Maʻi ʻaʻai Endometrial

ʻO ka maʻi ʻaʻai endometrial ka maʻi ʻaʻai e hoʻomaka i ka endometrium, ka uhi o ka ʻōpū (ʻōpū).

ʻO ka maʻi ʻaʻai endometrial ka ʻano maʻamau o ka maʻi ʻaʻai uterine. ʻAʻole ʻike ʻia ke kumu kikoʻī o ka maʻi ʻaʻai endometrial. Hiki i ka hoʻonui ʻia o ka pae o ka estrogen hormone ke hana i kahi kuleana. Hoʻoulu kēia i ke kūkulu ʻana o ka uhi o ka kōpū. Hiki i kēia ke alakaʻi i ka ulu nui ʻole o ka endometrium a me ka maʻi ʻaʻai.

Loaʻa ka hapa nui o nā maʻi ʻaʻai endometrial ma waena o nā makahiki o 60 a me 70. Hiki paha i kekahi mau hihia ma mua o 40 mau makahiki.

ʻO nā kumu aʻe e pili ana i kāu mau hormones hoʻonui i kou makaʻu no ka maʻi kanesa endometrial:

• ʻO Estrogen replacement therapy me ka hoʻohana ʻole o progesterone
• Mōʻaukala o endometrial polyps
• Nā manawa pinepine ʻole
• ʻAʻole hāpai
• Ka momona
• Diabetes
• ʻO Polycystic ovary Syndrome (PCOS)
• Ke hoʻomaka nei i ka menstruation i ka wā ʻōpio (ma mua o ka makahiki 12)
• Ke hoʻomaka nei i ka menopause ma hope o ka makahiki 50
• ʻO Tamoxifen, kahi lāʻau i hoʻohana ʻia no ka mālama ʻana i ka maʻi ʻaʻai umauma

ʻO nā wahine me nā kūlana aʻe e like me ka nui o ka makaʻu no ka maʻi kanesa endometrial.

• Kolone a i ʻole ka maʻi ʻaʻai umauma
• Maʻi maʻi gallbladder
• Piʻi koko kiʻekiʻe

Nā ʻōuli o ka maʻi ʻaʻai endometrial pū kekahi:

• ʻO ke kahe kūpono ʻole mai ka ʻōpala, me ke kahe ʻana ma waena o nā wā a i ʻole ke kiko / kahe ʻana o ke kahe ma hope o ka menopause
• ʻO ka lōʻihi loa, kaumaha, a i ʻole nā ​​manawa pinepine o ke kahe ʻana o ka maʻi ma hope o ka makahiki 40
• ʻO ka ʻeha o ka ʻōpū haʻahaʻa a i ʻole ke pelvic cramping

I ka wā mua o ka maʻi, maʻamau pinepine kahi hōʻike pelvic.

• I nā pae holomua, aia paha nā loli i ka nui, ke ʻano, a i ʻole ke ʻano o ka uterus a i ʻole nā ​​hale e pili ana.
• Pap smear (hiki ke hāpai i kahi kānalua no ka maʻi ʻaʻai endometrial, akā ʻaʻole ia e hōʻike iā ia)

Ma muli o kāu mau hōʻailona a me nā hopena ʻē aʻe, pono ʻia nā hoʻokolohua ʻē aʻe. Hiki i kekahi ke hana i kāu keʻena mālama ola. Hana ʻia nā mea ʻē aʻe i kahi haukapila a i ʻole kahi kikowaena.

