Experts point out that early symptoms of endometrial cancer is very clear that under normal circumstances would not be perceived to be the most common is the vaginal bleeding, so women must observe the changes of their own, early treatment is important, the following specifically Under the early symptoms of endometrial cancer:
1. Vaginal bleeding
Abnormal vaginal bleeding is the main symptom of cervical cancer patients (80% -85%), especially in postmenopausal vaginal bleeding should be cause for concern. Vaginal bleeding may be more or less, bleeding is often caused by rupture of tumor blood vessels, especially the food type tumor bleeding symptoms appeared earlier than from the amount, if the frequency of bleeding, blood loss can cause more severe anemia. Advanced cases, there may be vaginal bleeding resulting in shock, more common in the growth of aggressive tumors.
2. Vaginal discharge
Is the main symptom of cervical cancer patients. Vaginal bleeding occurred in the past. Initially there is no smell of vaginal discharge can be, with the growth of cancer, cancer of secondary infection, necrosis, increase the amount of the secretions, such as Taomi Shui-like or mixed blood, and with a bad smell. Involvement of endometrial cancer spupward, the secretion was blocked neck cancer, can not be discharged, the formation of uterine cavity fluid or empyema, the patient may appear lower abdominal discomfort, abdominal pain, low back pain and fever and other symptoms.
r>3. Pain
Is a symptom of advanced cervical cancer. Cancer extension along the adjacent tissues, violations of the pelvic wall, peripheral nerve compression, clinical manifestations, or the side of the sacral nerve, iliac persistent pain. Tumor compression or erosion of the ureter, the narrow tube, blocking lead to hydronephrosis, the performance side of the low back pain, even pain, and further development of renal failure, resulting in uremia. Lymphatic system lymphatic invasion lead to obstruction, the obstruction of the lower extremities back pain, swelling and other symptoms.
4. Systemic symptoms
Patients with advanced cancer tissue due to metabolism, absorption of necrotic tissue or infection which causes fever, body temperature is generally around 38 , a few up above 39 . Due to bleeding, consumption and anemia, weight loss or cachexia.
Experts advise: If there is vaginal bleeding, increased vaginal secretions, or body heat and so must the attention of women with timely and to the hospital for examination, early detection of cancer is very important.
Cause of endometrial cancer etiology and pathology of the real causes of morbidity so far unknown, but risk factors have long been people's attention. The risk factors: First, obesity increases estrogen excess
fat storage and increase in plasma androstenedione into estrone. The free estrone increased with activity, may be carcinogenic factor of endometrial cancer, or cancer-promoting factor. Second, diabetic patients with diabetes or abnormal glucose tolerance, their risk of endometrial cancer increased 2.8 times than normal. Third, high blood pressure and hypertension were more likely to endometrial cancer. Obesity, diabetes and hypertension coexist in three patients with endometrial cancer, called "the triad of endometrial" or "endometrial cancer syndrome." Three may be related to high-fat diet, whereas the high-fat diet and endometrial cancer are directly related. IV endometrial cancer menstrual disorders, menstrual disorder, more than the amount of those 3 times higher than normal women. Fifth, early menarche and late menopause before age 12 were more than 12 years after the menarche, the incidence of endometrial cancer more than 60%. The absolute light of endometrial cancer compared with normal women aged 6 years later. VI motherhood times of endometrial carcinoma occurred in the productive, not production, infertility were more likely. Seven showed no ovulation with polycystic ovary syndrome, leaving the endometrium at a high level, sustained under the effects of estrogen, progesterone regulation and lack of periodic endometrial exfoliation, while the occurrence of proliferative changes. Eight ovarian tumors secrete high levels of estrogen in the granular cell carcinoma, theca cell tumor, can cause menstrual disorders, postmenopausal bleeding and endometrial hyperplasia and endometrial cancer. September, endometrial hyperplasia can be a stage in the development of endometrial cancer, or no such stage. And severe dysplasia, carcinoma in situ can be regarded as the endometrium. X. exogenous estrogen in women taking estrogen with high risk of endometrial cancer, the risk with the dose, taking the length of time, and the suitability of the progesterone in the middle is discontinued and the patient characteristics and so on. After stopping risk reduction in the ash, but the risk continues the ancient years. Currently, estrogen and the causal relationship between endometrial cancer has been sufficient evidence. Estrogen in the estriol (E3) does not promote endometrial hyperplasia, and E2, E1, or a combination of estrogen ethinyl estradiol is easy to promote intimal hyperplasia, an increase in the risk of endometrial cancer. A pathology, gross pathology (a) diffuse type: The lesions can affect all or most of the endometrium. The early and not easy to distinguish endometrial hyperplasia. However, careful examination of cancer sites, there are some features of the normal boundaries between endometrial identifiable, that is, cancer of the mucous membrane thickening, rough and irregular in size of polypoid protrusions, and benign endometrial hyperplasia is soft, smooth surface. Malignant polyp-like protrusions larger, hard, brittle, the surface of superficial ulcers, ulcers and necrosis in advanced lesions, involving the entire endometrium; small number of cases may even spof invasive cervical canal and endometrial or extended to the vaginal vault. And benign polypoid endometrial hyperplasia confined only inside the mouth above the cervical canal because the cervix of endometrial hyperplasia caused by this abnormal endocrine function never react. In addition to the spof endometrial cancer, the development of the muscular layer to a certain stage can be violated, and even invasion to the uterine serosa can be transferred to the ovaries, uterus next to the rectum and bladder. Advanced tumor surface necrosis, ulcers, often secondary infection. (B) localized: rare. Limits the scope of cancer, involving only part of the endometrium, the appearance is the same as with the diffuse type. The scope of the surface is not cancerous, and to the deep muscular layer violations, resulting in infection of the uterus increases the formation of uterine wall, or necrotic ulcers, and even penetrating. Equally around the erosion or the late shift. Can be expressed as a localized polypoid or lime flower, nodular. The former is more common in early cases, which is more common in advanced cases, often accompanied by muscle infiltration. Localized tumors located in the Palace or Palace of the bottom corner. Polypoid benign tumor resembling normal endometrial polyps, but smooth and soft and covered with normal mucosa of