子宫肉瘤
Endometrial cancer is the most commonly diagnosed gynecologic cancer. 关于 50,000 American women are diagnosed with the disease every year. Endometrial cancer is also the most common form of uterine cancer, 所以它经常被称为子宫癌.
你需要知道的
- Endometrial cancer starts in the lining of the uterus — the endometrium.
- Being overweight or obese greatly increases a woman’s chance of developing endometrial cancer. 其他风险因素包括年龄, 家族病史, a diagnosis of polycystic ovary syndrome and prior use of the 乳腺癌 treatment drug tamoxifen.
- 症状包括阴道异常出血, 性交疼痛, 排尿困难或疼痛, 骨盆疼痛.
- 早期发现子宫内膜癌是很容易治愈的.
什么是子宫内膜癌?
子宫的内膜称为子宫内膜. Cancer of the endometrium is the most common cancer of the female reproductive organs.
Cancer of the endometrium is different from cancer of the connective tissue or muscle of the uterus, 哪个叫子宫肉瘤. 大约80%的子宫内膜癌是腺癌. This means the cancer occurs in the cells that develop the glands in the endometrium. 早期发现子宫内膜癌的治愈率很高.
子宫癌肉瘤是一种非常罕见的子宫癌, with characteristics of both endometrial cancer and uterine sarcoma. 它也被称为恶性混合中胚层肿瘤.
子宫内膜癌的类型
Endometrial cancers are usually grouped into one of four categories:
- p53基因突变
- 极突变
- 拷贝数高
- 拷贝数低
Clinical trials are being used to assess treatments for cancers found within each of these groups, 包括新的免疫疗法试验.
子宫内膜癌预防
子宫内膜癌的确切病因尚不清楚. 然而, doctors believe that avoiding the known risk factors when possible, using oral contraceptives or other forms of hormonal birth control, controlling obesity and controlling diabetes are the best ways to lower the risk of developing endometrial cancer.
子宫内膜癌的病因和危险因素
The following factors may increase a woman’s risk of developing endometrial cancer:
- 肥胖
- 动物脂肪含量高的饮食
- 子宫内膜癌、卵巢癌和/或结肠癌家族史 (遗传性非息肉病性结直肠癌)
- 12岁前开始月经
- 绝经后期
- 不孕(不能怀孕)
- 没有孩子
- 用他莫昔芬治疗乳腺癌
- Hormonal imbalance — having too much estrogen and not enough progesterone
- Estrogen replacement therapy for treatment of effects of menopause
- 糖尿病
- 个人经历 乳腺癌
- 个人经历 卵巢癌
- 盆腔癌的放射治疗史
- 个人经历 polycystic ovary syndrome or atypical endometrial hyperplasia
The risk for endometrial cancer increases as women get older, and it is most common in white women.
子宫内膜癌症状
Consult a doctor if you experience any/all of the following symptoms:
- Bleeding or discharge not related to your periods (menstruation) — over 90 percent of women diagnosed with endometrial cancer have abnormal vaginal bleeding
- 绝经后出血
- 排尿困难或疼痛
- 性交疼痛
- 骨盆疼痛和/或肿块
子宫内膜癌诊断
Diagnosis of endometrial cancer includes a review of your medical history and a general physical exam. 它还可以包括以下一个或多个内容.
- 盆腔内检查: This is done to feel for any lumps or changes in the shape of the uterus.
- 巴氏早期癌变探查试验 (亦称子宫颈抹片检查): This test involves microscopic exam of cells collected from the cervix, used to detect changes that may be cancer or may lead to cancer and to show noncancerous conditions, 比如感染或炎症. 然而，巴氏试验不能检测子宫内膜癌.
- 子宫内膜活检:本程序使用小, flexible tube that is put into the uterus to collect an endometrial tissue sample. The sample is examined under a microscope to see if cancer or other abnormal cells are present. An endometrial biopsy procedure is often done in a doctor’s office.
- 扩张和刮宫 (也叫D)&C)你的医生可能会建议你服用D&C if an endometrial biopsy is not possible or if further diagnostic information is needed. This is a minor operation in which the cervix is dilated (opened) so that the cervical canal and uterine lining can be scraped with a curette (spoon-shaped instrument). 病理学家检查组织是否有癌细胞.
- 经阴道超声 (也叫超声检查): This ultrasound test uses a small instrument, called a transducer, which is placed in the vagina. 如果子宫内膜看起来太厚，医生可能会做活检.
子宫内膜癌的治疗
Specific treatment for endometrial cancer will be determined by your doctor(s) based on:
- 你的整体健康和病史
- 疾病的范围
- Your tolerance for specific medications, procedures or therapies
- 对疾病病程的预期
- 你的意见或偏好
The choice of treatment depends on the stage of cancer — whether it is only in the endometrium, 或者如果它已经扩散到子宫或身体的其他部位. 大多数人会先接受手术治疗. 有些人可能需要额外的治疗. Generally, treatment for people with cancer of the endometrium includes one or more of the following.
- 手术:
- 子宫切除术 -手术切除子宫
- 输卵管卵巢切除术 -切除输卵管和卵巢的手术
- 盆腔淋巴结清扫术 -从骨盆切除一些淋巴结
- Para-aortic淋巴切除术 — removal of lymph nodes that surround the aorta, the main artery of the heart
- 腹腔镜淋巴结取样 — removal of lymph nodes through a narrow viewing tube called a laparoscope, which is inserted through a small incision (cut) in the abdomen (belly)
- 前哨淋巴结测图 — use of fluorescent imaging to identify potentially cancerous lymph nodes that would otherwise go undetected
- 放射治疗: the use of X-rays, gamma rays and charged particles to fight cancer. Brachytherapy and external beam radiation are the most common radiation therapies used to treat endometrial cancer. Novel techniques in image-based brachytherapy with directed magnetic resonance (MR) guidance offer better patient outcomes and fewer side effects.
- 化疗使用抗癌药物治疗癌细胞
- Immunotherapy: the process of activating the immune system’s natural ability to fight cancer
- 激素疗法: medication or surgical procedures that interfere with hormone activity
肥胖与癌症风险
Did you know that up to one-third of cancer deaths in women are attributed to excess body weight? Director of Gynecologic Oncology Amanda Fader and oncology dietitian Mary-Eve Brown discuss the correlation between the two. 了解你可以做些什么来降低风险.