• ʻO ke biopsy endometrial: Ke hoʻohana nei i kahi catheter liʻiliʻi a lahilahi paha (Tube), lawe ʻia nā mea mai ka uhi o ka uterus (endometrium). Nānā ʻia nā hunaola ma lalo o kahi microscope e ʻike ai inā he ʻano ʻokoʻa a maʻi ʻaʻai paha kekahi.
• Hysteroscopy: Hoʻokomo ʻia kahi mea like teleskopa lahilahi ma o ka ʻōpū a me ka wehe ʻana o ka cervix. Hiki iā ia ke nānā i ka mea hāʻawi i loko o ka kōpū.
• Ultrasound: Hoʻohana ʻia nā hawewe kani e hana i kiʻi o nā pelvic. Hana ʻia paha ka ultrasound ma ka ʻōpū a i ʻole ka huehue. Hiki i kahi ultrasound ke hoʻoholo inā ʻike ʻia a lahilahi ʻia ka uhi o ka uterus.
• Sonohysterography: Hoʻokomo ʻia ka wai i loko o ka kōpū ma o kahi puʻupuʻu lahilahi, ʻoiai e hana ʻia nā kiʻi ultrasound keu o ka uterus. Hiki ke hana i kēia kaʻina hana e hoʻoholo ai i ka loaʻa ʻana o kahi nui o ka nui o nā uterine i hōʻike ʻia i ka maʻi ʻaʻai.
• Mākēneki resonance kiʻi (MRI): I kēia hōʻike kiʻi, hoʻohana ʻia nā mākēneki mana e hana i nā kiʻi o nā mea kūloko.

Inā loaʻa ka maʻi ʻaʻai, hana ʻia paha nā hoʻokolohua kiʻi ʻana inā ʻike ʻia ua pālahalaha ka maʻi ʻaʻai i nā ʻāpana ʻē aʻe o ke kino. Kāhea ʻia kēia.

ʻO nā pae o ka maʻi ʻaʻai endometrial nā:

• Kahua 1: Aia wale ka maʻi ʻaʻai i ka kōpū.
• Kahua 2: Aia ka maʻi ʻaʻai i loko o ka kōpū a me ka cervix.
• Kahua 3: Ua pālahalaha ka maʻi ʻaʻai ma waho o ka kōpū, akā ʻaʻole ma ʻō aku o ka wahi pelvis maoli. Hiki paha i ka maʻi ʻaʻai ke hoʻopili i nā lymph nodes i ke pelvis a i ʻole kokoke i ka aorta (ke aʻa nui i loko o ka ʻōpū).
• Kahua 4: Ua pālahalaha ka maʻi ʻaʻai i ka ʻili o loko o ka ʻōpū, ʻōpū, ʻōpū, a i ʻole nā ​​mea ʻē aʻe.

Hoʻohālikelike ʻia ka maʻi ʻaʻai ma ka papa 1, 2, a i ʻole 3. ʻO ka papa 1 ka mea liʻiliʻi loa, a ʻo ka papa 3 ka mea ikaika loa. Aggressive ʻo ia hoʻi, ulu ka maʻi ʻaʻai a laha koke.

Nā koho lapaʻau e:

• ʻOki kino
• Lapaʻau hoʻomākala
• ʻO Chemotherapy

ʻO ke kaha e wehe i ka uterus (hysterectomy) hiki ke hana ʻia i nā wahine me ka maʻi kanesa pae mua 1. Hiki i ke kauka ke wehe i nā ohe a me nā ovaries.

ʻO ke kīʻaha hui pū ʻia me ka radiation therapy kekahi koho lapaʻau ʻē aʻe. Hoʻohana pinepine ʻia ia no nā wahine me:

• ʻO ka maʻi maʻi 1 kahi manawa kūpono e hoʻi, ua laha i nā lymph node, a i ʻole he papa 2 a 3 paha
• Maʻi pae 2

Chemotherapy a i ʻole hormonal therapy e noʻonoʻo ʻia i kekahi mau hihia, pinepine no ka poʻe me ka maʻi pae 3 a me 4.

Hiki iā ʻoe ke hoʻomāmā i ke koʻikoʻi o ka maʻi ma ke komo ʻana i kahi hui kākoʻo maʻi ʻaʻai. ʻO ke kaʻana ʻana me nā poʻe ʻē aʻe i loaʻa nā ʻike a me nā pilikia maʻamau e hiki ke kōkua iā ʻoe e noʻonoʻo ʻole.

Hoʻomaopopo pinepine ʻia ka maʻi ʻaʻai Endometrial i kahi wā mua.