different benign endometrial polyps; cancer polypoid neoplasm volume can be large, crisp, surface often necrosis . Sometimes a small polypoid cancer, but has all the malignant tissue, and has been the development of service or infringement of the deep muscular layer. Sometimes the small number of polyps cancer, diagnostic curettage may be When all of curettage, hysterectomy specimens in order to cause no traces of cancer. Of course, when you should pay attention to whether curettage specimens of the possibility of the wrong tone, to proof of suspicious reshould be to prevent missing the real patients. (C) of the polyps: endometrial cancer occur in the uterine horn, and is common in postmenopausal women. Second, the microscopic (1) cancer (adenocarcinoma): about 80% to 90%. Microscopically, endometrial glands increased, large and small, disorganized, was obviously back to back phenomenon. Showed a papillary epithelial sometimes, to highlight the formation of secondary intrauterine glands, showing gland sets gland phenomenon. Cells large, irregular, and a large change was pleomorphic, stained the cytoplasm less mitosis much less with interstitial infiltration of inflammatory cells. Poorly differentiated adenocarcinoma of the glandular see less structure disappeared, becoming solid Aikuai. International Association of Gynecology and Obstetrics (FIGO, 1970) proposed three endometrial cancer histological classification: grade (highly differentiated cancer): often restricted to the endometrium and occasionally papillary epithelial layer or multiple layers, arranged in irregular, interstitial less; level (moderately differentiated carcinoma): differentiation a bit weak, unclear outline of the gland, some of the solid Aikuai, cells lose polarity, mitotic figures common; grade (low differentiated or undifferentiated carcinoma) : poor differentiation, glandular structure disappeared, solid Aikuai based. (2) keratinized gland cancer (adenoacanthoma): also known as echinoderms gland cancer. Microscopically adenocarcinoma is characterized by mature and differentiated into groups with benign squamous epithelium, intercellular bridges and keratinization visible image or form keratin pearls. (3) squamous carcinoma (adeno-squamous carcinoma): also known as mixed carcinoma (mixed carcinoma), adenocarcinoma carcinoma and squamous cell carcinoma in two components. (4) clear cell carcinoma (clear cell carcinoma): tumors were tubular structure, microscopy, large amounts of varying sizes arranged back to back a small tube, transparent spikes lining cells, showed scarce cytoplasm, and a large and broke into the cavity within the interstitial collagen fibers. Patients with very early clinical manifestations can be no obvious symptoms, only in the census or other reasons for gynecological examination stumbled. Once the symptoms, the more performance for: (a) uterine bleeding: before and after menopause, irregular vaginal bleeding is the main symptom of endometrial cancer, usually small to moderate amount of bleeding, rarely heavy bleeding. Not only to younger patients or near easily mistaken for menopause, irregular menstruation, without timely treatment, even though doctors often neglect. Individuals who have delayed menstrual cycle, but the performance is not the law. In many postmenopausal patients showed persistent or intermittent vaginal bleeding. Endometrial cancer patients in general no bleeding. Late bleeding can be mixed with Lanrou tissue. (B) of the vaginal discharge: Due to the growth of the uterine cancer, cervical cancer less than the chances of infection, it may be only a small amount of the initial bloody vaginal discharge, but Sri Lanka after the infection, necrosis, there are a lot of foul-smelling pus and blood like liquid discharge . Sometimes drainage can be mixed with small fragments of cancer tissue. If the cervical cavity empyema, fever, abdominal pain, leukocytosis. General situation is rapidly deteriorating. (C) pain: the cancer and bleeding and drainage of cholestasis, irregular uterine contractions caused by stimulation of paroxysmal pain, accounting for about 10 to 46%. Such symptoms occur mostly in late. Such as cancer or erosion through serosa parametrial connective tissue, bladder, straight or pressure can cause pain and other organizations often were refractory and progressive increase; and more from the lumbosacral region, lower abdomen to the thigh, knee-length radiation. (D) Other: patients with advanced lower abdominal palpable increase their uterus and / or adjacent tissues and organs can cause the side of the lower limb swelling, pain, or pressure caused by the side of the ureter or renal pelvis and hydroureter caused by renal atrophy; or anemia, weight loss , fever, cachexia and other systemic failure in performance. Later age of onset of endometrial cancer, with pregnancy seems impossible, but with pregnancy or the literature there have been individual case reports of tubal pregnancy. Signs (a) of the systemic manifestations: a considerable proportion of patients with diabetes, hypertension or obesity. Anemia occurs in patients with long bleeding time. Patients with advanced cancer due to consumption, pain, loss of appetite, fever, cachexia occurs. (B) of the gynecological examination findings: Early No obvious change in the pelvic reproductive organs, the uterus is about 40% of normal, fibroids or disease to the late merger, the enlarged uterus. Postmenopausal women with uterine contraction but not significantly full, hard, in particular should be vigilant. Ovary may be normal or increased, or the tumor may be associated with feminization. Bimanual when the patients as a result of obesity, pain, or lack of cooperation and palpation is unclear, do not have to adhere to the identification, diagnosis is based not so much because of the size of the uterus. Cervical lesions in patients with multiple non-visible. Only in the late violation of the cervix, the cervix can be seen from prominent cancer. Department of parametrial invasion and cervical involvement are due after. (C) metastases: patients with advanced enlargement can be hard hit in the groin or melting into a block of all lymph nodes, or lung, liver metastasis, etc. signs. Auxiliary examination in patients with a history of endometrial cancer, mostly older women, menopause late, or menstrual irregularities; often infertile or parity much, combined with obesity, hypertension, diabetes mellitus; if there are irregular vaginal bleeding after menopause or foul drainage should be even more attention. Of young patients who have irregular vaginal bleeding, but also carefully to understand its causes, in particular, is also ineffective after treatment and curettage should be done. Vaginal discharge and abdominal pain are at an advanced stage symptoms. Early clinical examination found nothing more than the general gynecological examination, not the uterus, cervix smooth, accessories and no exceptions. Late phase of disease is greater than the corresponding age of the uterus, some of bimanual finger stained with bloody vaginal discharge or after the rot with a collapse of the cancer; others can be seen in the cervix has been prominent