Fat Girl Beware Of Endometrial Cancer What tests to do to prevent endometrial cancer

As one of the three common tumors of the female reproductive tract, the incidence of endometrial cancer has an increasing trend, especially in obese women, and has become an "epidemic". Experts point out that many patients with endometrial cancer have obesity, hypertension or diabetes at the same time. Therefore, obese women should be especially vigilant against endometrial cancer, in addition to losing weight as soon as possible to get rid of the title of "high-risk group", they should also go to the gynecology department regularly for relevant examinations.

Endometrial cancer, also known as uterine body cancer, is commonly occurring at an age of 58~61 years old.As one of the three common tumors of the female reproductive tract, the incidence of endometrial cancer has an increasing trend, especially in obese women, and has become an "epidemic". Experts point out that many patients with endometrial cancer have obesity, hypertension or diabetes at the same time. Therefore, obese women should be especially vigilant against endometrial cancer, in addition to losing weight as soon as possible to get rid of the title of "high-risk group", they should also go to the gynecology department regularly for relevant examinations.

What tests are done to prevent endometrial cancer?

For endometrial cancer, cytology from uterine cavity specimens can greatly improve the positive rate, which can usually be about 96% higher than the shutter, which is not lower than the positive rate of Pap smear for cervical cancer.

1. Uterine ultrasonography by B-ultrasound examination has certain significance for endometrial cancer in the size and location of the uterine cavity, the degree of muscle invasion, whether the tumor penetrates the uterine serosa or whether it involves the cervical canal, etc., and its diagnostic coincidence rate is 79. 3～81。 82%。 It has been reported that the accuracy of ultrasound in patients over 45 years of age and compared with hysteroscopy and biopsy is about 87%. In addition, Xie Yanggui et al. performed B-ultrasound examination according to the UICC staging method, according to the tumor location, muscle immersion, parauterine and adjacent organ involvement, and surgical exploration and pathological control, and its staging coincidence rate was 92. 9%。 B-ultrasound is one of the routine examinations for endometrial cancer, as it has no creative and radiological damage to patients. In particular, it has certain reference value in understanding muscle invasion and clinical staging.

2. Diagnostic curettage and curettage is an indispensable method for diagnosis. It is necessary to determine not only whether it is cancer, but also where it grows. If cervical adenocarcinoma is misdiagnosed as endometrial cancer, it is obviously inappropriate to treat it as general hysterectomy; It is also not advisable to treat endometrial cancer as adenocarcinoma of the cervix. However, microscopic examination does not distinguish between adenocarcinoma of the cervix and endometrial. Therefore, segmented curettage is required. First, use a small curette to scrape the internal tissues of the cervical canal, and then enter the noisy cavity to scrape the tissues of the horns on both sides of the uterus and the anterior and posterior walls of the uterine body, which are respectively bottled and labeled and sent for pathological examination. If there is resistance to the internal orifice, the cervix can be dilatated to No. 5 slightly. Segmented curettage is often slightly too deep when scraping the cervical canal, mistaking the contents of the uterine cavity for cervical canal cancer; or endometrial cancer perpendiculating into the cervical canal, which is mistaken for cervical canal cancer or uterine corpus cancer involving the cervical canal; Or it was originally cervical canal cancer, with too much cancerous tissue, and when the small curette entered the uterine cavity, it brought in a little cervical cancer tissue and mistakenly recognized that the cervical cancer had reached the uterine cavity. All kinds of conditions indicate that the lesion is late, and it should be treated according to the scope of cervical cancer surgery.

