Fat girls should be careful about endometrial cancer. What tests should be done to prevent endometrial cancer?

As one of the three most common tumors in the female reproductive tract, the incidence of endometrial cancer is on the rise, especially among obese women, and has become an "epidemic". Experts point out that many patients with endometrial cancer are also suffering from obesity, hypertension or diabetes. Therefore, obese women should be particularly vigilant about 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 for relevant examinations regularly.

Endometrial cancer is also known as uterine body cancer, and the most common age is 58-61 years old. As one of the three most common tumors in the female reproductive tract, the incidence of endometrial cancer has an upward trend, especially among obese women, and has become an "epidemic". Experts point out that many patients with endometrial cancer are also suffering from obesity, hypertension or diabetes. Therefore, obese women should be particularly vigilant about 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 for relevant examinations regularly.

What tests are done to prevent endometrial cancer?

For cytological examination of endometrial cancer, specimens taken from the uterine cavity can greatly increase the positive rate, usually as high as about 96%, which is not lower than the positive rate of cervical smears for cervical cancer.

1. Ultrasound examination of the uterus Ultrasound examination of the uterus is of certain significance in the size, location, degree of myometrial invasion, whether the tumor penetrates the uterine serosa or involves the cervical canal of endometrial cancer, and its diagnostic compliance rate is 79.3% to 81.82%. It has been reported that the accuracy of ultrasound is about 87% for patients over 45 years old and compared with hysteroscopy and biopsy. In addition, Xie Yanggui and others performed B-ultrasound examinations according to the UICC staging method, and compared with surgical exploration and pathology based on the tumor location, myometrial invasion, parauterine and adjacent organ involvement, and the staging compliance rate reached 92.9%. B-ultrasound examination does not cause creative and radioactive damage to patients, so it is one of the routine examinations for endometrial cancer. It has a certain reference value, especially in understanding myometrial invasion and clinical staging.

2. Diagnostic curettage and curettage is an indispensable method for diagnosis. It is necessary not only to determine whether it is cancer, but also to determine the location of the cancer. If cervical adenocarcinoma is misdiagnosed as endometrial cancer and treated as a general hysterectomy, it is obviously inappropriate; if endometrial cancer is misdiagnosed as cervical adenocarcinoma, it is also inappropriate. However, microscopic examination cannot distinguish between cervical adenocarcinoma and endometrial cancer. Therefore, segmented diagnostic curettage is required. First, use a small curette to scrape the tissue inside the cervical canal, then enter the uterine cavity to scrape the tissue of the two sides of the uterine horns and the anterior and posterior walls of the uterine body, and bottle them separately with labels and send them for pathological examination. If there is resistance when the inner opening is injured, the cervix can be slightly dilated to No. 5. Segmental curettage often involves a little too deep scraping of the cervical canal, mistaking the contents of the uterine cavity for cervical canal cancer; or endometrial cancer descends into the cervical canal, mistaking it for cervical canal cancer or uterine body cancer involving the cervical canal; or the original cervical canal cancer has too much cancer tissue, and when the small curette enters the uterine cavity, it brings in a little cervical cancer tissue, mistaking it for cervical cancer to have reached the uterine cavity. All these situations indicate that the lesions are already in a late stage, and they should be properly treated according to the scope of cervical cancer surgery.

3. Hysteroscopy Due to the application of fiber light sources and the improvement of uterine distension agents, this technology, which had been stagnant for a long time, has developed again in recent years. CO2 gas distends the uterus, the field of vision is clear, and it is safe to use with a flow meter device. Hysteroscopy can not only observe the uterine cavity, but also the cervical canal, especially the microscopic uterine cavity, and the cervical canal, especially the application of microhysteroscopy, which can be more detailed. The contact hysteroscope developed in recent years does not require uterine distension, making the examination simpler and safer. Under hysteroscopy, the location, size, and boundaries of the tumor can be observed, 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 to find smaller or early lesions. The accuracy of hysteroscopy in diagnosing endometrial cancer is 94%, and that of endometrial epithelial tumor is 92%. If direct biopsy is used, the accuracy rate is 100%. Pay attention to prevent complications such as bleeding, infection, and perforation during microscopic examination.

4. Retroperitoneal lymph node angiography can determine whether the pelvic and para-aortic lymph nodes have metastases, which is helpful for deciding the treatment plan. In stages I and II, the positive rates of pelvic lymph nodes are 10.6% and 36.5%, respectively.

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, and the fine structure of the tissue can be accurately depicted. CT can accurately measure the size and range of the tumor. 83% of patients with localized uterine wall tumors can determine the stage of the lesion. CT can also determine the metastatic nodules of uterine tumors to the surrounding connective tissue, pelvic and para-aortic lymph nodes, pelvic wall, and peritoneum. In particular, the examination of obese women is better than ultrasound. NRI is a three-dimensional scan, which is better than CT*two-dimensional scan. It can depict stage Ia endometrial cancer. It can also depict the extent of lesions infiltrating from the endometrium to the myometrium, that is, it is manifested as irregular high-signal endometrial thickening areas and the disappearance of low signals in the connecting areas between the myometrium. The overall accuracy of MRI diagnosis is 88%. It can accurately judge the degree of myometrial invasion (radiotherapy is not accurate), thereby more accurately estimating the tumor stage. MRI diagnosis is not ideal for smaller pelvic metastatic lesions and lymph node metastases.

What are the early symptoms of endometrial cancer?

Patients in the very early stages may have no obvious symptoms and may only be discovered accidentally during gynecological examinations for general surveys or other reasons. Once symptoms appear, they are usually manifested as:

(I) Uterine bleeding: Irregular vaginal bleeding before and after menopause is the main symptom of endometrial cancer. It is usually a small to moderate amount of bleeding, and rarely a large amount of bleeding. Not only are younger or near-menopausal patients prone to mistaking it for irregular menstruation and not seeking medical treatment in time, but even doctors often neglect it. Some individuals also have delayed menstrual cycles, but the symptoms are irregular. Postmenopausal patients often present with continuous or intermittent vaginal bleeding. Endometrial cancer patients generally do not have contact bleeding. Late bleeding may be mixed with rotten meat-like tissue.

(ii) Vaginal discharge: Since adenocarcinoma grows in the uterine cavity, the chance of infection is less than that of cervical cancer. Therefore, in the early stage, there may be only a small amount of bloody leucorrhea, but later, if infection and necrosis occur, a large amount of foul-smelling pus and blood-like fluid will be discharged. Sometimes the discharge may contain small fragments of cancerous tissue. If pus accumulates in the cervical cavity, it will cause fever, abdominal pain, and leukocytosis. The general condition will also deteriorate rapidly.

(III) Pain: The cancer and its bleeding and the accumulation of fluids stimulate the irregular contraction of the uterus, causing paroxysmal pain, accounting for about 10-46%. This symptom mostly occurs in the late stage. If the cancerous tissue penetrates the serosa or erodes the connective tissue around the uterus, bladder, or compresses other tissues, it can also cause pain, which is often stubborn and progressively worsens; and it often radiates from the lumbar sacral region and lower abdomen to the thighs and knees.

(IV) Others: Late-stage patients may feel an enlarged uterus and/or adjacent tissues and organs in the lower abdomen, which may cause swelling and pain in the lower limb on that side, or compress the ureter, causing hydronephrosis or renal atrophy on that side; or symptoms of systemic failure such as anemia, weight loss, fever, cachexia, etc. may occur.