polypoid masses. However, endometrial cancer and uterine fibroids may exist, so the uterus is too large are not as advanced endometrial cancer. Endometrial cancer cytology vaginal cytology diagnosis rate than cervical cancer is low, its causes: columnar epithelial cells do not always come off; exfoliated cells reach the vagina through the neck often dissolved, denatured, not easy to recognize chief; Cervical stenosis sometimes atresia, vaginal exfoliated cells is difficult to achieve. In order to increase the positive diagnosis rate, many scholars take the position samples, the method has been improved, with increased levels of diagnosis, uterine membrane Na-positive diagnosis rate of cancer has greatly improved. B-ultrasound examination of uterine endometrial cancer in uterine size, location, myometrial invasion, serosal uterine perforation or if the tumor involved the cervical canal and so is of some significance, the diagnosis rate of 79.3 ~ 81.82%. There are reports of patients aged over 45 inspections and controls with hysteroscopy and biopsy, ultrasound accuracy rate of about 87%. In addition, Yang Gui Xie and other reference line B-Check the UICC staging, according to tumor site, muscle dip, parametrium and adjacent organ involvement were, with surgical exploration and pathology, and its phased compliance rate of 92.9%. B-for the examination of patients with no creativity and radioactive damage, so it is a routine examination of endometrial cancer is one. Especially in the understanding of myometrial invasion and clinical staging, has a certain reference value. Check the diagnostic curettage curettage indispensable for the diagnosis method. Not only must be clear whether the cancer, but also the growth of cancer site specific. If misdiagnosed as cervical cancer, endometrial cancer, while the general hysterectomy treatment, clearly wrong; case of mistaken for endometrial cancer and cervical cancer treatment, nor are appropriate. However, microscopic examination can not distinguish cervical adenocarcinoma or endometrial cancer. Therefore needs to be sub-curettage. First with a small curette scraping cervix tissue, and then scraped into the uterine cavity on both sides of the noise angle and the anterior and posterior wall tissue Palace, bottles were marked, sent for pathological examination. If there is resistance within the population was killed when cervical dilatation to take a 5. Often in the curettage segment neck when shaving a little too deep, the uterine contents mistaken for cervical cancer are; or endometrial cancer into the neck down, mistaken for a neck cancer or uterine cancer involving the neck; or the original for the cervical cancer, cancer too, when a small curette into the uterine cavity, the cervical cancer tissues and into the misconception that cervical change has reached the uterine cavity. Said the disease has a variety of conditions are late, all the range should be treated as proper operation of cervical cancer. Hysteroscopy and the application of fiber light changes of uterine distention agent, this early again in recent years, the development of technological stagnation. CO2 gas uterine distention, clear vision, to be equipped with flow metering devices, the use of very safe. Hysteroscopy can be observed not only the uterine cavity, and can observe the neck, especially the micro cavity, and can observe the neck, especially the application of micro hysteroscopy was observed to be more detailed. Developed in recent years hysteroscopy, no house to check the expansion simpler and more security. Hysteroscopy can observe the tumor location, size, boundaries are limited or diffuse, is exogenous or endogenous, and whether the cervical canal involvement, etc.; biopsy of suspicious lesion to help find small or early lesions. Hysteroscopy Diagnostic accuracy of endometrial cancer was 94%, endometrial intraepithelial neoplasia was 92%. If the biopsy is of direct spend up to 100% accuracy. Microscopy pay attention to prevent bleeding, infection, perforation and other complications. Retroperitoneal and pelvic lymph node imaging can clearly whether aortic lymph node metastasis, in order to facilitate treatment decisions. , stage, pelvic lymph node positive rates were 10.6% and 36.5%. CT scan and magnetic resonance imaging computer image tomography (CT) and magnetic resonance imaging (MRI) CT diagnosis of endometrial cancer has some value, CT scan image clarity, organization can accurately delineate the fine structure of tumor size, scope, CT can accurately measure the uterine wall tumor confined to the 83% who can determine the disease stage. CT can also determine the tumor to the surrounding uterine tissue, pelvic and aortic lymph nodes and the pelvic wall, peritoneal nodules. Especially for obese women is superior to ultrasound examination. NRI is a three-dimensional scanning, two-dimensional scan is superior to CT *), a period of endometrial cancer can delineate. And from endometrial lesions can be to delineate the extent of myometrial invasion, which showed high signal was irregular thickening of the endometrium, the myometrium connection between the disappearance of low signal area. The overall diagnostic accuracy of MRI was 88%, it can accurately determine the degree of myometrial invasion (radiotherapy which are not allowed), so a more accurate estimate of tumor stage. Of small metastases and pelvic lymph node metastases, MRI diagnosis is not ideal. CT and MRI in the diagnosis of endometrial cancer, certain unique characteristics, but the diagnostic accuracy rate was not high compared with B, and the costs compared with expensive and increase the economic burden of patients, in general, by cytology, B ultrasonic examination, and then by diagnostic curettage pathology, most patients can be clearly dual diagnosis. Differential diagnosis of endometrial cancer diagnosis as described above, generally is not difficult, but sometimes confused with other diseases, as well as delay in diagnosis. Should identify the following: bleeding after menopause should be alert to whether the first malignancy, despite progress with age, postmenopausal bleeding in the proportion of malignant tumors has been greatly reduced. If Knitis and other reports, 40 years postmenopausal bleeding malignant disease accounted for 60 to 80%, 70 to 25 ~ 40% of the lung, 80 and to 6 to 7%. Su should be reported internally and wide, and 60 years accounted for 76.2% of malignant disease, endometrial cancer, malignant disease accounted for 12.9% .80 late, He-Feng Huang and other reports, 22.7% of malignant disease, and malignant endometrial cancer accounted for 45.5% of cases, cervical cancer accounts for 43.6%. Zheng Ying and other reports, accounting for 24.9% of malignant disease (benign 73.3%), ranking the first postmenopausal bleeding 2. Look from menopause, menopause 5 years, 14%, 5 to 15 years of menopause accounted for 68.3%. Seen in malignant tumors with the progress of the age, endometrial cancer on the rise. He-Feng Huang reports even more than the cancer. Postmenopausal bleeding is not necessarily proportional to the degree with cancer. The amount of bleeding may rarely, bleeding lesions not many times