Inā ʻaʻole i pālahalaha ka maʻi ʻaʻai, 95% o nā wahine e ola nei ma hope o 5 mau makahiki. Inā ua pālahalaha ka maʻi ʻaʻai i nā lālā mamao, ma kahi o 25% o nā wahine e ola nei ma hope o 5 mau makahiki.

Pākuʻi ʻia paha i kekahi o kēia mau mea:

• Anemia ma muli o ke kahe o ke koko (ma mua o ka hōʻailona)
• Perforation (hole) o ka uterus, hiki ke hana ʻia ma kahi D a C a i ʻole biopsy endometrial
• Nā pilikia mai ke ʻoki, radiation, a me ka chemotherapy

Kāhea i kahi manawa me kāu mea hāʻawi inā loaʻa iā ʻoe kekahi o kēia mau mea:

• Kekahi kahe ʻana o ke kahe a i ʻole ke kiko ʻana ma hope o ka hoʻomaka o ka menopause
• Kahe ʻana a i ʻole ke kiko ʻana ma hope o ka moekolohe a douching paha
• ʻOi aku ka lōʻihi o ke kahe ʻana ma mua o 7 mau lā
• Kūlohelohe pōʻaiapuni i kū i ʻelua mau manawa i kēlā me kēia mahina
• Hoʻokuʻu hou ma hope o ka hoʻomaka ʻana o ka menopause
• ʻEha pelvic a i ʻole cramping i hele ʻole

ʻAʻohe hōʻike loiloi maikaʻi loa no ka maʻi ʻaʻai endometrial (uterine).

ʻO nā wahine me nā kumu pilikia no ka maʻi ʻaʻai endometrial e ukali pono ʻia e kā lākou kauka. Hoʻopili kēia i nā wahine e lawe nei:

• Estrogen replacement therapy me ka ʻole o ka progesterone therapy
• ʻO Tamoxifen no 2 mau makahiki

ʻO nā hoʻokolohua pelvic pinepine, Pap smear, nā ultrasound vaginal, a me ka biopsy endometrial e noʻonoʻo ʻia i kekahi mau hihia.

Hoʻemi ʻia ka makaʻu no ka maʻi ʻaʻai endometrial e:

• Mālama i kahi kaupaona maʻamau
• Ke hoʻohana nei i nā pila hoʻomalu hānau ma mua o hoʻokahi makahiki

Endometrial adenocarcinoma; Uterine adenocarcinoma; Maʻi ʻaʻai Uterine; Adenocarcinoma - endometrium; Adenocarcinoma - kōpū; Maʻi ʻaʻai - uterine; Kanesa - endometrial; Ka maʻi ʻaʻa ʻula kōpū

• Hysterectomy - ʻōpū - hoʻokuʻu
• Hysterectomy - laparoscopic - hoʻokuʻu
• Hysterectomy - heʻe - hoʻokuʻu
• Pāhawewe pelvic - hoʻokuʻu

• Pelvic laparoscopy
• Anatomia hānau wahine
• D a me C
• ʻO ka biopsy endometrial
• Hysterectomy
• Uterus
• Maʻi ʻaʻai Endometrial

ʻO Armstrong DK. Maʻi ʻalā Gynecologic. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 189.

ʻO Boggess JF, Kilgore JE, Tran A-Q. Maʻi ʻaʻai Uterine. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 85.

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

Pūnaewele ʻo National Cancer Institute. Hoʻomaʻamaʻa maʻi ʻaʻai Endometrial (PDQ) - mana ʻoihana olakino. www.cancer.gov/types/uterine/hp/endometrial-treatment-pdq. Hoʻohou i Kēkēmapa 17, 2019. Loaʻa iā Malaki 24, 2020.

Pūnaewele Pūnaewele Manuahi Manuahi. Nā kulekele hana lapaʻau NCCN i ka oncology (nā alakaʻi NCCN): nā neoplasms uterine. Mana 1.2020. www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Hoʻohou ʻia Malaki 6, 2020. Loaʻa iā Malaki 24, 2020.