Uterine malignancy
Introduction
Introduction to uterine malignancies A uterine malignancy is a malignant tumor that occurs in the vaginal and cervix of the uterus. The metastasis of cervical cancer can spread directly to adjacent tissues and organs, down to the vaginal vault and the vaginal wall. The uterus can be invaded upwards, and the pelvic tissue can be invaded to both sides. The bladder can be invaded forward and the rectum can be invaded backward. It can also be transferred to the cervix, intraorbital, extra-orbital, and inguinal lymph nodes through lymphatic vessels, and even to the clavicle and other lymph nodes in the late stage. Hematogenous metastasis is relatively rare, and common metastatic sites are lung, liver and bone. Cervical cancer is one of the most common malignancies in gynecology. basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of infection: non-infectious Complications: ascites
Cause
Causes of uterine malignancies
Genetic factors (10%):
There is no doubt that any cancer has a certain hereditary nature, and of course endometrial cancer is no exception. According to clinical statistics, about 20% of patients with endometrial cancer have a family history, and their family history is 2 times higher than cervical cancer.
Pathological factors (20%):
If there is long-term damage to the cervix, broken skin, erosion, inflammation, it may turn into early cervical cancer cells. The cause of uterine cancer smoking will increase the chance of cervical cancer, one will reduce the body's immunity and accelerate the development of cervical cancer cells, and the other is that smoking itself may produce some substances that may lead to the development of cervical cancer cells.
Environmental factors (25%):
The study found that women who do not have sex often have almost no cervical cancer, and the sooner they have inappropriate sex, the more likely they are to develop uterine cancer. In terms of sexual partners, if women have more than two male partners, their chances of developing cervical cancer are significantly increased.
Physiological factors (25%):
Endometrial hyperplasia has a certain tendency to cancer, so it is classified as precancerous lesions, and its hyperplasia is divided into simple type, complex type and atypical hyperplasia. Simple hyperplasia develops into endometrial cancer of about 1%; complex hyperplasia is about 3%; dysplasia develops into endometrial cancer by about 30%.
Estrogen factor (20%):
Under normal circumstances, if female friends suffer from uterus-related diseases such as anovulatory dysfunctional uterine bleeding, polycystic ovary syndrome, and functional ovarian tumors, they should take estrogen more or less. Naturally stimulate the endometrium to cause its lesions. Understand the exact cause of uterine cancer in order to receive better treatment.
Prevention
Uterine malignancy prevention
1. Avoid unclean sexual intercourse and improper sexual relations, active genital sores patients are absolutely prohibited from having sex with anyone.
2. During the treatment period, sexual intercourse is prohibited, and the spouse is also required to check if necessary.
3. Care for local damage should be kept clean and dry to prevent secondary infection.
4. After the cure or recurrence, we must pay attention to prevent colds, cold, fatigue and other predisposing factors to reduce recurrence. At present, there is no specific prevention method. Animal experiments show that the inoculation of HSV dead vaccine or live attenuated vaccine has an immune effect, so the virus is closely related to certain cancers, so it is not used for routine prevention. The recent use of purified herpesvirus envelope glycoprotein as a vaccine can avoid the carcinogenic risk of herpesvirus DNA. ACV also has a preventive effect. The condom can reduce the spread of the disease, especially during the asymptomatic detoxification period, but when the genital damage occurs, the condom can not be used to avoid transmission.
Complication
Uterine malignant tumor complications Complications ascites
After repeated chemotherapy for advanced uterine cancer, ascites and pelvic metastasis are prone to occur. Abdominal bloating pain, irregular vaginal bleeding.
Symptom
Uterine malignant tumor symptoms Common symptoms Primary dysmenorrhea uterine bleeding cachexia uterine cavity empyema vaginal bleeding vaginal discharge increased vaginal discharge is black water-like pelvic drooping fever is thin
Very early patients can have no obvious symptoms and are found by chance only during census or other reasons for gynaecological examination. Once symptoms appear, they are often expressed as:
(A) uterine bleeding : irregular vaginal bleeding before and after menopause is the main symptom of endometrial cancer, often a small to moderate amount of bleeding, rarely a large amount of bleeding. Not only younger or near menopausal patients are more likely to mistaken menstruation and not seeing a doctor in time, even if the doctor is often negligent. Individuals also have delayed menstrual cycles, but the performance is irregular. After menopause, patients often show persistent or intermittent vaginal bleeding. Patients with endometrial cancer generally have no contact bleeding. In the late bleeding, there may be rotten meat-like tissue.