the cancer may have been obvious. Gynecological examination should be carefully done so, find out the vagina, cervix, uterus, annex any abnormal conditions exist. Because there may exist two or more lesions, such as the existence of senile vaginitis with endometrial cancer at the same time, it can not afford to have found a lesion to the neglect of further examination. In addition to cytology, the sub-curettage checkups are essential steps in diagnostic curettage for endometrial cancer diagnosis rate was 95%. Domestic Chengwei Ya reported that 10 448 cases of postmenopausal endometrial curettage uterine bleeding, endometrial cancer, which accounted for 11.4% (51 cases), Luo Qidong et al reported 8.7%. Reported in the literature ranging from 1.7 to 46.6%, generally below 15%. Dysfunctional uterine bleeding often occurs menopause menstrual disorders, particularly more frequent bleeding, regardless of uterine size is normal, you must first do curettage, and then clear the nature of the treatment. Endometrial cancer had better students in the early reproductive growth stage and even women. Shandong Provincial Hospital, patients with endometrial cancer have been mixed, only 26 years old, 3 years menorrhagia, dysfunctional uterine bleeding by treatment fails, the last curettage confirmed endometrial cancer. Therefore, irregular uterine bleeding treatment of young women 2 to 3 months with no response, should also be identified curettage situation. Endometrial hyperplasia more common in women of childbearing age. Endometrial hyperplasia and severe form of the organization, it is sometimes difficult to distinguish well-differentiated adenocarcinoma. Usually atypical endometrial hyperplasia, can be expressed as focal pathology, there is flattening of the normal epithelial cell differentiation is better, or see squamous metaplasia, fat lotus pulp color, no necrosis infiltration performance. Endometrial adenocarcinoma and large cell nucleus, chromatin increased, deeply stained, cell differentiation is not good, more than nuclear fission, less cytoplasm, and often necrosis and infiltration. With the differentiated identification of early endometrial adenocarcinoma: dysplasia often have the complete surface epithelium, and adenocarcinoma is not, so as to see a more complete or flattening of the surface epithelium can be excluded endometrial adenocarcinoma. In addition, necrosis of endometrial adenocarcinoma often bleeding; respond differently to medications, atypical hyperplasia, small dose that is slow work, persistence length, once the withdrawal may soon relapse; age: younger and more considered atypical hyperplasia, endometrial adenocarcinoma challengers who take account of the possible. Submucosal uterine sarcoma or endometrial polyps performance of menorrhagia or more extended period, or bleeding at the same time fluid or bloody discharge associated with vaginal discharge, clinical manifestations and endometrial cancer are very similar. However, the uterine cavity through the exploration, sub-curettage, uterine lipiodol angiography, or hysteroscopy can make differential diagnosis. Cervical cancer and endometrial cancer, same as the performance of irregular vaginal bleeding and drainage increased. If pathology is considered to come from cervical squamous cell carcinoma. If the cancer is identification of the would be difficult, such as mucus glands can be found, then the primary in the neck more likely. Japan Okudaira so that in invasive cervical adenocarcinoma, carcinoembryonic antigen (CEA) a high rate of positive expression, therefore, immunohistochemistry for CEA, cervical adenocarcinoma and endometrial help identification. Primary fallopian tube carcinoma vaginal discharge, vaginal bleeding and lower abdominal pain, vaginal smears likely to find cancer cells and endometrial cancer, but similar. The fallopian tube cancer, endometrial biopsy negative parametrial palpable mass, different from the endometrial cancer. If mass is not small and palpation of the table who were diagnosed by laparoscopy. Old endometritis uterine empyema usually presents combined vaginal discharge pus, bloody or pus and blood drainage of the uterus increases more soft. Then check through the expansion of B from the Palace cancer, inflammatory infiltration saw the organization. Pyometra often associated with cervical cancer or endometrial cancer management co-existence, identification must be attention. In the treatment of endometrial cancer in four types of endometrial cancer in the Chinese ancient medical books and the "bleeding" and "Five Ribbon," "disease positive" and described similar. By the spleen and liver and kidney dysfunction, three dirty, hot and humid Ecchymosis, Accumulation uterus, or liver qi stagnation, blood stasis, meridian obstruction, the course of time due to accumulation in the belly. Endometrial cancer medicine will be divided blood heat, qi type, blood stasis, kidney-type IV symptomatic treatment. TCM IV endometrial cancer: 1. Blood heat and the main card of this type occurs in patients with endometrial cancer vaginal bleeding or bleeding suddenly dripping constantly, Xiong Xie fullness, upset, irritability, red tongue, thin yellow tongue coating , pulse a few strings. Therapeutic: Liver and heat, accompanied by bleeding. Recipe: Modified Danzhi Xiaoyaosan. Bupleurum, Atractylodes, Angelica, white peony root, Poria, mint, Dan, Gardenia, Motherwort, blood over charcoal, licorice. 2. Qi Principal Certificate or violent collapse of blood dripping dirty, pale quality of clear, pale, tired limbs Shenpi, shortness of breath lazy words. Pale or the tongue side of teeth marks, moss thin profits, slow weak pulse weak. Therapeutic: Qi and spleen, astringent to stop bleeding. Qi-type treatment of endometrial cancer Recipe: Yi Yuan Jian addition and subtraction. Ginseng, astragalus, licorice moxibustion, Atractylodes, Cimicifuga, leaves, donkey-hide gelatin (molten). 3. Blood collapse when the main license only, not the net dripping, or sudden volume, there are the stasis block, lower abdomen pain and refused to press. Dark purple tongue or the side of a die in a prison point, fur is thin, or astringent pulse string fine. Therapeutic: blood circulation stasis, stopping pains. Treatment of blood stasis herbs endometrial cancer: Xuefuzhuyutang addition and subtraction. Peach kernel, safflower, angelica, habitat, Chuanxiong, red peony root, Bupleurum, Yan Hu, myrrh, licorice. 