Khansa ya Endometrial

Khansa ya Endometrial ndi khansa yomwe imayamba mu endometrium, gawo la chiberekero (m'mimba).

Khansa ya Endometrial ndi khansa yodziwika kwambiri ya chiberekero. Zomwe zimayambitsa khansa ya endometrial sizidziwika. Kuchuluka kwa mahomoni a estrogen kumatha kugwira ntchito. Izi zimapangitsa kuti chiberekero chikhale chambiri. Izi zitha kubweretsa kufalikira kwachilendo kwa endometrium ndi khansa.

Matenda ambiri a khansa ya endometrial amapezeka azaka zapakati pa 60 ndi 70. Nthawi zingapo zimachitika asanakwanitse zaka 40.

Zinthu zotsatirazi zokhudzana ndi mahomoni anu zimawonjezera chiopsezo chanu cha khansa ya endometrial:

• Mankhwala obwezeretsa Estrogen osagwiritsa ntchito progesterone
• Mbiri ya ma polyps a endometrial
• Nthawi zosachitika
• Osakhala ndi pakati
• Kunenepa kwambiri
• Matenda a shuga
• Matenda a Polycystic ovary (PCOS)
• Kuyambira kusamba adakali aang'ono (asanakwanitse zaka 12)
• Kuyamba kusamba ukatha zaka 50
• Tamoxifen, mankhwala omwe amagwiritsidwa ntchito pochiza khansa ya m'mawere

Azimayi omwe ali ndi zinthu zotsatirazi akuwonekeranso kuti ali pachiwopsezo chachikulu cha khansa ya endometrial:

• Colon kapena khansa ya m'mawere
• Matenda a gallbladder
• Kuthamanga kwa magazi

Zizindikiro za khansa ya endometrial ndi monga:

• Kutuluka magazi mosazolowereka kumaliseche, kuphatikizapo kutuluka magazi pakati pa msambo kapena kupenya / kutuluka magazi mutatha kusamba
• Kutalika kwanthawi yayitali, kolemera, kapena pafupipafupi kwa magazi kumaliseche atakwanitsa zaka 40
• Kumva kupweteka m'mimba kapena kupweteka kwa m'chiuno

Kumayambiriro kwa matenda, kuyesa m'chiuno nthawi zambiri kumakhala kwachilendo.

• Pakapita patsogolo, pakhoza kukhala kusintha pakukula, mawonekedwe, kapena kumva kwa chiberekero kapena zomuzungulira.
• Pap smear (imatha kukayikira za khansa ya m'mapapo, koma osazindikira)

Kutengera ndi zomwe mwapeza ndi zomwe mwapeza, mayeso ena angafunike. Zina zitha kuchitika muofesi ya omwe amakuthandizani. Zina zitha kuchitidwa kuchipatala kapena malo opangira opaleshoni:

• Endometrial biopsy: Pogwiritsa ntchito catheter yaying'ono kapena yopyapyala (chubu), minofu imachotsedwa m'mbali mwa chiberekero (endometrium). Maselo amayesedwa pansi pa microscope kuti awone ngati ena akuwoneka kuti siabwino kapena ali ndi khansa.
• Hysteroscopy: Chida chaching'ono chooneka ngati telesikopu chimalowetsedwa kudzera kumaliseche ndi potsekula kwa khomo lachiberekero. Amalola woperekayo kuti aone mkati mwa chiberekero.
• Ultrasound: Mafunde omveka amagwiritsidwa ntchito popanga chithunzi cha ziwalo zam'mimba. The ultrasound akhoza kuchitidwa m'mimba kapena vaginally. Ultrasound imatha kudziwa ngati chiberekero cha chiberekero chikuwoneka chachilendo kapena cholimba.
• Sonohysterography: Madzi amayikidwa m'chiberekero kudzera mu chubu chowonda, pomwe zithunzi za ukazi za ultrasound zimapangidwa ndi chiberekero. Njirayi itha kuchitidwa kuti mudziwe kupezeka kwa chiberekero chilichonse chachilendo chomwe chingakhale chisonyezo cha khansa.
• Kujambula kwa Magnetic resonance (MRI): Muyeso yojambula iyi, maginito amphamvu amagwiritsidwa ntchito popanga zithunzi za ziwalo zamkati.

Ngati khansa ipezeka, kuyesa kuyerekezera kungachitike kuti muwone ngati khansayo yafalikira mbali zina za thupi. Izi zimatchedwa staging.

Magawo a khansa ya endometrial ndi awa:

• Gawo 1: Khansara ili mchiberekero kokha.
• Gawo 2: Khansara ili mchiberekero ndi khomo pachibelekeropo.
• Gawo 3: Khansara yafalikira kunja kwa chiberekero, koma osati kupitirira m'chiuno moona. Khansa imatha kuphatikizira ma lymph node m'chiuno kapena pafupi ndi aorta (mtsempha waukulu m'mimba).
• Gawo 4: Khansara yafalikira mpaka mkatikati mwa matumbo, chikhodzodzo, pamimba, kapena ziwalo zina.

Khansa imatchulidwanso kuti giredi 1, 2, kapena 3. Gulu 1 ndiye lankhanza kwambiri, ndipo giredi 3 ndiye loopsa kwambiri. Wankhanza zikutanthauza kuti khansara imakula ndikufalikira mwachangu.

Njira zochiritsira ndi izi:

• Opaleshoni
• Thandizo la radiation
• Chemotherapy

Opaleshoni yochotsa chiberekero (hysterectomy) itha kuchitidwa mwa azimayi omwe ali ndi khansa yoyambirira. Dokotala amathanso kuchotsa machubu ndi thumba losunga mazira.

Kuchita opaleshoni limodzi ndi mankhwala a radiation ndi njira ina yothandizira. Amagwiritsidwa ntchito nthawi zambiri kwa amayi omwe ali ndi:

• Matenda a Gawo 1 omwe ali ndi mwayi wobwerera, afalikira ku ma lymph node, kapena ali giredi 2 kapena 3
• Gawo lachiwiri la matenda

Chemotherapy kapena mankhwala a mahomoni amatha kuganiziridwa nthawi zina, makamaka kwa iwo omwe ali ndi gawo lachitatu ndi lachinayi.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Khansa ya Endometrial nthawi zambiri imapezeka koyambirira.

Ngati khansara siinafalikire, amayi 95% ali moyo atatha zaka 5. Ngati khansara yafalikira kumadera akutali, pafupifupi amayi 25% amakhalabe ndi moyo atatha zaka zisanu.

Zovuta zitha kukhala izi:

• Kuchepa kwa magazi chifukwa chakutaya magazi (asanadziwike)
• Kuwonongeka (chibowo) cha chiberekero, komwe kumatha kuchitika mu D ndi C kapena kumapeto kwa biopsy
• Mavuto a opaleshoni, radiation, ndi chemotherapy

Itanani kuti mudzakumane ndi wokuthandizani ngati muli ndi izi:

• Kutaya magazi kulikonse kapena malo omwe amapezeka pakutha kwa kusamba
• Kutuluka magazi kapena kuwona pambuyo pogonana kapena kugona
• Kutuluka magazi kumatenga nthawi yayitali kuposa masiku 7
• Kusamba kosasamba komwe kumachitika kawiri pamwezi
• Kutulutsa kwatsopano kutha kusamba kwayamba
• Kupweteka kwa m'mimba kapena kuphwanya komwe sikuchoka

Palibe kuyesa koyeserera kwa khansa ya endometrial (uterine).

Amayi omwe ali pachiwopsezo cha khansa ya endometrial ayenera kutsatira kwambiri madokotala awo. Izi zikuphatikiza azimayi omwe akutenga:

• Mankhwala obwezeretsa Estrogen popanda mankhwala a progesterone
• Tamoxifen kwa zaka zoposa 2

Kuyesedwa kwapafupipafupi, mapepala a Pap smears, mazira a m'mimba, ndi ma biopsy a endometrial angaganizidwe nthawi zina.

Kuopsa kwa khansa ya endometrial kumachepetsedwa ndi:

• Kukhala ndi kulemera kwabwinobwino
• Kugwiritsa ntchito mapiritsi a kulera kwazaka zopitilira

Endometrial adenocarcinoma; Chiberekero adenocarcinoma; Khansa ya mchiberekero; Adenocarcinoma - endometrium; Adenocarcinoma - chiberekero; Khansa - chiberekero; Khansa - endometrial; Khansa ya m'mimba

• Hysterectomy - m'mimba - kutulutsa
• Hysterectomy - laparoscopic - kutulutsa
• Hysterectomy - ukazi - kutulutsa
• Kutulutsa kwapakati - kutulutsa

• Ziphuphu zam'mimba
• Matupi achikazi oberekera
• D ndi C
• Zolemba za Endometrial
• Kutsekemera
• Chiberekero
• Khansa ya Endometrial

Armstrong DK. Khansa ya amayi. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: mutu 189.

[Adasankhidwa] Boggess JF, Kilgore JE, Tran AQ. Khansara ya chiberekero. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 85.

Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Khansa ya Endometrial. Lancet. 2016; 387 (10023): 1094-1108. (Adasankhidwa) PMID: 26354523 pubed.ncbi.nlm.nih.gov/26354523/.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya Endometrial treatment (PDQ) -ukadaulo waukadaulo. www.cancer.gov/types/uterine/hp/endometrial-kuchiza-pdq. Idasinthidwa pa Disembala 17, 2019. Idapezeka pa Marichi 24, 2020.

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala a NCCN mu oncology (malangizo a NCCN): zotupa m'mimba. Mtundu 1.2020. www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Idasinthidwa pa Marichi 6, 2020. Idapezeka pa Marichi 24, 2020.