Qhov Tseem Ceeb - Endometriosis vs Endometrial Cancer
Endometriosis thiab endometrial cancer yog ob yam mob uas vim yog pathological derangement ntawm cov ntaub so ntswg uas ua rau lub tsev menyuam. Qhov tshwm sim ntawm endometrial nto epithelium thiab / los yog cov qog endometrial thiab stroma sab nraud ntawm lub tsev menyuam kab noj hniav yog hu ua endometriosis. Cov qog nqaij hlav endometrial yog cov qog nqaij hlav uas tshwm sim hauv endometrium. Qhov sib txawv tseem ceeb ntawm endometriosis thiab endometrial cancer yog tias endometriosis yog ib qho mob zoo thaum cov qog nqaij hlav endometrial yog malignancies uas tuaj yeem muaj teeb meem rau lub neej.
YEndometriosis yog dab tsi?
Qhov muaj cov kab mob endometrial nto epithelium thiab / lossis cov qog endometrial thiab stroma sab nraud ntawm lub uterine kab noj hniav yog hu ua endometriosis. Qhov tshwm sim ntawm tus mob no yog siab heev ntawm cov poj niam uas muaj hnub nyoog ntawm 35-45 xyoo. Peritoneum thiab zes qe menyuam yog qhov chaw tshaj plaws uas cuam tshuam los ntawm endometriosis.
Pathophysiology
Qhov tseeb mechanism ntawm pathogenesis tsis tau to taub. Muaj plaub lub ntsiab lus lees paub.
Menstrual Regurgitation thiab Implantation
Thaum lub caij ua poj niam, qee cov qog nqaij hlav endometrial tuaj yeem txav mus rau hauv qhov kev taw qhia rov qab es tsis txhob txav mus los ntawm qhov chaw mos. Cov qog thiab cov ntaub so ntswg uas siv tau no tau cog rau ntawm qhov chaw peritoneal ntawm cov kab noj hniav endometrial. Qhov kev xav no tau txhawb nqa los ntawm qhov siab ntawm qhov tshwm sim ntawm endometriosis ntawm cov poj niam uas muaj qhov txawv txav ntawm qhov chaw mos uas pab txhawb kev txav mus los ntawm kev coj khaub ncaws.
YCoelomic Epithelium Transformation
Feem ntau cov hlwb uas kab sib txawv ntawm cov poj niam qhov chaw mos xws li Mullerian ducts, peritoneal nto thiab zes qe menyuam muaj keeb kwm. Txoj kev xav ntawm coelomic epithelium transformation qhia tias cov hlwb no redifferentiate rau hauv lawv cov primitive daim ntawv thiab ces hloov mus rau hauv lub endometrial hlwb. Cov cellular redifferentiations tau xav tias yuav tshwm sim los ntawm ntau yam tshuaj lom neeg tso tawm los ntawm endometrium.
Kev cuam tshuam ntawm caj ces thiab kev tiv thaiv kab mob
Qhov muaj peev xwm ntawm cov hlwb endometrial tsiv mus rau qhov chaw nyob deb ntawm cov kab mob endometrial los ntawm cov ntshav thiab cov hlab ntsha lymphatic tsis tuaj yeem raug cais tawm.
Ntxiv rau, iatrogenic ua rau xws li kev cog qoob loo thiab kev raug digoxin kuj suav nrog ntau qhov ua rau endometriosis.
YOvarian Endometriosis
Ovarian endometriosis tuaj yeem tshwm sim los yog sab hauv lossis sab hauv.
Cov Kab Mob Tsis Txaus Siab
Cov kab mob loj heev feem ntau tshwm sim raws li cov cim hlawv ntawm lub zes qe menyuam. Muaj ntau cov kab mob hemorrhagic nyob rau saum npoo uas ua rau muaj qhov tshwm sim zoo li no. Cov kab mob no feem ntau cuam tshuam nrog kev tsim cov adhesions. Xws li adhesions tsim nyob rau tom qab nam ntawm zes qe menyuam ua rau nws fixation rau zes qe menyuam fossa.
Endometrioma
Endometriotic cysts lossis chocolate cysts ntawm zes qe menyuam muaj cov yam ntxwv xim av xim av. Cov hlwv no tshwm sim ntawm qhov chaw ntawm zes qe menyuam thiab maj mam nkag mus rau hauv lub cortex. Endometriotic cysts tuaj yeem tawg tawm lawv cov ntsiab lus tawm, ua rau tsim cov adhesions.