4. Main symptoms of vaginal bleeding kidney deficiency, and how much different the color red, dizziness, tinnitus, palpitations, five upset hot, the two zygomatic red red, weak waist. Red tongue, little coating, rapid pulse. Therapeutic: Yu Yin ney, solid red bleeding. Treatment of this type commonly used in patients with endometrial cancer side Zuogui Pill. Rehmannia, Chinese yam and medicine, dogwood, dodder seed, wolfberry fruit, antler, (molten), Ligustrum, Eclipta prostrata, Agrimony, blood over charcoal, palm charcoal. The treatment of endometrial cancer and dispelling evil and righting principle is used. Early to heat and dampness, qi and blood circulation, spleen and liver and kidney to strengthening and restoring three dirty conditioning, solid protection Chong and Ren; late should righting the main tumor and eliminating pathogenic factors, changes in the weak state of patients, but also zero-suppression drugs the main tumor, and induce differentiation and apoptosis, the tumor without injury is. In short, the treatment when the rise and fall according to the severity of pathogen, balancing the proportion of righting and Quxie medication. Treatment of endometrial cancer treatment guidelines, should be based on clinical staging, cell differentiation, the patient whole body situation and other factors considered decision. Because most endometrial adenocarcinoma, is not sensitive to the radiation therapy, so treatment with surgery, there are other radiotherapy, chemotherapy and other drugs combined therapy. Surgery Bickenbach (1967) have now been finalized, surgery alone is better than radiotherapy alone, the 5-year cure rate of surgery is 20% higher than the radiation. According to the domestic Zhang Xiyin of endometrial cancer and other long-term follow-up observation of 516 cases of surgery alone was 72% healthy existence, preoperative radiotherapy and surgery was 60%. 5,-year survival rates were observed in 85.9% ~ 88.8%, 82.5% ~ 85.8%, 81.4% ~ 84.8% and 77.3% ~ 81.7%. Shows the results of surgical treatment. Range of surgical lesions could be clearly and correctly to the clinical stage, extent of surgery to the right decision. In the past, according to FIGO staging in 198 for fascia are usually outside of hysterectomy and bilateral oophorectomy; of those will be used for extensive hysterectomy and bilateral pelvic lymph node dissection. , of those who have surgery may be the first surgery, resection of the lesions as much as possible, reduce the tumor, postoperative radiotherapy or progesterone treatment. Otherwise, it should first progesterone, radiotherapy and / or chemotherapy, surgery may be there again when the surgery. Patients still need to be complemented by other treatment. The new 1988 FIGO clinical stage, suggesting that clinicians, cancer of stage a person, the line outside the traditional fascial hysterectomy and bilateral oophorectomy, Yin Daoyi cut 2cm, is the appropriate extent of surgery. While those who have muscular invasion, especially those of deep myometrial invasion, and expand the scope of operation, according to the traditional surgery, implementation of extensive hysterectomy and pelvic lymph node dissection. Control check whether the enlarged aortic lymph nodes, a lymph node biopsy is the line active, inhibiting / or conventional aortic lymph node dissection. Of and of surgery also should be the scope of the purposes of the foregoing extensive hysterectomy and pelvic and / or para-aortic lymph node dissection. , we should try to line tumor cytoreductive surgery. Comparison of the 1972 Milton and sub-total hysterectomy radical hysterectomy (without lymph node dissection) of the 5-year survival rate, the former was 75.7%, which was 91.4%. Tips to expand the scope of hysterectomy (at least for the time radical hysterectomy) can help reduce the recurrence rate. Also note that: (a) find the ascites or peritoneal washing cells; incision retroperitoneal, or take on a trip to ascites centrifugation to find cancer cells. Without ascites, the peritoneal injection of 200ml saline to wash the abdominal cavity, suction fluid centrifugation to find cancer cells. Where cancer cells are found (reported in the literature, cancers was 11.4%, with the rise of the tumor group was significantly increased, such as grade 18.1%). In addition to surgery, we must also add other adjuvant therapy. (B) to determine when the operation of myometrial invasion: the size of the uterus is less than the normal stage cancer surgery patients due to limited time for some reason, can first remove the uterus accessories, hysterectomy specimens were split as to determine whether myometrial invasion. Of course, sometimes difficult to judge of specimens, microscopic fine changes can note the following: gland cancer, myometrial invasion was jagged, irregular shape, while the basal layer of the gland is round without angle; gland cancer invasion No body around the endometrial stromal and basal stroma surrounding the glands often; Invasion peri edema. Carcinoma of the gross specimen in the lower uterine segment, see who should be conducted according to the scope of Phase surgery. (C) not y dissection: pelvic and abdominal aortic conventional exploration lymph nodes, swollen by at least do a biopsy, a technique also allows the patient condition, the possible dissection. Sensitivity to radiotherapy radiotherapy cancer is not high, radiotherapy ineffective. However, in elderly patients with severe medical illness or surgery or taboo can not be surgery, radiation therapy is still a have a certain effect of treatment. Radiotherapy including the cavity and in vitro two photos. Intracavitary irradiation, the current use more 137CS, 60CO, etc., radium has been basically abandoned. External irradiation and other multi-linear accelerator with 60CO. According to other reports of domestic Wu Yuzhen, uterine cavity packing method commonly used in radiotherapy, preoperative complications filling low of 1%. External radiation therapy may be the scope of the original tumor and infiltration of individual specific treatment, such as uterine or pelvic lymph node metastasis, preoperative radiotherapy may be cervical cancer. Radiotherapy plus surgery with surgery plus radiation therapy, is a lot of controversy over the years but has not been fully resolved. Some scholars believe that preoperative radiotherapy can improve the 5-year survival, but also those who hold negative . Preoperative radiotherapy plus benefits are: the size of the tumor can shrink, which will help surgery; inactivated cancer cells, reduce the postoperative recurrence and the possibility of distant metastasis; reduce the chance of infection. It can improve the cure rate. Therefore, if radiation speculation, could be considered optional. The cancer has deep soaking muscle, with poor cell differentiation, preoperative intracavitary radiotherapy, surgery should be added in vitro irradiation. In of these advantages, the conditions to have radiotherapy, the need to preoperative radiotherapy with radiotherapy and surgery is still appropriate. After the treatment of vaginal metastasis and recurrence prevention issues are still controversial. Most scholars believe that radiation therapy after vaginal surgery or radiotherapy after surgery can reduce the recurrence rate of the vagina. Progestin therapy after surgery or radiation used for recurrence or metastasis of the cases, but also for well-differentiated adenocarcinoma, early, young patients need to retain reproductive function. Pregnancy induced drugs as an integral part of comprehensive treatment, is recommended. Vaginal progesterone can reduce the recurrence rate after surgery, it is also widely used after surgery or radiation adjuvant treatment. Progesterone treatment of endometrial cancer mechanism, currently considered to be directly to the tumor cells, so from the malignant transformation of normal endometrium to inhibit cancer cell DNA and RNA