Examination for endometrial cancer

How is endometrial cancer detected? Endometrial cancer is a type of malignant tumor and has become a killer of women. The disease is more common in postmenopausal women, but it can also occur in premenopausal women or even younger women. Given the prevalence of the disease, it is necessary for us to increase our understanding of it. Let's take a look at its examination items.

1. Medical history: Endometrial cancer patients are mostly elderly women with delayed menopause or irregular menstruation. They are often infertile or have few parities, and are associated with obesity, hypertension, and diabetes. If they have irregular vaginal bleeding or foul-smelling discharge after menopause, they should be paid more attention. For young patients with irregular vaginal bleeding, the cause should also be carefully clarified, especially those who have been treated but have not been effective should also undergo curettage. Vaginal discharge and abdominal pain are already late symptoms.

2. Clinical examination: In the early stage, general gynecological examination often reveals nothing. The uterus is not large, the cervix is ​​smooth, and the appendages are normal. In the late stage of the disease, the uterus is larger than the corresponding age. Some patients may have bloody leucorrhea or rotten cancerous tissue on the finger cot after bimanual examination; some patients may have protruding polyp-like tumors at the cervical opening. However, endometrial cancer can coexist with uterine fibroids, so an enlarged uterus is not necessarily an advanced endometrial cancer.

3. Cytology examination: The diagnosis rate of vaginal cytology examination for endometrial cancer is lower than that for cervical cancer. The reasons are: ① Columnar epithelial cells do not often fall off; ② When the fallen cells pass through the cervical canal to the vagina, they are often dissolved and denatured, making them difficult to identify; ③ Sometimes the cervical canal is narrow and closed, making it difficult for the fallen cells to reach the vagina. In order to improve the positive diagnosis rate, many scholars have improved the location and method of taking specimens. With the improvement of diagnostic technology, the positive diagnosis rate of endometrial cancer has also been greatly improved. How is endometrial cancer detected?

4. Ultrasound examination: Uterine ultrasound examination is of certain significance in the size, location, degree of myometrial invasion, whether the tumor has penetrated the uterine serosa, or whether it has involved the cervical canal, etc. of endometrial cancer. Ultrasound examination is non-creative and non-radioactive to patients, so it is one of the routine examinations for endometrial cancer. It is especially valuable in understanding myometrial invasion and clinical staging.

5. Diagnostic curettage: 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 tissues 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 at the inner opening, the cervix can be slightly dilated to No. 5. Segmental curettage often goes too deep when scraping 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 and 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 treated according to the scope of cervical cancer surgery.

6. Hysteroscopy: Due to the application of fiber light sources and the improvement of uterine distension agents, this technology, which had long been stagnant, has developed again in recent years. CO2 gas distends the uterus, and the field of vision is clear. It is very 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 can also observe the cervical canal, especially the use of microhysteroscopy, which allows for more detailed observation. The contact hysteroscope developed in recent years does not require uterine distension, making the examination simpler and safer. 7. Retroperitoneal lymph node angiography: It can determine whether the pelvic and para-aortic lymph nodes have metastasized, which is conducive to determining the treatment plan.

How is endometrial cancer detected? The diagnosis of any disease is a major blow to the patient and his or her family, but what hits the family the most is that the patient has no will to live and is unwilling to fight the disease. Therefore, what the patient needs to do is to adjust his or her mentality in time and actively accept treatment. Modern medical technology is becoming more and more advanced. We have reason to believe that as long as active treatment is provided, there is hope.