YPelvic Endometriosis
Uterosacral ligaments yog cov qauv cuam tshuam feem ntau los ntawm tus mob no. Cov ligaments tuaj yeem tau txais kev sib tw nodular thiab thicken vim yog kev cog qoob loo ntawm cov ntaub so ntswg endometrial.
YRectovaginal Septum Endometriosis
Cov kab mob endometrial nyob rau hauv lub uterosacral ligaments tuaj yeem nkag mus rau lub qhov quav ntawm lub qhov quav. Tom qab lawv tsiv mus rau lub qhov quav, cov ntaub so ntswg endometrial tsim cov adhesions ntom ntom uas thaum kawg ua rau tag nrho obliteration ntawm lub hnab ntawm Douglas. Dyspareunia thiab hloov cov cwj pwm hauv plab yog cov tsos mob ntawm cov kab mob endometriosis.
peritoneal endometriosis
Qhov no suav nrog cov hmoov hlawv hom kab mob tshwm sim ntawm peritoneum.
YDeep Infiltrating Endometriosis
Kev nkag mus ntawm cov qog endometrial thiab stroma ntau dua 5cm hauv qab lub peritoneal nto yog txheeb xyuas tias qhov tob infiltrating endometriosis. Qhov no ua rau mob pelvic hnyav thiab dyspareunia. Mob plab thiab dysmenorrhea yog lwm cov tsos mob ntawm qhov tob infiltrating endometriosis.
Cov tsos mob ntawm endometriosis
- Congestive dysmenorrhea
- Ovulation mob
- Deep dyspareunia
- mob plab pelvic
- Kev mob ntshav qab zib sacral
- mob plab mob
- kev ua poj niam txawv txav xws li oligomenorrhea thiab menorrhagia
Cov tsos mob ntawm Endometriosis ntawm Distal Sites
- Lub plab - ib qho ntshav los ntawm lub qhov quav, kev mob plab zom mov, thiab dyschezia
- zais zis - dysuria, hematuria, zaus, thiab ceev
- Pulmonary – hemoptysis, hemopneumothorax
- Pleura - pleuritic mob hauv siab, ua tsis taus pa
Diagnosis
Kev kuaj mob yog raws li cov tsos mob classic.
Kev tshawb nrhiav
- CA 125 qib- nce hauv endometriosis
- Anti-endometrial antibodies nyob rau hauv cov ntshav thiab peritoneal kua
- YUltrasonography
- MRI
- Laparoscopy - qhov no yog qhov ntsuas kub rau kev kuaj mob endometriosis
- Biopsy
Kev tswj hwm
Kev tswj tus neeg mob endometriosis nyob ntawm plaub yam tseem ceeb
- poj niam hnub nyoog
- Nws xav kom cev xeeb tub
- Mob hnyav ntawm cov tsos mob thiab qhov twg ntawm qhov txhab
- Cov txiaj ntsig ntawm kev kho yav dhau los
Kev Tswj Xyuas Kev Kho Mob
- Tshuaj ntsuab tuaj yeem muab rau qhov mob nyem
- Kev kho hormonal nrog cov tshuaj tiv thaiv kab mob, progesterone, GnRH thiab lwm yam.
Kev Tswj Xyuas Kev Kho Mob
- Kev phais phais (piv txwv li laparoscopy lossis laparotomy)
- Kho cov kev phais mob xws li adhesiolysis, ib feem ntawm kev tshem tawm ntawm cov ntaub so ntswg adenomyotic thiab tubal flushing nrog roj-soluble media
Qhov no ua tau tsuas yog thaum tus neeg mob tsev neeg ua tiav lossis muaj mob endometriosis loj heev
Endometrial Cancer yog dab tsi?
Cov qog nqaij hlav endometrial yog cov qog nqaij hlav uas tshwm sim hauv endometrium. Adenocarcinomas yog hom qog nqaij hlav endometrial tshaj plaws.
Muaj ob hom kab mob endometrial adenocarcinomas li,
- Hom 1 - cov qog nqaij hlav no yog cov tshuaj estrogen nyob ntawm thiab feem ntau tshwm sim hauv cov poj niam hluas. Lawv feem ntau muaj qhov ntsuas tau zoo.
- Hom 2 - hom 2 endometrial carcinomas feem ntau pom hauv cov poj niam laus thiab tsis yog tshuaj estrogen. Qhov no ua rau lawv qhov kev mob tshwm sim tsis zoo dua li ntawm hom 1 carcinomas.