synthesis, reduce the division, thereby inhibiting cancer cell reproduction, Finally, growth or shrinkage of the tumor was replaced by endometrium. Commonly used drugs are: medroxyprogesterone acetate (medroxy progesterone acetate), megestrol acetate (megestrol acetate), 17 - OH progesterone has been acid (17-OH progesterone caproate), and 18 - methyl norethisterone (norgestrel) and so on. MPA: medroxyprogesterone acetate, also known as. Available short-acting oral; long-term (depo-provera) for injection, 200 ~ 400mg, intramuscularly, 2 times a week, with 3 to 6 months, or to change the maintenance dose after 12 weeks of 200mg / d. Oral rarely used, usually beginning 5 to 6 weeks, at least weekly oral administration of 3mg, after the 400mg / d, long-term use. Megestrol acetate: brand name women tablets, 40 ~ 160mg / d, orally for 12 weeks, change the maintenance dose 500mg, 2 times per week. Progesterone has been acid: 500mg / d, intramuscularly, 1 day, 12 weeks after the change 500mg, 1 week 2 times, a total of 6 months. Progesterone treatment of endometrial cancer drugs objective response in 30 to 35%, sustained remission and even cure about 90%. Progestin drugs for non-cytotoxic drugs, safe, and very little toxicity. Common side effects are mild Shuinazhuliu and gastrointestinal reactions, the other may have high blood pressure, acne, breast pain, 0.6% of allergic reactions, but no cause of death in 1 case. On the heart, liver and kidney function, with damage should be used with caution. Antiestrogen therapy with tamoxifen (tamoxifen) is a non-steroidal anti-estrogen drug, itself a slight androgenic effect. It is competing with estradiol estrogen receptor (ER), take anti-estrogen receptor role of the sky. After serving the drug, increased tumor PR, progesterone treatment benefit. Usually advanced cases, recurrence or metastasis. Can be used alone (progesterone ineffective treatment) or pregnancy hormones, or with chemotherapy drugs in combination with applications. Dose of 20mg / d, orally, several weeks after the result is not significant, may be doubled applications. Has been reported, the first application of the load for the 80mg / d. Side effects are nausea, vomiting, rash, hot flashes, bone marrow suppression, thrombocytopenia, vaginal bleeding, high blood calcium and so on. Chemotherapy used for patients with advanced or recurrent metastasis. Conditional to the cancer PR, ER testing in pregnancy when the hormone receptor-positive when the treatment of choice; when the receptor-negative, then more chemotherapy. Receptors determined unconditionally, well-differentiated cancer cells, progesterone should be used, differentiation is not far behind payment option chemotherapy. (A) single-drug chemotherapy with CTX application :5-FU more effective than sure. (B) combined multi-drug chemotherapy combination chemotherapy instead of a single anti-cancer chemotherapy treatment trends in modern times. Endometrial cancer chemotherapy regimens are: ADR (37.5mg/m2) and CTX (500mg/m2) IV, treatment interval of 21 days, objective response rate 62.5% (Muggia, etc., 1977); DDP (60mg/m2), ADR ( 50mg/m2) and CTX (600mg/m2), treatment interval of 28 days, the objective response rate 57.1% (Koretz, etc., 1980); VCR (vincristine 1.5mg), ADR (40mg/m2), CTX (500mg/m2 ) vein, plus 5-FU500mg/m2 intravenous 2 days, treatment interval of 21 days, objective response rate 50% (Kauppila et al, 1980). Chemotherapy regimens, more inclined and progesterone drugs the same time. Chinese medicine treatment of endometrial cancer to endometrial cancer? Endometrial cancer with traditional Chinese medicine can be in the early postoperative treatment, conditioning has played the role of traditional Chinese medicine, can achieve uphold, enhance immunity effect. Gynecologist, said the general body of endometrial cancer patients is poor, decreased immunity, easily lead to other infections. Chinese medicine is based on the compatibility of the patient's status can change at any time to adjust the patient's condition in order to achieve the effect of improving the quality of life of patients. Commonly used in the treatment of endometrial cancer with traditional Chinese medicine: blood circulation drugs, such as Salvia, safflower, peach kernel, triangular, Ezhu etc.; clearing and detoxifying drugs, such as diffusa, dandelion, Zeeland, etc.; spleen tonic drugs, such as Atractylodes, Poria, ginseng, yam and so on; Some people believe that consumption of vaginal cancer, severe disability allowance, can Yin. Chinese herbal medicine for cancer and some have a certain special effect, such as stone see through and so on. Chinese medicine treatment of endometrial cancer principles: (a) Differential Treatment 1. Most of the existence of endometrial uterine cancer increases, the first clinical manifestations of irregular vaginal bleeding, mainly because of liver Qi stagnation, blood stasis No , Chong and Ren disorders. Expelling liver qi stagnation, qi and relieves congestion, stasis to stop bleeding. Party elections in Hong edge Guiling Pill 2. Advanced endometrial cancer with abdominal pain, vaginal discharge quantity for the main symptoms, mainly because the liver and kidney, Ecchymosis within the knot, with the veins missed appointments. Expelling Ziyinqingre, dehumidification only zone, circulation pain. Qing Fang selected by Decoction. (B) Differentiation and Treatment 1. Syndrome: abnormal vaginal bleeding, color dark red, blood clots, the amount, vaginal discharge Chibai same sticky quality Watchtower, smells fishy, abdominal pain, chest swelling or fullness, upset dry mouth, scanty dark urine, constipation, purple-red tongue, yellow tongue fur, pulse a few strings. Governing Law: Soothing Sanjie, Qingrejiedu. Recipe: Cinnamon Twig and Poria Pill. 2. Spleen deficiency syndrome: irregular vaginal bleeding, pale quality of thin, white vaginal discharge Chibai, sticky thin like Amoy Migan Shui, stench was unbearable, with backache Shenpi, palpitations shortness of breath, abdominal pain, falling, poor appetite, dreams, loose stool, pale tongue, greasy tongue fur, pulse. Governing Law: Spleen Qi, only with dampness. Recipe: End with Decoction. Endometrial cancer after endometrial cancer diet note after note what diet? (1) Yichi thistle vegetables, melon, water chestnut, barley, Ficus pumila fruit, plum, burdock root vegetables, oysters, turtles, seahorses. ? (2) bleeding should be eating shark fin, sea cucumber, shark fish, black fungus, mushroom, mushrooms, mussels, beans. (3) edema Yichi sturgeon, Ulva, red bean, corn, carp, mud carp, loach, clams, pancreas, fish, duck, lettuce, coconut pulp. ? (4) low back pain Yichi seeds, walnut meat, barley, leeks, plums, chestnuts, taro, turtles, jellyfish, royal jelly, horseshoe crab, crab. ? (5) leucorrhea more Yichi squid, mussels, clams, razor clams, oysters, turtles, jellyfish, sheep pancreas, birds, cowpea, ginkgo, walnut, lotus seed, Gorgon fruit, celery. ? (6) prevention and treatment of chemotherapy, radiotherapy side effects of the food: tofu, pork liver, herring, carp, squid, duck, beef, frog, hawthorn, plum, green beans, figs. ? Also need to note the following points in order to avoid recurrence: 1, diet should be light, do not eat lamb, shrimp, crab, eel, salted fish, blackfish and other developed properties. 