Сancer of a body of a uterus at pregnancy RK Ministry of Health The Kazakh National Medical university of S. D. Asfendiyarov ҚР Денсаулық сақтау министрілігі С.Ж. Асфендияров атындағы Қазақ Ұлттық Медицина университеті On a subject: Еxecuted: Vansinvina Madina JM g Сhecked: Kaidarova A.B. Almaty 2013.

1.Uterine cancer definition 2.Causes and stages of development of endometrial cancer 3.The classification of cancer of the uterus 4.Symptoms of uterine cancer 5.Diagnosis of cancer of the uterus 6.Treatment of cancer of the uterus 7.The prognosis of cancer of the uterine body 8.Prevention of cancer of the uterus

Cancer of a body of a uterus – the most widespread malignant tumor of bodies of a small basin at women.

The cancer of a body of a uterus meets mainly at the age of years. Spotting allocations from sexual ways (90%) are usually noted; uterine bleedings (80%); plentiful vaginal allocations with slime impurity (10%). Uterine cancer ranks first among cancers of female genital mutilation, as in the structure of all female cancer pathology - an intermediate position between breast cancer and cervical cancer. The upward trend in the incidence of endometrial cancer in gynecology due in part to an increase in overall survival of women and of their time in postmenopausal women, as well as the rapid growth of frequency of such diseases as chronic giperestrogeniya, anovulation, infertility, uterine fibroids, endometriosis, etc. The most common uterine cancer develops in women of perimenopausal and postmenopausal (mean age years).

Causes and stages of development of endometrial cancer : In gynecological oncology etiology of cancer of the uterus is considered from the point of view of several hypotheses. One of them - the hormone binds the occurrence of cancer of the uterus with the manifestations giperestrogenii, endocrine and metabolic disorders, as noted in 70% of patients. Giperestrogeniya characterized by anovulatory cycles and bleeding, infertility, late menopause, hyperplastic and neoplastic processes in the ovaries and uterus. Hormone-dependent endometrial cancer is more common in patients with obesity, hypertension, diabetes, feminizing ovarian tumors, repeated interruptions of pregnancy receiving estrogen hormone replacement therapy, with family history of ovarian cancer, endometrial, breast, colon. Underlying conditions for uterine cancer are endometrial hyperplasia, uterine polyps.

The third hypothesis links the development of endometrial neoplasia with genetic factors. In the development of cancer of the uterus like the steps of: functional impairment (giperestrogenii, anovulation) morphological changes in the background (zhelezistokistoznaya hyperplasia, endometrial polyps) morphological pre-cancerous changes (atypical hyperplasia and dysplasia) malignant neoplasia

Metastasis of cancer of the uterus occurs by lymphatic, hematogenous, and an implantation method. When variant affects the lymphatic inguinal, iliac, para-aortic lymph nodes. In the case of hematogenous metastasis of tumor screenings are found in the lungs, bones and liver. Implantation spread of cancer of the uterus is possible with tumor invasion of the myometrium and perimetry, the involvement of the visceral peritoneum, omentum.

The classification of cancer of the uterus According to the histopathological classification of forms of cancer of the uterus secrete adenocarcinoma mezonefroidnuyu (clear cell) adenocarcinoma, squamous cell, serous, zhelezistoploskokletochny, mucinous, and undifferentiated carcinoma. By type of growth distinguishes endometrial cancer with exophytic, endophytic and mixed (endoekzofitnym) growth. According to the degree of cell differentiation uterine cancer may be highly differentiated (G1), moderately differentiated (G2) and poorly differentiated (G3). Most uterine cancer localized in the bottom, at least in the lower segment. In clinical oncology classification used by stage (FIGO) and the system of TNM, to assess the prevalence of the primary tumor (T), nodal involvement (N) and the presence of distant metastases (M).

Stage 0 (Tis) - pre-invasive cancer of the uterine body (in situ) Stage I (T1) - the tumor does not extend beyond the body of the uterus IA (T1a) - cancer of the uterus infiltrates less than half the thickness of endometrium IB (T1b) - uterine cancer invades half the thickness of the endometrium IC (T1s) - cancer of the uterus infiltrates bolee1 / 2 thickness of the endometrium Stage II (T2) - swelling goes to the cervix but does not extend beyond its borders IIA (T2a) - noted the involvement of the endocervical IIB (T2b) - cancer invades the stroma of the cervix Stage III (T3) - is characterized by local or regional spread of the tumor IIIA (T3a) - spread or metastasis of the tumor in the ovary or serosa, the presence of atypical cells in effusions or ascites rinse waters IIIB (T3b) - spread or metastasis of the tumor in the vagina IIIC (N1) - metastasis of cancer of the uterus in the pelvic or para-aortic lymph nodes Stage IVA (T4) - the spread of the tumor on the lining of the large intestine or bladder IVB stage (M1) - metastasis to lymph nodes and distant organs.