(2) vaginal discharge : because adenocarcinoma grows in the uterine cavity, the chance of infection is less than that of cervical cancer, so there may be only a small amount of bloody vaginal discharge in the early stage, but after infection and necrosis, there is a large amount of septic discharge of pus-like liquid. . Sometimes draining can contain small fragments of cancerous tissue. If the cervix is empyema, it causes fever, abdominal pain, and leukocytosis. The general situation has also deteriorated rapidly.
(3) Pain : Due to cancer and its stagnation of blood and drainage, it stimulates irregular contraction of the uterus and causes paroxysmal pain, accounting for 10 to 46%. Most of this symptom occurs in the advanced stage. Such as cancer tissue penetrating the serosa or eroding the paracancerous connective tissue, bladder, straight or oppressing other tissues can also cause pain, often intractable and progressive aggravation; and more from the lumbosacral region, lower abdomen to thighs and knees.
(4) Others : patients with advanced stage can touch the enlarged uterus of the lower abdomen or adjacent tissues and organs can cause swelling and pain in the lower limbs, or pressure the ureter to cause pelvic ureteral hydrops or kidney atrophy; or anemia, weight loss, Fever, dyscrasia and other systemic manifestations.
Endometrial cancer occurs at a later age, and it may not be possible to have a pregnancy, but there have been reports of individual pregnancy or tubal pregnancy in the literature. Irregular vaginal bleeding, bleeding can occur at any time, except for hormone therapy. If vaginal bleeding occurs in postmenopausal women undergoing hormone replacement therapy, similar to menstruation, it indicates the possibility of uterine cancer. Therefore, if there is any abnormal vaginal bleeding or a large amount of bleeding, you should go to the hospital as soon as possible. Vaginal bifurcation, pink, brown, watery or viscous, with odor. A pelvic examination revealed an enlarged uterus. Weight loss, weakness, lower abdomen, back and leg pain. This happens when the cancer metastasizes or spreads.
Examine
Examination of uterine malignancies
1. Pap smear examination: It is a simple, reliable and painless examination method. The doctor will scrape the cells of the cervix and upper part of the vagina with a scraping rod and a cervical brush. After being stained, it is sent to the laboratory for examination. The purpose is to detect cells with abnormalities in the cervix and its vicinity. Negative examination should be considered when the smear test is negative, the mastoid and cytomegalovirus are positive, and the antigen CEA and CA-754 are in an intensity response. The best time to smear is from the end of each menstrual cycle to the next ovulation period.
2. Pelvic examination: The doctor will open the vagina to observe the upper part of the cervix and vagina. From the abdomen or internal medicine, the organs in the pelvic cavity such as the uterus, ovaries, fallopian tubes, vagina, bladder and rectum can be examined. There is an exception.
3. Colposcopy: Colposcopy is a 40-fold microscope that examines the cervix in detail under a special light source. From the changes of epithelial cells, benign and malignant lesions were produced. A direct view of the suspected lesion was made using a colposcope for histological determination.
4. Conical resection: When the Pap smear or pelvic cavity is found to be abnormal, further testing is needed to find out where the problem lies. The doctor will cut the conical tissue around the cervix and cervix and send it to the pathology laboratory for examination to determine if there is any lesion.
5. Dilatation and curettage: The doctor first expands the cervix and then sticks into the scraping to scrape the tissue of the endometrium and cervix for examination.
6. Computed tomography (CT) and magnetic resonance (MRI), positron emission tomography (PET): When it is determined to be cervical cancer, you need to do computed tomography (CT) magnetic resonance (MRI), or PET Learn if cervical cancer is spreading.
7. Other related tests: including blood, urine test and chest X-ray.
Diagnosis
Diagnosis and diagnosis of uterine malignant tumor
diagnosis
The most common symptom of cervical cancer during pregnancy is vaginal bleeding. After the exclusion of persistent vaginal bleeding caused by obstetric factors, cervical lesions should be highly suspected. This is, patients often complain of increased vaginal discharge, and patients with advanced stage may have pain in the lower part of the waist or thigh. The same as non-pregnancy cervical cancer diagnosis, colposcopy and cervical cell screening is an important means of screening for cervical cancer in pregnancy.
Differential diagnosis
Different from other lesions of the cervix.
