yezi zinto zakhiwo, i-tumor ihlala ifumana inkqubo enobudlova. I-Macroscopically, ngaphandle kokusetyenziswa kwezixhobo kunye nokunyuka okukhulu, le fom ayifani ngokungafani nezinye i-adenocarcinomas. Ngaphandle kufana ne-polypoid okanye isilonda. Ukuqulunqwa kwefom ye-pathology kwenziwa kwinqanaba elincinci, ngokuqwalasela umlinganiselo wokwahlukana kwamacandelo ngamnye.
Umdlavuza we-endometrial
Umhlaza wesi-Serous ungowomkhulu omkhulu we-epithelial neoplasms. I-Pathology yenziwe ngokusuka kwintsholongwane okanye echithwayo kwiisunithi ze-epithelial. Kule meko, kubakho nzima ukuseka imvelaphi yaloo nto. Le fom ibonakaliswa ngumjikelezo ophucukileyo, kwaye ifumaneka xa ibhinqa lihlolwa ngokukhawuleza kumjikelezo, inkqubo yokuzala. Iimpawu zomdlavuza we-endometrial yale fomu kunzima ukuxilonga kumfazi.
Ngomhlaza weCancer
Olu hlobo lwe-oncology lubonakaliswa ngokusasazeka kweeseli eziqukethe i-intra-cytoplasmic mucin ngaphakathi. Le ndlela ye-pathology i-10% yazo zonke iimeko ze-oncology yomzimba wesisu. Isici esahlukileyo se-neoplasm ukuhlukaniswa okuphezulu kwezinto ezixubileyo, eziqinisekiswa yi-ultrasound diagnostic kunye ne-microscopy eyongezelelweyo yesampuli. Umhlaza omninzi uvame ukuphathwa ngogqirha ngenxa yokuthatha isisindo somzimba.
Umdlavuza we-Endometrial we-uterus - iimpawu kunye neempawu
Xa umdlavuza we-endometrial ukhula, iimpawu zentsholongwane zenzeka emva kwexesha elide. Uninzi lwezigulane azikhalazi ngexesha le-neoplasm. Oku kuchaza ukuba ukuhlaselwa ngengozi rhoqo kwesi sifo ngexesha lokufuna izizathu zokungaqhelekanga kwinkqubo yokuzala. Uphawu oluphambili olubonisa umdlavuza ngumzimba wegazi.
Ezi zikhuphayo azixhomekeke kwixesha lokuya esikhathini. Abangenasiphelo, ngokuhlala behamba kunye nentlungu encinci, ekhohlisa izigulane. Abafazi ngokwabo bathabatha uphawu lweempawu zenyanga ngokungaqhelekanga kwaye badibana nodokotela kuphela emva kokuphindaphinda ngokuphindaphindiweyo. Ukuqhuba ukuxilongwa ngokungafaniyo kunceda ukusungula isizathu esiyintloko sokukhulelwa kwamanzi - umhlaza we-endometrium ye-uterine.
Njengoko i-pathology iqhubeka, i-symptomatology ikhula. Phakathi kwezinye iimpawu zesifo esinjalo njengomhlaza we-endometrial, kubalulekile ukuhlula:
- Ukubonakala kwabamhlophe kukukhutshwa kwegazi kwi-tract tract. Yenzeke xa i-tumor ikhula. Ukuqokelela kwisigxina se-uterine saloo mfihlo, kubangela ukuvalelwa kwintlungu esezantsi, ukutsala umlingiswa.
- Ukukhutshwa kwamanzi okuphuma kumfazi. Ukugqithiswa kwe-outflow ye-leucorrhea kunokubangela ukusuleleka, kubangele ukubunjwa kwe-pyometers-isakhiwo se-pus kwi-uterine cavity. Ibhinqa ngexesha elifanayo lilungisa ukubonakala kwintlungu yendalo, ukunyuka kwamaqondo okushisa komzimba, ukungonakaliswa kwintlalo-ntle.