3. Due to the application of fiber light source and the modification of uterine bulking agent, hysteroscopy, which has been stagnant early, has developed again in recent years. CO2 gas swells, the field of vision is clear, and it is safe to use under the flowmeter device. Hysteroscopy can not only observe the uterine cavity, but also observe the cervical canal, especially the microscopic uterine cavity, and can also observe the cervical canal, especially the application of microhysteroscopy, the observation can be more detailed. In recent years, the contact hysteroscopy has been developed, which does not require uterine distension, making the examination easier and safer.Hysteroscopy can observe the location, size, boundaries of the cancer, whether it is localized or diffuse, whether it is exophytic or endophytic, and whether the cervical canal is involved. Biopsy of suspicious lesions can help detect smaller or early lesions. The accuracy of hysteroscopy in diagnosing endometrial cancer was 94%, and that of endometrial epithelioma was 92%. If direct biopsy is used, the accuracy rate is 100%. During microscopic examination, care should be taken to prevent complications such as bleeding, infection, and perforation.

4. Retroperitoneal lymphogram can confirm whether there is metastasis of pelvic and para-aortic lymph nodes, so as to facilitate the decision of treatment plan. In stage I and II., the positive rate of pelvic lymph nodes was 10, respectively. 6% and 36. 5%。

5. Computerized tomography (CT) and magnetic resonance imaging (MRI) CT has a certain value in the diagnosis of endometrial cancer, the CT scan image is clear, the fine structure of the tissue can be accurately described, the size and scope of the tumor can be accurately measured by CT, and 83% of the patients with uterine wall tumor limitation can determine the lesion stage. CT can also identify uterine tumor metastases to peripheral connective tissues, pelvic and para-aortic lymph nodes, pelvic wall, and peritoneal metastases. In particular, in obese women, the examination is preferred to ultrasonography.NRI is a three-dimensional scan, which is superior to CT*two-dimensional scan) and can be traced for stage I.a membrane cancer. It can also trace the breadth of lesion infiltration from the endometrium to the myometrium, that is, it is manifested as an irregular hyperintense endometrial thickening area, and a hypointensity disappearance to the connecting area between the myometrium. The overall diagnostic accuracy of MRI is 88%, and it can accurately determine the degree of muscle invasion (radiotherapy is not accurate), so as to accurately estimate the tumor stage. For minor pelvic metastases and lymph node metastases, MRI diagnosis is not ideal.

What are the early symptoms of endometrial cancer?

Very early patients may be asymptomatic and may be found only incidentally during a screening or other gynecological examination. Once symptoms appear, they usually manifest as:

(1) Uterine bleeding: Irregular vaginal bleeding before and after menopause is the main symptom of endometrial cancer, which is often small to moderate bleeding and rarely heavy bleeding. It's not just younger or near-menopausal patients who are prone to misthinkingIrregular menstruation, not seeing a doctor in time, even doctors are often negligent. There are also some people who have delayed menstrual cycles, but the manifestations are irregular. Postmenopausal patients often present with persistent or intermittent vaginal bleeding. Patients with endometrial cancer generally do not have contact bleeding. Late bleeding may be mixed with rotten flesh-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 leucorrhea in the early stage, but in the later stage, infection and necrosis occur, a large amount of foul-smelling pus and blood-like fluid is discharged. Sometimes the discharge can contain small fragments of cancerous tissue. If there is empyema in the cervix, it can cause fever, abdominal pain, and leukocytosis. The general situation is also rapidly deteriorating.

(3) Pain: due to the stasis of cancer and its bleeding and discharge, it stimulates the irregular contraction of the uterus and causes paroxysmal pain, accounting for about 10~46%. This symptom is more likely to occur in an advanced stage. If the cancerous tissue penetrates the serous membrane or erodes the parauterine connective tissue, bladder, straightening or compressing other tissues, it can also cause pain, which is often refractory and progressively worsening; It mostly radiates from the lumbosacral region and lower abdomen to the thighs and knees.

(4) Others: In advanced disease, the enlarged uterus or/or adjacent tissues and organs in the lower abdomen can be palpable, which can cause swelling and pain in the lower limbs on the side, or compress the ureter, causing hydroureteral hydroureters or kidney atrophy on the side; or anemia, weight loss, fever, cachexia and other manifestations of systemic failure.