Muchirwere weEntometrial - zvinokonzera uye zviratidzo zvemhando dzose dzekenza

Muchirwere weEntometrial inowanzorwara zvirwere zvekuberekwa. Chirwere chepachirwere chinotangira chimiro, saka hachiwanzoongororwa muzvikamu zvekutanga. Ngationgororei zvakadzama kenza ye endometrium: zviratidzo nezviratidzo, zvinokonzera, mafomu, mazano makuru erapi.

Muchirwere weEntometrial - njodzi zvinhu

Mune varwere vane kenza yemapendometri, zera rinowanzopfuura makore 45-50. Izvo zvinokonzera kushanduka kwemugadziro mumasero eUterine yakatsetseka ndiyo nzira inobatanidza nekuenda kumwedzi. Kuparara kwehutano hwekuberekwa hahupfuuri pasina mutezo wemuviri. Pakati pezvimwe zvinogona kuisa mungozi, vanachiremba vanoona mamiriro ezvinhu akadai se:

• kushungurudzika kwegoutocrine system, zvirongwa zvemagetsi emuviri - chirwere cheshuga, kutetesa;
• arterial hypertension;
• zvinokonzerwa nehomoni-inotarisana nehutano hwekubereka - hyperestrogenism;
• maronda-anobata mavari-maitiro - Bhanner's tumor muzvishanu zvose zvinosangana nekenza;
• Stein-Levental syndrome - yakabatanidzwa nekenza yemapendometri mu 30% yematambudziko;
• genetic predisposition;
• mutoro wakaremara - kuvapo kwehama dzepedyo dzechirwere-kufanana nezvirwere;
• kunonoka kutanga kwepabonde, kusakosha kwayo;
• kusabatwa kwekudzivirira uye kubereka muna anamnesis;
• kunonoka kumwedzi (pashure pemakore 55);
• iyo inonzi hormone therapy (kushandiswa kweTamoxifen).

Muchirwere weEntometrial - classification

Maererano neAlltological International Classification, chirwere chekupedzisira chemuviri chekuberekwa chinopatsanurwa kuva maitiro anotevera:

• adenocarcinoma;
• edzai cell cell adenocarcinoma;
• squamous cell carcinoma;
• mucheche wepenzi;
• mucinous;
• kenza yeserous;
• glandular-squamous;
• kenza isina kufanirwa.

Bvisai cell cell endometrial adenocarcinoma

Bvisai cell cell adenocarcinoma inowanzoitika kakawanda kupfuura mamwe maitiro ehutachiona. Nokuti rudzi urwu rwekenza rinoratidzwa nekuvapo kune nzvimbo dzakagadzikana dzezvinyama guru polyhedral epithelial cells. Inowanzotaurwa kuti kuvapo kwemasero anowanzoitika kunowanzosiyana nezvikamu zve chiedza-cell adenocarcinomas. Dzimwe nyanzvi dzinofunga kuti pathologies uye meson-fusion masero kune boka iri. Zvinhu izvi zviri kunze zvinofanana nechipikiri chesaga nehosi.

Endometrial carcinoma ye gland

Muchirwere unonyadzisa we endometrium inorwara umo masero masero anonyanya kubatanidzwa mune izvi. Mukuita, glandular adenocarcinoma inokanganisa uterine cavity uye cervical canal. Urwu urwere hwekenza hunokwana makumi manomwe kubva muzana zvezvese zvehutano, huzhinji hunowanikwa mune vakadzi vakwegura, asi hunowanikawo kune vechidiki.

Squamous cell carcinoma ye endometrium

Squamous cell carcinoma yechipfuva chinoreva maharaplasms akaipa. Maumbirwo emakumbo acho anobva kumakamuri epa epithelium flat, iyo inowana dhigirii yakasiyana yeatypia. Nekuwedzera kwehutachiwana mumashure ekupedzisira, masero anoshandura kuenda kunharaunda yemugero wemirairo. Mumamiriro ezvinhu akadaro, oncology inowanikwa munguva yekuongorora gynecological. Nokuda kwekushaikwa kwechimiro chemakiriniki akajeka, hazviwanikwi mumavambo ekutanga. Zviratidzo zvisingaoneki zvehutano zvinosanganisira:

• kurwadziwa kwepamuviri;
• kusagadzikana kwebhanyi uye rectum;
• spotting uye leucorrhoea.

