Tumors of the female organs of the reproductive system are very common in the gynecological area. Similar pathologies represent a fairly large group of diseases.
Adenocarcinomas can form in the uterine neck, endometrium, or in the tissues of the ovaries from the cellular structures that produce secretion of mucosal secretions.
Concept and statistics of the disease
The adenocarcinoma of the uterine body or the cervical canal is a tumor formed from abnormal cellular structures of the glandular tissue.
Similar tumoral processes most often affect the uterine base and can develop asymptomatically for a long time.
When the adenocarcinoma spreads through the low-tidal organs, the patients begin to have lumbar pains and increase the abdomen volume, there are abnormal vaginal discharge and nonspecific oncosimptomatics.
Most often adenocarcinomas are formed in postmenopausal women( for 50).
Uterine adenocarcinoma refers to hormone-dependent tumors.
The glandular tissue of the inner uterine layer undergoes rebirth and abnormal growth with a background of changes in the level of steroid sex hormones.
When the estrogen level is increased, the cellular structures of the endometrial layer grow abnormally, which significantly increases the likelihood of the onset of the tumor process.
The occurrence of uterine adenocarcinoma can be triggered by factors:
- Anovulation - when the mature egg does not go out in the middle of the cycle;
- Infertility of caused by organic reproductive disorders;
- Premature menarche - when menstruation begins at an early age of 12 years or later the onset of menopause. This factor is due to the fact that with prolonged menstruation, the woman prolongs the estrogenic effect on the endometrial uterine layer, as a result the risk of oncological processes is significantly increased;
- Failures of the cycle associated with ovulation suppression accompanied by reduced progesterone and elevated estrogen;
- Obesity - it is proved that fatty tissue is capable of producing estrogen hormones;
- Absence of genera - in women who have not given birth, the likelihood of developing the cancer of the uterine body increases manifold;
- Hormone therapy - on the duration and dosage of drugs depends on the likelihood of development of oncology;
- Benign hormone producing tumor processes in the ovaries ;
- Ovarian polycystic;
- Hypertensive disease;
- Long-term treatment with Tamoxifen , for example, in the treatment of malignant tumors in the dermis-iron tissues;
- Hereditary predisposition;
- Other pathologies of the uterus.
To provoke uterine adenocarcinoma can also carcinogenic factors like activity at the enterprises with the raised harmfulness, pernicious habits, unhealthy food( fast food, fatty products, abusing meat, etc.).
Usually symptomatic signs of adenocarcinoma of the uterus begin to manifest themselves in the second stage of the oncology process, when the lesion extends to the cervical canal( cervix).
In women capable of childbearing, the development of adenocarcinoma can be manifested by abnormally long monthly as well as uterine bleeding in the intervals between menstruation. The most prone to this oncology of women in menopausal age, so the main manifestation of the disease in these patients is the sudden resumption of menstruation after a long absence.
In general, for the uterine adenocarcinoma, typical manifestations are:
- Aching sensation on the lower part of the waist and abdomen, permanent character;
- Cycle failure;
- Uncaused abdominal growth;
- Abundant menstrual bleeding;
- The presence of uterine and vaginal bleeding in women at menopausal and postmenopausal ages;
- Pain during and after sexual intercourse;
- Frequent causeless minor temperature increases;
- Sleep problems and irritability;Excessive fatigue and lack of performance.
When oncology extends beyond the uterine boundaries, patients complain of pain in the perineal region, which become more intense with urination, sexual contact, or defecation. Also after sexual intercourse, vaginal bleeding becomes pronounced.
The uterine cervix adenocarcinoma is relatively rare in 10% of cases, and the remaining 90% of cervical cancer is a squamous cell form of tumors.
Adenocarcinoma is formed from mucus-producing cells, and can be endophytic or exophytic in nature.
In endophytic character, the spread of the tumor process occurs due to deepening into the cervical canal towards the uterine body. When exophytic, the growth of the tumor process is directed to the vagina.
A similar oncology is detected by performing a Pap test or a Pap test, which is a study of a swab from the uterine neck for the presence or absence of cancer cells.
Often, pathology develops secretly, so a timely Pap test often allows you to detect oncology at an early stage of development.
The adenocarcinoma of the uterine body is a malignant tumor that forms from the mucous and muscular tissues of the uterus.
In essence, such education is a hormone-dependent malignant tumor. Slightly more than half of cases of such a cancer is characterized by localization on the uterine day, much less often the tumor process is located on the uterine neck or on the entire cavity of the organ.
With the oncology development, the area of the lesion is gradually expanding due to the spread of cancer to neighboring cellular structures. As a result, the body and cervix of the uterus, the tubes and ovaries, surrounding the uterus of the tissue, lymph nodes and lymphatic pathways can simultaneously be involved in the oncology process.
Similar oncology is found mainly in premenopausal age, and is diagnosed by histological examination of scrapes from the uterine neck.
There are 4 stages of development of uterine adenocarcinoma:
- In the first stage, tumor processes are localized in the uterine body;
- In the second stage, the cancer spreads to the cervical canal;
- In the third stage, the tumor affects the surrounding cellulose, metastasis occurs in the regional lymph nodes, vagina;
- In the fourth stage, the tumor process extends far beyond the borders of the low-tidal organs, can germinate into the urinary or intestinal tissues, and distant metastasis also appears.
Adenocarcinoma differs in different levels of cellular differentiation: a highly differentiated, moderately differentiated and low-differentiated form of the oncological process.
A similar form of uterine adenocarcinoma is characterized by the fact that its malignant and abnormal cellular structures practically do not differ from normal healthy cells of the uterus.