Symptoms of uterine cancer When preserved menstrual uterine cancer may manifest long heavy menstrual periods, irregular bleeding acyclic, in connection with which women may mistakenly treated for a long time about ovarian dysfunction and infertility. In postmenopausal patients having blood discharge scanty or abundant nature. In addition to bleeding, uterine cancer is often observed leucorrhea - copious watery liquid bleach, and in severe cases can have a color selection of meat slops or purulent, rotten ( putrid ) smell. Later symptoms of cancer of the uterus are pain in the abdomen, lower back and sacrum constant or colicky. Pain syndrome is marked with involvement onkoprotsessa serous membrane of the uterus, compression of the nerve plexus parametrial infiltration. When descending spread of cancer of the uterus in the cervix may develop cervical stenosis and pyometra. In the case of compression of the ureter tumor infiltration occurs hydronephrosis, accompanied by pain in the lower back, uremia, with tumor invasion into the bladder noted hematuria. With direct tumor invasion or sigmoid colon constipation occur, there is mucus and blood in the stool. The defeat of the pelvic organs is often accompanied by ascites. In advanced cancer of the uterine body often develops metastatic (secondary ) cancer of the lung, liver.

Diagnosis of cancer of the uterus Object diagnostic step is to establish a localization step of the process, the morphological structure and the degree of tumor differentiation. Gynecological examination to determine the increase in uterine size, presence of cancer parametrial infiltration and rectovaginal tissue, enlarged epididymis.

Pelvic ultrasound - an important diagnostic screening test for cancer of the uterine body. An ultrasound scan determines the size of the uterus, it outlines the structure of the myometrium, the nature of tumor, depth of tumor invasion, localization, metastatic processes in the ovaries and pelvic lymph nodes. With the aim of visual estimates of the prevalence of cancer of the uterus performed a diagnostic laparoscopy. To exclude distant metastasis of cancer of the uterus shows the inclusion in the survey ultrasound of the abdomen, chest X-ray, colonoscopy, cystoscopy, excretory urography, CT, urinary tract and abdominal cavity. In the diagnosis of endometrial cancer should be differentiated from endometrial polyps, endometrial hyperplasia, adenomatosis, submucosal myoma of the uterus.

Treatment of cancer of the uterus Treatment option for uterine cancer determined by the stage onkoprotsessa accompanying the background, pathogenic variant of the tumor. In cancer of the uterus gynecology applies methods of surgery, radiotherapy, hormonal, chemotherapeutic treatment. Treatment of primary cancer of the uterine body may include holding endometrial ablation - the destruction of the basal layer and be part of the myometrium. In other cases, shows pangisterektomiya resectable or extended hysterectomy with bilateral lymphadenectomy and salpingooforektomiey. In the formation of pyometra is held probing Gegara cervical dilators and the evacuation of pus. When invasion of the myometrium and the prevalence of cancer of the uterus in the postoperative radiation therapy is assigned to the vaginal area, pelvic area of regional metastasis. In the complex therapy of cancer of the uterus by indications include chemotherapy with cisplatin, doxorubicin, cyclophosphamide. Given the sensitivity of the tumor to hormone therapy treatments are assigned antiestrogens, progestins, estrogengestagennymi means. When conserving therapy of cancer of the uterus ( endometrial ablation ) further conducted the induction of the ovulatory menstrual cycle by using combined hormonal preparations.

Prevention of cancer of the uterus A set of preventive measures include the elimination of giperestrogenii: control of body weight and of diabetes, normalization of menstrual function, competent selection of contraception, early surgical removal of feminizing tumors, etc. Secondary prevention of cancer of the uterus is reduced to the timely identification and prolechivaniyu background and pre- cancerous proliferative diseases, conduct regular onkoskrininga all healthy women, surveillance of patients at risk for endometrial cancer.

List used literature: matki-rak-endometriyahttp:// matki-rak-endometriya 4.