- I-syndrome ye-Pain - ivela xa inkqubo yentsholongwane isasazeka, utshintsho olungenayo kwi-pelvic cavity. Ngokukhula ngokukhawuleza kwe-tumor, kukho uxinzelelo lwe-ureter, kukho iintlungu kwi-lumbar region.
- Ukuphululwa kwenkqubo yokucoca kunye nokuchaswa. Ubungakanani obukhulu besifo esiyintloko sikhupha imbonakalo yeempawu ezongezelelweyo (ukukhathazeka ngokucoca, ukuchasana, ukunyaniseka, ukunyaniseka, ukunyanzela ukuphazamiseka).
- Ukuphululwa komjikelezo wesini - ukwandisa, ukunciphisa, ukwandisa umthamo wegazi lokuya esikhathini. Ngokuqhelekileyo kudibaniswa neenguqu ze-hormones kwisigulane somzimba.
Umdlavuza we-Endometrial - izigaba
Ngokuxhomekeke kwimbonakaliso yekliniki kunye nobukhulu besifo, izigaba ezilandelayo zomhlaza wesifo se-endometriyamu ziyahlukana, ngokwemigangatho ye-International Federation of Obstetricians kunye ne-Gynecologists (FIGO):
1. Inqanaba lesiteji (0) - kukho i-hyperplasia ye-endometrial ye-atypical, eyona nqanaba lokuqala le-oncology.
2. Isigaba sokuqala - i-tumor ayihambi ngaphaya komzimba wesisu (IA-C). Iyavunyelwa ukuhlukanisa:
- ISIQEPHU-i-tumor ayiyi kuhluma ngaphakathi, iyancitshiswa ngumgca we-epithelium;
- ISIGABA sendawo - umgca we-muscular ubandakanyeka kwinkqubo ye-pathological, kwaye ayifinyeleli kwimida yayo;
- Isigaba se-ІС - i-carcinoma ihluma isiqingatha se-muscular lay and deep, kodwa ayifinyeleli kwi-serosa.
2. Icandelo lesibini lihlukaniswe:
- ІІА - kuphela izigulane ezibandakanyekayo;
- ISIQEPHU sesigaba - i-stroma ichaphazelekayo.
3. Isigaba sesithathu - umhlaza we-endometrium ushiya umda wequmrhu, kodwa awuhambi ngaphaya kwe-pelvis encinci. Ngokuxhomekeke kwiimpawu zekliniki, eli nqanaba lihlulwe ngo:
- I-ІІІА - i-carcinoma ihluma i-membrane okanye ichaphazela izixhobo;
- I-ІІІС - ibonakala ngokubonakala kweemetastase kwii-lymph nodes ezikufutshane.
4. I sigaba sesine:
- i-tumor ihluma kwi-bladder okanye i-rectum-IVA.
- ukubonakala kweemastastas ezikude ngaphandle kwe-pelvis encinci - IVB.
Umhlaza we-Endometrial - ukuxilongwa
Iimpawu zomdlavuza we-endometrial wesibeleko zibonakalisa ukuhlolwa ngokubanzi kwesigulane. Ngenjongo yale:
- i-ultrasound ye-vaginal yamalungu e-pelvic;
- i-hysterocervicoscopy - ukutshitshiswa kwezicubu ze-pelvic kunye neentsholongwane ukwenzela ukuba i-microscopy eqhubele phambili;
- Ukuchaneka kwezitho zomzimba zesisu;
- colonoscopy ;
- i-cystoscopy.
Umhlaza we-Endometrial kwi-ultrasound
Umhlaza wesifo se-Endometrial kwi-ultrasound, iimpawu zazo ezichazwe ngasentla, zinokufunyanwa ngumzobo ongasemva. Kule sifundo, ugqirha ufumene umzobo ojikelezayo okanye ongaqhelekanga. Iimvumi ezincinci zandise i-echogenicity kunye nesakhiwo esifanayo. Kule meko, umtya we-tumor udla ngokuphindaphindiweyo (kunye nokungena, ukuguquka kwemijikelo). Ukwenyuka kwe-acoustic conductivity ye-tumor kudala umphumo we-acoustic, ophucula uphawu lwe-echo. Ngoko oogqirha baxilonga umdlavuza we-endometrial wesibeleko, iimpawu zazo nazo ziqinisekiswa ngokuhlalutya.
Umdlavuza we-Endometrial - oncomarkers
I-Onkomarkery - izinto eziphilayo ezisebenzayo, ezenziwe ngokusemthethweni kwiselfini somhlaza. Ziqukethe i-molecule yeprotheni apho i-lipid ne-carbohydrate ifakwe. Amakishi aphuhliswa ngokuxhomekeka kwisigaba senkqubo ye-pathological, iimpawu eziqhelekileyo zesakhiwo se-tumor. Ngokwengxenye bayangena kwigazi, apho bafunyaniswa ngoncedo lwee-laboratory izifundo. Ukufumana i-microinvasive umdlavuza we-endometrial, izigulane zinikezelwa kwezi zilandelayo:
- i-squamous cell carcinoma antigen (SCCA);
- CA 125;
- umdlavuza we-anti-cancer (CEA);
- ummatsalane umhlaza we-CA 27-29.
Umhlaza we-Endometrial - unyango
Emva kokufunda malunga nokuxilongwa okubi, umbuzo wokuqala wezigulane: ingaba umhlaza wesifo se-endometrial uyaphathwa. Ogqirha bakhuluma malunga nokubuyiswa. Isiphumo esiyimpumelelo sixhomekeke kuhlobo lwe-pathology, ubunzima besifo, isigaba. Ezi zilandelayo zonyango zisetyenziswe kunyango:
- indlela yokugada;
- yonyango ;
- chemotherapy ;
- hormonotherapy.
Ukukhethwa kwendlela yokonyango kuxhomekeke kwiimeko ezininzi. Xa ukhetha indlela yokwelapha unyango, oku kulandelayo kuthathwa ingqalelo:
- kwisigaba sesifo;
- ubungakanani besisu;
- sakhiwo sakhe;
- isantya sohlulo;
- bunzulu bokuhluma;
- ukusasazeka kwe-tumor ngaphaya kwelilungu elichaphazelekayo.
Kule ndlela, ugqirha usetyenziswa ngokuphindaphindiweyo kunabanye. Iyanciphisa ukuphindaphinda komdlavuza we-endometri. Ngethuba lokusebenza, oogqirha abanakususa kuphela izicubu ezichaphazelekayo kwiqumrhu, kodwa baphinde bahlole abafuphi. Isiteji sokuphanda siquka:
- Ukuhlaziywa kwesigxina somzimba;
- ukuqhuba i-biopsy ye-lymph nodes;
- uvavanyo lwe-cytological yeesampuli zesisampuli.
Ngokusekelwe kwiziphumo ezifunyanwe ngexesha lokuhlola, isigqibo senziwe malunga nomsebenzi:
- ukutshatyalaliswa kwesibeleko (ukupheliswa komzimba ngokugcwele) kunye neefowuni;
- ukukhutshwa ngokugqithisileyo kwesibeleko kunye neefowendage kunye ne-lymphadenectomy - ukususwa kwesibeleko kunye ne-lymph nodes zendawo.
Umdlavuza we-Endometrial - ukuhlaziya
Ukuqaphela xa kuqikelelwe isiphumo sesi sifo:
- kwinqanaba lokugula;
- ubudala;
- ubunzulu beenguqu ezinzulu;
- isantya sohlulo;
- ubungakanani besisu.
Enye yezinto zokumisela i-metastase yomdlavuza we-endometri, ekhoyo kwii-lymph nodes. Kuye kwasungulwa ngokukhawuleza ukuba, ekubeni i-diagnostic yomdlavuza we-endometrial yesigaba sokuqala, i-82% yezigulane zihlala iminyaka emihlanu okanye ngaphezulu. Xa ufumanisa ukuba isifo kwisigaba sesibini, kunye nokuphathwa kakuhle kweyeza, i-65% yezigulane zihlala ngaphezu kweminyaka emihlanu. Kwi-25% yamatyala okugula, ukuqhubela phambili kwesi sifo nge-prognosis engavumelekanga.