Iron-squamous cell carcinoma ye endometrium

Iron-squamous cell carcinoma yemaviri endometrial ndiyo imwe nzira yakasiyana yezvirwere. Chimwe chinhu chakasiyana nacho ndechekuvapo kwechirwere chinonzi dimorphic structure. Simba uye zvinyoronyoro zvinowanikwa mune zvakadaro. Sezvo mutemo, saramous cell inowedzera pamusoro pekuchera. Ichi chimiro chekenza yemakemikari inokonzera 4% yezviitiko zvose zvehutano. Zvinowanzoonekwa kune vakadzi vakwegura kudarika makore 55, mumatambudziko akasiyana anowanikwa kune vechidiki.

Mukuenzanisa nemamwe adenocarcinomas, glandular squamous cell carcinoma ine kusiyana kwakadzika. Nemhaka yezvinhu izvi zvakarongeka, bundu racho rinowanzotora nzira ine utsinye. Zvine macroscopically, pasina kushandiswa kwezvigadziri uye kuwedzera kukuru, fomu iyi inenge isiri yakasiyana nedzimwe adenocarcinomas. Kunze kwakafanana nehuwandu hwepodhidhi kana chironda chekuonda. Kugadzirisa maitiro ehutano kunoitwa pamwero wakakura, uchifunga nezvehuwandu hwekuparadzaniswa kwezvinhu zvakasiyana.

Mushonga weSerous endometrial

Kenza yeSerous ndeyeboka guru re epithelial neoplasms. Pathology inoumbwa kubva kune masero akachinjwa kana kuti akapera simba epithelial tissue. Muchiitiko ichi, zvinowanzomesa kusimbisa kutanga kweizvi. Ichi chimiro chinoratidzwa nekufamba kwenguva, uye chinowanikwa apo mukadzi ari kuongororwa nguva dzose pakufamba, kubereka. Zviratidzo zvekenza yemakemikari yemufananidzo uyu zvakaoma kufungidzira kumukadzi pachake.

Mucin Cancer

Rudzi urwu rwehutachiona hunoratidzwa nekupararira kwemasero ane intra-cytoplasmic mucin mukati mavo. Iyi yehutano inokonzera 10% yezviitiko zvose zve oncology yemuviri wemuviri. Chimwe chinhu chinoparadzaniswa neoplasm ndiyo yakakonzeresa yakakura yezvimarara, iyo inotsigirwa ne ultrasound diagnostic uyezve microscopy yemuenzaniso weiyo. Kanzera ine utano inowanzobatwa navanachiremba semugumisiro wekutora gestagens.

Muchirwere weEntometrial wechibereko - zviratidzo nezviratidzo

Apo kenza yemapendometri inokura, zviratidzo zvehutachiona hunoitika pashure penguva refu. Vakawanda vanorwara havanyunyuti panguva yechaoplasm. Izvi zvinotsanangura nguva nenguva kuerekana kuerekana kuongororwa kwechirwere ichi munguva yekutsvaga zvinokonzera kusakanganisika muhutano hwekubereka. Chiratidzo chikuru chinoratidza chirwere uterine kubuda ropa.

Izvozvi zvisingabatanidzi nguva yekuenda kumwedzi. Havasi varombo, vanowanzofambidzana nechisimba chiduku, chinonyengedza varwere. Vakadzi ivo pachavo vanotora zviratidzo zvekuwedzera kwemazuva ose uye vanoenda kunechiremba chete mushure mekudzokorora kudzokorora. Kuita zvakasiyana-siyana kuongororwa kunobatsira kusimbisa chikonzero chechokwadi chekubuda ropa - kenza ye uterine endometrium.