This type of cancer is often characterized by a superficial distribution in the myometrium layer.
If the highly differentiated adenocarcinoma does not go beyond the limits of the myometrium, the probability of its metastasis is only 1%.
Uterine adenocarcinoma of moderate differentiation is characterized by a high diversity of abnormally altered cellular structures.
The development and distribution of such a variety of oncogenesis is almost identical to the highly differentiated adenocarcinoma.
This form of uterine adenocarcinoma differs only in that a much larger number of cells are involved in the oncological process.
Similar adenocarcinoma is characterized by a higher severity of lesion. It is characterized by a high risk of developing all kinds of complications and side pathological processes. Cancer spreads with a lymph flow into the low-tidal lymph nodes.
Metastasis by lymphogenesis is observed in 9% of cases of moderately differentiated adenocarcinoma. And in young patients up to 30 metastasis is not observed at all.
Adenocarcinoma of low differentiation is the third stage of uterine cancer, in terms of histological parameters.
For this form of uterine cancer, there is a pronounced polymorphism of cellular structures. Such a cancer is characterized by a high degree of malignancy, manifested in the rapid and large-scale formation of abnormally altered tissues.
This type of cancer has a minimally favorable outcome, because the likelihood of regional lymph node metastasis is almost inevitable.
Specialists classify adenocarcinoma into several varieties:
- Endometrioid is the most common uterine oncopathology, accounting for about 75% of cancers. Such a tumor grows into the myometrium layer only superficially, therefore, if detected at the initial stages, it is characterized by positive prognostic data;
- Squamous cell - is formed mainly from squamous cell structures, is very rare, usually develops against the background of cervical cancer;
- The papillary form of is a tumor formed from a combination of papillate growths( papillomas), so it looks similar to cauliflower.
The diagnostic process involves a gynecological examination using instrumental and laboratory testing.
The simplest diagnostic technique is a biopsy, however, it is characterized by low informativeness at the onset of the oncological process.
The probability of detecting oncology at the initial stages using aspiration biopsy is about 50%.
If suspicious manifestations were detected during screening, then ultrasound examination of low-tidal organs is prescribed.
A special place in the diagnostic process is given to the method of hysteroscopy. For this purpose, a hysteroscope is inserted into the uterus, through which the research is carried out, as well as the sampling of the material, which is further investigated by the method of histology.
Often resorted to scraping the uterine cavity in order to conduct a microscopic examination of the resulting biomaterial in the future.
The greatest therapeutic effect is different treatment, involving the removal of the uterus and appendages followed by a course of radiotherapy and chemotherapy.
With uterine adenocarcinoma, pantheisterectomy or extirpation is used. Rehabilitation postoperative period takes about 1-2 months.
The first day after an operation, a woman may experience some soreness and discomfort, a constant feeling of fatigue and weakness, may be disturbed by problems with stool and urination, and vomiting and vomiting.
Radiation treatment for uterine adenocarcinoma is used before and after surgery. Irradiation can be carried out remotely or by means of brachytherapy, when a special cylinder is placed in the uterus, from which the radiation emanates.
Sometimes after surgery, chemotherapy is prescribed. If the adenocarcinoma is inoperable, then radiation and chemotherapy act as the main treatment techniques.
Chemotherapeutic treatment is carried out with preparations like:
- 5-Fluorouracil, etc.
Because adenocarcinoma is considered a hormone-dependent tumor, it is often used hormone therapy, aimed at reducing the level of estrogen hormones.
Prognosis and prophylaxis of
The prognosis for uterine adenocarcinoma is considered the most positive if the oncology process was diagnosed at the initial stage of development.
In addition, favorable predictions have highly differentiated adenocarcinomas of , which were promptly operated and do not have metastases.
- Practice shows that at the first stage of the oncology process the probability of complete recovery of the patient is maximally great after an operative intervention with subsequent radio and chemotherapy. Within a year the patient will be able to live the same life. The chances of a final recovery in patients reach 90%.
- In the second stage, treatment, like predictions, is more complex. It is necessary to remove the uterus, why a woman loses the ability to give birth. Recovery will take a long time, however, even after it a normal healthy state of the body is still not achieved. The probability of recovery is about 75%.
- In the third stage of uterine cancer, the predictions are mostly unfavorable, as there is extensive metastasis, which forces to remove part or all of the vagina. Survival does not exceed 50%.
- And in the fourth stage of the disease the question is already being put in relation to preserving the life of the cancer patient. The probability of a fatal outcome during the first Five-Year Plan at the stage of metastasis is about 10-20%, but the final parameters depend on the size and metastasis of oncoforming.
There is no specific prophylaxis for uterine adenocarcinoma, therefore the chance of avoiding uterine cancer is increased if a woman follows several recommendations:
- It is recommended to undergo an annual( ideally - every six months) gynecological examination;
- Periodically conduct ultrasound examination of low-tidal organs;
- Correct endocrine disorders;
- In time to treat premalignant pathologies of the uterine body and cervix;
- Healthy food, excluding carcinogens, fast food, chemical additives, fatty foods, etc.;
- Moderate daily exercise that promotes weight control;
- In the presence of obesity, it is necessary to take measures to normalize weight;
- Adequate treatment of diabetes and hypertension.
If a woman among blood relatives has cases of oncology of the breast, uterus, ovaries or cervix, then she should be especially attentive to the health of these organs, because she is more at risk of being among oncopacycles.
In addition, it is necessary to timely and fully treat infectious and inflammatory pathologies of the reproductive system.
Video on laparoscopic surgery for cervical cancer: