First, the early symptoms of invasive carcinoma in situ and often without any symptoms, many found in the census. Cervical cancer is the main symptoms of vaginal bleeding, vaginal discharge, such as pain and more. Their performance in the form and extent of the disease and cervical cancer and pathology sooner or later have a certain type of relationship.
(A) the majority of vaginal discharge more patients with cervical cancer have different degrees of increased vaginal discharge. Since the early stimulation of the existence of cervical cancer gland secretion of hyperthyroidism, a mucus-like Leucorrhea, with the development of cancer, cancer tissue necrosis and loss of secondary infection, Leucorrhea variable opacity, such as Taomi Shui-like blood or pus-like, with Special stench.
(B) of irregular vaginal bleeding early Leucorrhea performance for a small amount of blood and sexual contact with vaginal bleeding, patients often have sexual intercourse or defecation after a small amount of vaginal bleeding to treatment. Of vaginal bleeding after menopause, should look for reasons. Cervical cancer is often very irregular vaginal bleeding, usually after the first few, less time for a long time. Cauliflower-bleeding early
, in Yiduo, advanced cancer erosion of large vessels, can cause fatal bleeding a lot. As a long-term repeated bleeding, often in patients with secondary anemia.
(C) pain for advanced cervical cancer symptoms. A pain reasons, mainly due to pelvic nerve infiltration by cancer or oppression. If the obturator nerve, the sacral nerve, vascular or pelvic wall involvement, it can cause severe pain, and sometimes radiation to the lower extremities. Other reasons for the pain: cervical cancer, was blocked, intrauterine secretions or poor drainage formation of intrauterine empyema, a lower abdominal pain; cancer Gongpang violations, oppression or infiltration by the ureter, can cause ureter Ureteropelvic or stagnant water, a spasm of pain or the side of the lower abdomen or severe pain on both sides; oppression iliac lymph cancer, iliac vessels to return to disruption, there can be pain and swelling in the lower limbs.
(4) other symptoms of advanced cervical cancer of the bladder, can cause frequency, Niaotong or hematuria, or even obstetric fistula. As pressure on both sides of ureter obstruction, can cause urinary closure and uremia, is one of the leading causes of death. When the cancer spread oppression or abuse back at the rectum, often Lijihouzhong, blood in the stool or bowel problems, or even a rectovaginal fistula.
Advanced cancer can occur due to long-term consumption of evil disease.
Second, the early signs of cervical cancer and screening of local eye does not recognize, the majority only varying degrees of erosion or minor contact bleeding, and even some cervical smooth appearance. The suspicious or clinical have been able to identify the patients with cervical cancer, should be careful gynaecological examinations and necessary investigation of the body, so as to facilitate early diagnosis and to identify the type and extent of tumor growth.
(A) gynaecological examinations
1. Genital attending the attention of the perineum as whether cancer. Late occasional patient transfer from perineum. In addition, cervical and vulvar cancer can co-exist.
2. Kuiqi check on a repeated vaginal bleeding, the best that first consultation, a preliminary understanding of the disease after gentle to Add to Kuiqi inspection, so as to avoid broke cancer caused by bleeding.
Peep main purpose is to understand cervical patterns, such as suspected cancer, understand their type, size, involved the scope of the vagina and cervix, if necessary, limited to 3 percent of the Tu compound Dianye examinations.
Early cervical cancer partial change was not obvious, cervical cytology-blowing. It was assisted by two test check: ① organizations brittle test: 2 mm in diameter probe of the first cervical suspicious gently pressing regional and cervical slowly sliding surface, such as soft reduction can be inserted into cervical organizations, said here organizations crisp, may For cancer, from biopsy confirmed; ② organizations flexibility test: As the cancer of flexibility diminish or disappear, or when used long tweezers Yashe Ban倒头soft reduction of cervical surface, such as cancer are feeling hard, and easy Zhicui Hemorrhage. Normal tissues of flexibility, and pressure to resume soon after the original shape and color.
3. Vaginal means attending to the index finger inside the vagina I touch all the vaginal wall, cervix and cervical surface of the Ministry of attention to texture, and cancer of the blood, such as whether Zhitao.
4. In addition to attending a two-to understand the cervical lesions, but also understand the uterus size
, texture, and activities on both sides of the annex, and whether mass Gongpang, thickening and tenderness.
5. Triple attending the attention of the anterior rectal smooth, the back wall of the vagina flexibility, the size of the cervix and hardness, next to the main ligament and cervical sacral ligament whether thickening and hardening, flexibility and nodules flu disappeared, and there Penbi Cancer invasion and metastasis, such as swollen lymph nodes. Triple up inspection is to identify cervical cancer-staging an indispensable step.
(B) general inspection of cervical cancer in patients with systemic investigation is necessary, not only can learn whether the lesions distant metastasis, but also provide the basis for the development of treatment. Advanced search of patients, they should pay attention to iliac fossa, groin and collarbone on whether swollen lymph nodes, kidneys can touch, whether Kouji kidney pain, and other areas.
(C) other supporting check for a better understanding of cancer proliferation, transfer the location and scope, should be based on the specific situation of some of the necessary examinations, such as lens or chest radiography, cystoscopy, rectum mirror, IVP, lymphatic contrast And isotopes, such as kidney examination. Huotizuzhi pathological examination of the diagnosis
Cervical cancer the most reliable basis, whether through the cancer biopsy sooner or later must confirm the diagnosis. This is because some cervical lesions like amoeba cervicitis, were it not difficult to biopsy confirmed. Furthermore biopsy can also be a type of cancer and its degree of differentiation.
The main way to the proliferation of cervical cancer as a direct spread and lymphatic transfer, transfer a small number of blood circulation.
First, direct spread is the most common form of expansion. Cancer can spread directly or through the lymphatic invasion and violation of the nearby tissues and organs.
(A) of the field down to infiltration and vaginal fornix vaginal wall because the shallow dome, so the back wall of the vagina wall often than before the invasion. Sometimes invasive vaginal wall with a spacing, along the vaginal mucosa cells can be under the lymphoid tissue disseminated, more distant from the cervix in isolated metastasis.
(B) of cancer to spread to both sides and Penbi Gongpang organizations as the Organization Gongpang osteoporosis, lymphatic very rich, once the perforation of cervical cancer sarcolemma, along Gongpang to the rapid spread, involving the main ligament, the sacral ligament And even Penbi organizations. When the ureter caused by the invasion or oppression obstruction, the water can cause renal pelvis and ureter.
(C) of cervical cancer since the violation to be spread to the neck of the Palace of the occurrence of more.
(D) of adjacent organs violations of advanced cervical cancer of the bladder can move forward, backward can be invaded and rectum. As the bladder and cervix than the relationship between the rectum and cervix more closely, often through the first anterior vaginal violations of the bladder, rectum to the vagina after perforation at, involving the rectum. But see less of the rectum.
Second, cervical lymph node metastasis is the most important means of transfer. Is generally along the first cervical lymphatic next transferred to the obturator, iliac, and iliac, and other regional lymph nodes, and then transferred to the iliac, presacral adjacent lymph nodes and abdominal aorta. Late patients can be transferred to the clavicle on the distant lymph nodes or deep groin lymph nodes.
Henrikson generals cervical cancer lymph node metastasis divided into two groups: ① a group: Gongpang including the lymph nodes, next to cervical (ureter) lymph nodes, obturator lymph nodes, internal iliac lymph nodes, lymph nodes and sacral external iliac lymph nodes; ② two groups: Including the iliac lymph nodes, groin lymph nodes and para-aortic lymph nodes.
The incidence of metastasis with the clinical stage increase, but the author of the report of the lymphatic transfer rate of significant difference. China Shanghai, Beijing and other reporting period Ⅰ metastasis rate of 5.4 ~ 7.7%, Ⅱ period of the transfer rate of 35 to 42 percent. 1980 Shandong Medical University Hospital, and other statistics of seven hospitals with 1,376 cases of cervical cancer surgery check samples see, I view 74/638 cases, the metastasis rate was 11.6%, Ⅱ period 237/711 cases, the rate of metastasis 33.3%. It was integrated foreign operation and autopsy data, the rate of transfer of lymphatic: Ⅰ period (104/645), accounting for 16%; Ⅱ period (87/282)
, accounting for 31%; Ⅲ period (61/101), accounting for 60 %; Ⅳ period (12/16), accounting for 75 percent.
Clinical and pathological confirmed that some cases have appeared very early metastasis, while some cases are no late pelvic lymph node metastasis, such differences may be related to the lymphatic itself immune effects. Shandong Medical University Pathology had 462 cases of cervical cancer survive for more than five years after the pelvic lymph nodes under a form of observation, found that lymphocytes advantage of the transfer rate of 10.72 percent, germinal center edge of the transfer rate of 35.9 % Reduction in lymphocyte-transfer rate of 28.21 percent.
博文