Sezvo chirwere chinopfuurira, zviratidzo zvinowedzera. Pakati peimwe zviratidzo zvechirwere chakadai sekenza yemapendometri, zvakakosha kusiyanisa:

1. Kuonekwa kwevatsvene ndiko kubudiswa kwechirwere kubva pamutsipa weropa. Ita kana ronda rakura. Kuunganidzwa mukati mehutachi uterine yezvinyorwa zvakadaro, zvinokonzera kunzwisa kurwadza mumudumbu pasi, kudhonza unhu.
2. Purulent discharge from the vagina. Kuputika kwekubuda kwechiroro kunogona kukonzera utachiona, kukanganisa kuumbwa kwemapirometers - chivako chepus mu uterine cavity. Mukadzi panguva imwechete anogadzirisa maitiro ekurwadziwa kwechimiro chinoputika, kuwedzera kwekushisa kwemuviri, kuora kwehupenyu hwose.
3. Pain syndrome - inoratidzika apo chirwere chetachiona chinopararira, kuchinja kwepachirwere mumhepo. Nekukurumidza kukura kwemarara, pane kuwirirana kwehuputi, kune marwadzo munharaunda ye lumbar.
4. Kuita zvechisimba kwekugadzirisa nekudzivirira. Kukura kukuru kwechirwere chekutanga kunokonzera kuonekwa kwezviratidzo zvehumwe (kunyanya nekudhonza, kupereta, tenesmus - zvenhema, zvinorwadza zvinokuvadza kuzvidzivirira).
5. Kusvibiswa kwekuenda kumwedzi - kureba, kupfupika, kuwedzerwa simba rekuenda kumwedzi. Kazhinji inobatanidza kuchinja kwehomoni mumuviri wemurwere.

Kanzera yeEntometrial - zvikamu

Zvichienderana nezvipatara zviratidzo uye huwandu hwehutachiona, zvikamu zvinotevera zvekenza yemakemikari yechibereko chinoratidzika, maererano nehutano hwe International International of Obstetricians uye Gynecologists (FIGO):

1. Zero nharo (0) - kune inypical endometrial hyperplasia, iyo inotanga kuitika ye oncology.

2. Chikamu chekutanga - chirwere hachipfuuri mberi kwemuviri wechibereko (IA-C). Inogamuchirwa kusiyanisa:

• ІА chikwata - chirwere chisina kumera mukati, chinogadziriswa nehupamhi hwe epithelium;
• ² chikwata - muscular layer inobatanidzwa mukugadzirisa zvirwere, uye haisviki pakati payo;
• I ІС danga - carcinoma inowedzera hafu ye muscular layer uye yakadzika, asi haisviki pane serosa.

2. Chikamu chechipiri chakakamurwa kuva:

• ІІА - chete zvipembenene zvinobatanidzwa;
• Umudziro wekutanga - stroma inoshandiswa.

3. Chikamu chechitatu - kenza ye endometrium inosiya muganhu wechiri, asi haipfuuri kudarika mapfupi maduku. Zvichienderana nemakiriniki, zvikamu izvi zvakakamurwa kuva:

• ІІІА - carcinoma inokura sembrane kana kuti inobata zvipfeko;
• ІІІС - inoratidzika nechitarisiko chemasimisita mumakiromodhi ari pedyo.

4. Nharo yechina:

• bundu racho rinowedzera mukanyoka kana rectum - IVA.
• chimiro chemasastases ari kure kunze kwebato duku - IVB.

Muchirwere weEntometrial - kuongororwa

Kupa zviratidzo zvekenza yemakemikari yemuchembera chiratidzo chekuongorora kwakakwana kwomurwere. Nechinangwa cheizvi:

• vaginal ultrasound yenhengo dzemuviri;
• hysterocervicoscopy - kupera kwemaviri emapenzi uye emudzimai kuitira mamwe microscopy;
• kunyoresa kwemuviri nhengo dzomuviri;
• colonoscopy ;
• cystoscopy.

Muchirwere weEntometrial pa ultrasound

Kanzera yeEntometrial pa ultrasound, zviratidzo zvayo zvinorondedzerwa pamusoro apa, zvinogona kuongororwa nechinyorwa chekare. Muchidzidzo chino, chiremba anoona zvakakosha kana kuti zvisina kufanira. Zvidumbu zviduku zvakawedzera echogenicity uye maitiro akafanana. Muchiitiko ichi, mhirizhonga yechipfuva inowanzowanzo (kunyange nekupinda, mitsva inoshanduka). Izvo yakawedzera acoustic conductivity ye tumarara inogadzira an acoustic effect, iyo inosimudzira chiratidzo chechiratidzo. Saka vanachiremba vanofungisisa kenza yemarometrium yechibereko, zviratidzo zvayo zvinotsigirwawo nekuongorora.

Muchirwere weEntometrial - incomarkers

Onkomarkery - biologically active substances, yakagadzirwa mukenza yemukenza. Izvo zvinowanikwa neprotein molecule iyo inonzi lipidhyidhyidrate yakaiswa. Zvikwangwani zvakagadzirirwa zvichienderana nechikamu chekuita kwehutachiona, humwe hutsika hwechimiro chemuviri. Chikamu inopinda mukati meropa, kwaanoonekwa nekubatsirwa kweongororo ye laboratori. Kuti uongorore mishonga inonzi microinvasive endometrial, varwere vanogoverwa kune zvinotevera zvipembenene:

• squamous cell carcinoma antigen (SCCA);
• CA 125;
• kenza-embryonic antigen (CEA);
• chirwere chekenza CA 27-29.

Muchirwere weEntometrial - kurapwa

Sezvo wadzidza nezvehutano hunotyisa, mubvunzo wekutanga wevarwere: kana kana kwete chirwere chekupedzisira kwemakemikari inorapwa. Vanachiremba vanotaura pamusoro pekugona kuregererwa. Kubudirira kunobudirira kunoenderana nerudzi rwehutachiona, kuoma kwechirwere, chikwata. Izvi zvinotevera kurapwa zvinoshandiswa mukurapa:

• chirurgic method;
• radiation therapy ;
• chemotherapy ;
• hormonotherapy.

Kusarudzwa kwemuitiro wekurapa kunoenderana nezvimwe zvinhu. Pakusarudza nzira yekurapa kurapa, zvinotevera zvinotorwa:

• danga rechirwere;
• tumarara tukuru;
• histological structure;
• chiyero chekusiyanisa;
• kudzika kwekumera;
• kupararira kwechirwere chinopfuura kamuviri.

Nezvizvi, nzira yekuvhiya inoshandiswa kakawanda kupfuura dzimwe. Inoderedza kudzokorora kwekenza yemapendometri. Munguva yekushanda, vanachiremba vanongobvisa zvigunwe zvakagadzikana kubva munhengo, asiwo vanoongorora avo vari pedyo. Kutsvakurudza kunosanganisira:

• Kudzokorora kwemuviri wepamuviri;
• kutakura biopsy ye lymph nodes;
• cytological examination of a tissue sample.

Kubva pamigumisiro yakawanikwa panguva yekuongorora, sarudzo inogadziriswa pakuwanda kwebasa racho:

• kubviswa kwechibereko (chizere chekutsvaga nhengo) nezvikamu;
• radical extirpation ye chiberekero ne appendages uye lymphadenectomy - kubviswa kwechibereko pamwe chete nemakirini emunharaunda.

Muchirwere weEntometrial - prognosis

Kusarudza paunofanotaura nezvekuguma kwechirwere ndezvekuti:

• danga rekudzivirira;
• age;
• kudzika kwevasi kuchinja;
• chiyero chekusiyanisa;
• tumor size size.

Chimwe chezvinhu zvinogadzirisa ndeye metastases yemukenza wependometrial, iyo inowanikwa munzvimbo dzemuLymph nodes. Izvo zvave zvichinyatsozivikanwa kuti, sezvo kuongororwa kwekenza yemapendometri yekutanga, 82% yevarwere vanorarama makore mashanu kana kupfuura. Apo kuongororwa nechirwere muchikamu chechipiri, uye kukodzera kwakakodzera kwerapi, 65% yevarwere vose vanorarama makore anopfuura mashanu. Muna 25% yezviitiko zvehutachiona, kufambira mberi kwechirwere ichi nechisarudzo chisina kunaka chinoratidzwa.