2, eat chili, Ma pepper, raw onions, raw garlic, white wine and other spicy food and drinks. 3, fasting longan, red dates, donkey-hide gelatin, royal jelly and other hot, blood coagulation and hormone-containing ingredients. 4, eat lean meat, chicken, eggs, quail eggs, carp, turtles, white fish, cabbage, asparagus, celery, spinach, cucumber, melon, mushrooms, tofu, kelp, seaweed, and fruit. 5, food rationing, not overeating. 6, adhere to the low-fat diet, eat lean meat, eggs, green vegetables, fruit. 7, eat more whole grains such as corn, beans and so on. 8, eat nutritious dried foods such as peanuts, sesame seeds, melon seeds. 9, not eat spicy, wine, frozen and other foods. Prevention of a disease, because the cause is unknown, is still not prevent its occurrence, should be done on patients suspected comprehensive and detailed examination. Strengthen health education, bleeding after menopause, menopause menstrual disorders should be to rule out the possibility of cancer for young women with menorrhagia and treatment 2 to 3 months with no response, should be done and endometrial cytology and neck lining checking, extensive anti-cancer census. In particular, to have high risk factors, screening more meaningful. Confirmed as endometrial hyperplasia or atypical adenomatous hyperplasia of precancerous lesions, the situation should be based on the patient with total hysterectomy. Second, strict indications for estrogen control, and rational use. Menopausal and postmenopausal women should be used with caution. Ying Yuan time not too long, the volume should not be large; and should be closely observed response. Third, surgical treatment should be taken to avoid spof cancer cells or direct planting, resulting in failure to cure, to promote relapse. Precautionary measures, see the former pathology, direct way to the spof the transfer items. Fourth, treatment should be regularly followed up. Prognosis better prognosis of endometrial cancer. The prognosis with clinical stage, pathological type, organization, and myometrial invasion by section, the adequacy of treatment, and whether the transfer of lymph nodes, abdominal cavity with or without cancer, tumor ER, PR of the level, and even patients Age and other factors. Moreover, the factors are interrelated. Introduction to endometrial cancer endometrial cancer diet what diet? To improve the treatment of cancer have their own constitution from the beginning, from the starve cancer cells. Eat more alkaline food, improve their acidic, the body must also add organic nutrients, so as to starve cancer cells at the same time, restore their immunity. What is endometrial cancer diet? 1 endometrial cancer diet, alkaline foods: beans, carrots, apples, cabbage, onion, tofu and so on. Endometrial cancer diet for 2, strongly acidic foods: egg yolk, cheese, white sugar or persimmon, mullet roe, dried cod. 3 endometrial cancer diet, acidic food: ham, bacon, chicken, tuna fish, pork, eel, beef, b, wheat, butter, horse meat. Endometrial cancer diet for 4, acidic foods: rice, peanut, beer, wine, fried tofu, seaweed, clams, octopus, catfish. Endometrial cancer diet 5, the alkaline food: dried radish, soybean, carrot, tomato, bananas, oranges, pumpkin, strawberry, protein, dried plum, lemon, spinach and so on. 6 endometrial cancer diet, alkaline foods: grapes, tea, kelp buds, kelp, lemon and so on. 7 endometrial cancer diet, drinking green tea can prevent endometrial cancer. A special research shows that drinking green tea in particular, for endometrial cancer may have some preventive effect, but this effect may be limited to prevention of premenopausal women. Survey results show that green tea drinking, especially by not drinking than those who suffer from the risk of endometrial cancer decreased. And tea times more risk of endometrial cancer decreased the more evident. 7 times a week drinking and 7 times more, the risk of endometrial cancer decreased by about 20%. Against endometrial cancer endometrial cancer hazard mainly for the following 5 points. 1 Infertility: about 50% of patients with endometriosis associated with infertility, unexplained infertility in patients, about 30-40% suffer from endometriosis. Endometriosis with infertility, often due to diseases caused by pelvic mass, adhesions, tubal blockage poor follicular development or ovulation disorder caused by such factors. 2, dysmenorrhea, endometriosis: clinical features of endometriosis as a progressive dysmenorrhea, is common and prominent features, and more for the secondary, that is, since the beginning occurrence of endometriosis, menstrual cramps, patients complained in the past and No pain, began to appear from a certain period of dysmenorrhea, can occur before menstruation, menstruation and after menstruation. 3, rectal irritation: the cyclical nature of aggravated sexual rectal irritation is rare in other gynecological diseases, is the most valuable diagnostic of this disease symptom. Rectum, anus, vulva bulge, falling pain, tenesmus and stool frequency increased sense. When the lesions gradually increased, the symptoms become more evident, but after symptoms disappear. 4, of irregular menstruation endometriosis: endometriosis patients often have menstrual cycles, increased or prolonged menstrual period by the amount of such phenomena, indicating the performance of patients with ovarian dysfunction. Irregular menstruation can be used as diagnostic reference, but there is no value in differential diagnosis. 5, sexual pain: When present in the vaginal fornix endometriosis nodules, nodule or adhesion rectal depression, or when ovarian adhesions in the pelvic floor, may have sexual intercourse painful. Late symptoms of endometrial cancer endometrial cancer endometrial cancer, also known as uterine cancer, originating in the uterine body, is derived from endometrial cancer, uterine lining cells of the non-normal growth. Endometrial cancer usually occurs in women over 50 years, causing endometrial cancer the most common cause is that in the human body, compared with progesterone, estrogen excess. What are the symptoms of endometrial cancer and how is it treated? 1, vaginal discharge due to the growth of the uterine cancer, cervical cancer less than the chances of infection, it may be only a small amount of the initial bloody vaginal discharge, but Sri Lanka after the infection, necrosis, there are a lot of foul-smelling pus and blood like liquid discharge. Sometimes drainage can be mixed with small fragments of cancer tissue. If the cervical cavity empyema, fever, abdominal pain, leukocytosis. General situation is rapidly deteriorating. 2, irregular bleeding after menopause vaginal bleeding is the main symptom of endometrial cancer, usually small to moderate amount of bleeding, rarely heavy bleeding. Not only to younger patients or near easily mistaken for menopause, irregular menstruation, without timely treatment, even though doctors often neglect. Individuals who have delayed menstrual cycle, but the performance is not the law. In many postmenopausal patients showed persistent or intermittent vaginal bleeding. Endometrial cancer patients in general no bleeding. Late bleeding can be mixed with Lanrou tissue. 