Etiology
Lub ntsiab lus ntawm cov kab mob ntawm cov qog nqaij hlav endometrial tseem tsis paub meej. Tab sis muaj kev sib raug zoo ntawm qhov nce qib ntawm cov tshuaj estrogen thiab qhov tshwm sim ntawm cov qog nqaij hlav endometrial.
Risk Factors
- Kev rog
- Nulliparity
- Late menopause (>52 xyoo)
- Kev kho tshuaj estrogen tsis pom zoo
- Hommon hloov kho
- Tsev neeg keeb kwm ntawm mob qog nqaij hlav hauv plab lossis zes qe menyuam
Kev siv cov tshuaj tiv thaiv qhov ncauj lossis cov tshuaj progesterone nkaus xwb thiaj txo tau txoj kev pheej hmoo ntawm qog nqaij hlav endometrial.
Tshuaj Kho Mob
- Kev los ntshav ntawm qhov chaw mos yog qhov kev nthuav qhia ntau tshaj plaws. Qhov no tuaj yeem yog los ntshav tom qab yug me nyuam los yog los ntshav los ntawm qhov chaw mos.
- Nyob rau hauv cov poj niam premenopausal, tuaj yeem muaj cov tsos mob xws li los ntshav thaum cev xeeb tub, cov ntshav tawm qhov chaw mos, los ntshav hnyav, mob plab plab lossis dyspareunia.
- Nyob rau hauv tus kab mob siab heev, tus neeg mob tuaj yeem tshwm sim nrog lwm yam kev tshwm sim xws li fistula, pob txha metastases, lub siab ua haujlwm tsis zoo lossis cov tsos mob ua pa.
- Thaum kuaj lub ncauj tsev menyuam, tuaj yeem los ntshav los ntawm phab ntsa tsev menyuam.
- Kev kuaj lub tsev menyuam Bimanual qhia pom tias muaj lub tsev menyuam loj.
Daim duab 02: Cov theem ntawm Endometrial Cancer
Diagnosis
Qhov tseem ceeb ntawm kev kuaj mob yog,
- YUltrasound scanning
- YEndometrial biopsy
- Hysteroscopy
- MRI tau ua raws li kev kuaj mob qog nqaij hlav endometrial txhawm rau txheeb xyuas qhov muaj cov kab mob metastatic.
Staging of Endometrial Carcinomas
| 1 | Kwv yees rau lub cev |
| 1a | Tsawg dua 50% ntxeem tau |
| 1b | Ntau tshaj 50% ntxeem tau |
| 2 | Tumor invading cervical stroma |
| 3 | Kev kis tus kabmob hauv cheeb tsam thiab cheeb tsam |
| 3a | Ntawm serosa ntawm lub tsev menyuam |
| 3b | Ntxhais chaw mos thiab/lossis parametrium |
| 3c | Metastases rau pelvic thiab/los yog para aortic nodes |
| 4 | Nyob deb ntawm metastases |
Kev tswj hwm
- Kev phais tshem tawm tag nrho cov kab mob malignant yog qhov kev cuam tshuam feem ntau hauv kev tswj hwm ntawm endometrial carcinomas. Tus txheej txheem phais uas ua nyob rau hauv cov txheej txheem no yog hu ua tag nrho hysterectomy thiab ob tog salpingectomy.
- Postoperative radiotherapy yog siv los ua kev kho mob ntxiv.
Kev Tshawb Fawb
Cov tsos mob ntawm cov qog nqaij hlav endometrial sib txawv raws li theem ntawm kev loj hlob ntawm tus kab mob raws li qhia hauv qab no.
| Stage | 5-xyoo ciaj sia (%) |
| I | 88 |
| II | 75 |
| III | 55 |
| IV | 16 |
Dab tsi yog qhov zoo sib xws ntawm Endometriosis thiab Endometrial Cancer?
Ob qho xwm txheej yog kab mob ntawm cov ntaub so ntswg endometrial
Qhov txawv ntawm Endometriosis thiab Endometrial Cancer yog dab tsi?
Endometriosis vs Endometrial Cancer |
|
| Kev muaj cov kab mob endometrial deg epithelium thiab / lossis cov qog endometrial thiab stroma sab nraud ntawm lub tsev menyuam kab noj hniav hu ua endometriosis. | Cov qog nqaij hlav endometrial yog cov qog nqaij hlav uas tshwm sim hauv endometrium. |
| Kev mob hnyav | |
| Ntawm no yog qhov mob zoo. | Ntawm no yog yam mob phem. |
| Pathogenesis | |
| Cov caj ces thiab kev tiv thaiv kab mob ua lub luag haujlwm tseem ceeb hauv kev tsim cov kab mob endometriosis. Kev phais phais thiab kev raug digoxin yog qhov ua rau iatrogenic loj. | Qib nce ntawm estrogen muaj kev sib raug zoo nrog qhov tshwm sim ntawm cov qog nqaij hlav endometrial. Yog li ntawd, rog rog, ntshav qab zib, nulliparity, lig menopause (>52 xyoo), unopposed estrogen therapy, hloov tshuaj hormones, tsev neeg keeb kwm ntawm mob qog noj ntshav los yog zes qe menyuam yog cov tseem ceeb txaus ntshai. |
| Tshuaj kho mob | |
|
Qhov chaw kho mob tseem ceeb yog, · Congestive dysmenorrhea · Ovulation mob · Deep dyspareunia · Chronic pelvic pain · Qo sacral backache · mob plab plab · Subfertility · Menstrual abnormalities xws li oligomenorrhea thiab menorrhagia |
Qhov txawv txav ntawm qhov chaw mos yog qhov kev nthuav qhia ntau tshaj plaws. Nyob rau hauv cov poj niam premenopausal, muaj peev xwm ua tau hnyav qhov chaw mos los ntshav, los ntshav intermenstrual, thiab cov ntshav stained qhov chaw mos. Qee zaum, tuaj yeem muaj dyspareunia thiab mob plab. |
| Diagnosis | |
|
Kev kuaj mob feem ntau yog raws li cov tsos mob classic Hauv qhov xwm txheej tsis ntseeg, kev tshawb nrhiav hauv qab no tuaj yeem ua kom tsis suav nrog lwm qhov ua tau. · CA 125 qib- nce hauv endometriosis · Anti-endometrial antibodies nyob rau hauv cov ntshav thiab peritoneal kua · Ultrasonography ·MRI · Laparoscopy - qhov no yog qhov ntsuas kub rau kev kuaj mob endometriosis · Biopsy |
Qhov tseem ceeb ntawm kev kuaj mob yog, · Ultrasound scanning · Endometrial biopsy · Hysteroscopy · MRI tau ua tiav tom qab kuaj mob qog nqaij hlav endometrial txhawm rau txheeb xyuas qhov muaj cov kab mob metastatic. |
| Kev tswj hwm | |
|
Kev Tswj Xyuas Kev Kho Mob · Cov tshuaj tua kab mob tuaj yeem muab rau kev kho mob · Hormonal therapy with contraceptive agents, progesterone, GnRH thiab lwm yam. Kev Tswj Xyuas Kev Kho Mob · Kev phais mob (piv txwv li laparoscopy lossis laparotomy) · Kho cov kev phais mob xws li adhesiolysis, ib feem ntawm kev tshem tawm ntawm cov ntaub so ntswg adenomyotic thiab tubal flushing nrog roj-soluble media · Kev phais kho mob tsuas yog ua tiav thaum tus neeg mob tsev neeg ua tiav lossis nyob rau hauv qhov mob loj heev endometriosis |
Kev phais tshem tawm tag nrho cov kab mob malignant yog qhov kev cuam tshuam feem ntau hauv kev tswj hwm ntawm endometrial carcinomas. Tus txheej txheem kev phais ua nyob rau hauv cov txheej txheem no yog hu ua tag nrho hysterectomy thiab ob sab salpingectomy. Postoperative radiotherapy yog siv los ua kev kho mob ntxiv. |
Summary – Endometriosis vs Endometrial Cancer
Cov qog nqaij hlav endometrial yog cov qog nqaij hlav uas tshwm sim hauv endometrium. Lub xub ntiag ntawm endometrial nto epithelium thiab / los yog cov qog endometrial thiab stroma sab nraum lub hauv ob sab phlu ntawm lub uterine kab noj hniav yog hu ua endometriosis. Qhov sib txawv tseem ceeb ntawm endometriosis thiab endometrial cancer yog endometriosis ib tug benign mob thaum cov qog nqaij hlav endometrial yog malignancies uas yuav muaj teeb meem rau lub neej.
Download PDF Version ntawm Endometriosis vs Endometrial Cancer
Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li daim ntawv ceeb toom. Thov download PDF version ntawm no Qhov txawv Ntawm Endometriosis thiab Endometrial Cancer