3, pain, cancer and bleeding and the drainage of cholestasis, irregular uterine contractions caused by stimulation of paroxysmal pain, accounting for about 10 to 46%. Such symptoms occur mostly in late. Such as cancer or erosion through serosa parametrial connective tissue, bladder, straight or pressure can cause pain and other organizations often were refractory and progressive increase; and more from the lumbosacral region, lower abdomen to the thigh, knee-length radiation. 4, other patients with advanced lower abdominal palpable increase their uterus or, and adjacent tissues and organs can cause the side of the lower limb swelling, pain, or pressure caused by the side of the ureter or renal pelvis and hydroureter caused by renal atrophy; or anemia, weight loss, fever , cachexia and other systemic failure in performance. According to the above symptoms, then the secondary inspection, once the symptoms, treatment should be positive. So the treatment of endometrial cancer what where? There are surgery, radiotherapy and chemotherapy, Chinese medicine treatment. Early surgical treatment of endometrial cancer to take big chances of healing, surgical removal of the uterus, cervix, ovaries and fallopian tubes. If the cancer has been transferred, the doctor may also remove pelvic lymph nodes, combined with Chinese medicine after conditioning treatment, but surgery has certain indications and contraindications, the need to physical capacity of patients and tumor size to determine the location and development . Radiotherapy frail and have serious medical complications can not be resistant to surgery, and surgery is not appropriate for more than , including intracavitary and external irradiation. Anti-cancer chemotherapy or radiotherapy in advanced unresectable and treatment for recurrent cases, the available 5 - fluorouracil (5-Fu), cyclophosphamide (CTX), mitomycin (MMC), doxorubicin (BDR) , cisplatin (DDP) and other combination chemotherapy have a certain effect. Either after surgery or radiotherapy and chemotherapy, will give a certain amount of bodily injury patients, so in general surgery and chemotherapy before and after treatment give patients medicine to improve the patient's own resistance to help kill cancer cells. Treatment for endometrial cancer are commonly used traditional Chinese medicine ZXC compound cantharidin capsule, javanica oil oral liquid, oral cinobufotalin, Xiaoaiping tablets. In addition, patients with endometrial cancer to bring physical pain also brought a lot of mental burden. Therefore, the people around, including health care workers and their families have confidence and comfort for patients, encourage patients to actively cooperate with treatment. Stage a period of: tumor limited to endometrium. b of: depth of invasion 1 / 2 myometrium. c of: depth of inva 1 / 2 myometrium. , a period: only cervical mucous glands involved. b of: cervical stromal involvement. a period of: tumor involving the serosa and (or) attachment and (or) positive peritoneal cytology. b of: vaginal metastases. c of: pelvic lymph nodes and (or) para-aortic lymph node metastases. a period of: tumor invasion and bladder or rectal mucosa. b period: distant metastases, including intra-abdominal and (or) inguinal lymph node cancer of the food can be one of nine fish: a result of fish containing 3 fatty acids, can reduce cholesterol, reduce platelet aggregation within blood vessels, reducing coronary occlusion and the probability of myocardial infarction, animals can inhibit colorectal cancer was found. Second, cruciferous vegetables: broccoli, mustard greens, cabbage, Chinese cabbage, broccoli, etc., are rich in antioxidant vitamins C and carotenoids, can damage the cells against free radicals. In addition, these vegetables also contain "drawing Duo Class" and "sulfur-containing organic compounds," the former function of the prevention of breast cancer, which can produce many enzymes in the body, relieve cancer-causing toxic hazard. Third, the soy: soy containing "isoflavones substances" on the part of cancer prevention help. The medical study confirmed that eating 60 grams a day of soy, blood cancer half effective concentration to inhibit breast cancer, endometrial cancer, ovarian cancer and prostate cancer growth. Fourth, whole grains: whole grains rich in "Cassia", can lift the activity of intestinal carcinogens, rich in fiber has been determined to prevent colorectal cancer effect. Fifth, selenium, sulfur and other organic compounds in the vegetables: onions, garlic is rich in sulfur, selenium, and "allyl cysteine sulfur", can help the liver detoxify and prevent liver cancer. According to the U.S. large-scale studies have shown that garlic can prevent heart disease in addition, but also can reduce the incidence of colorectal cancer; a week to eat 3 garlic people, the probability of suffering from colorectal cancer who do not eat less than one-third. VI foods containing vitamin C: Vitamin C can reduce free radical damage to the cell gene, to avoid cell carcinoma of, and foods rich in vitamin C include grapefruit, orange, lemon, pomelo and so on. Seven, red fruits and vegetables: tomatoes, papaya, cantaloupe, sweet potatoes and so rich in carotene, after feeding in the body into vitamin A, to protect the eyes and the purpose of anti-cell oxidative stress. The study also found that more intake of carotenoids can inhibit prostate cancer occurred. VIII, tea and red wine: red wine is fermented with grape skins together, to save the precious grape skin antioxidant, to prevent the human body against free radicals. Human cells are known to cause free radical oxidation of blood pressure, diabetes, myocardial infarction, stroke and cancer. Studies have shown that drinking a small cup of red wine a day can reduce the incidence of these diseases, but excessive alcohol will increase the anti-hepatitis and cirrhosis mortality. In addition, tea and red wine contain flavonoids, on the part of the cancer preventive effect. IX leaves: green cauliflower, broccoli, cabbage and spinach are rich in folic acid, methionine can increase the amount of blood has anti-cancer effect. 1 Basic Information book information
Title: Endometrial carcinoma of: Wang Six Publisher: Peking University Medical Press Publication date: January 2010 ISBN: 9787811168013 Book Size: 16 to open Price: 118 yuan Introduction "endometrial cancer" Introduction: the womb Film cancer is one of common gynecological malignancies, serious harm to the health of women. "Endometrial cancer" on the basis of endometrial cancer, epidemiology, etiology, pathogenesis, pathology, clinical manifestations, diagnosis, treatment and prognosis were more systematic and comprehensive exposition. Especially for standardized treatment of endometrial cancer, multimodality therapy, dialectical therapy in medicine and diet therapy, new treatment techniques and drug application in detail, reflect the current research results of endometrial cancer. About six Wang, 1965 strangers, male, Mongolian, MD, Peking University Professor. Deputy Director, Department of Obstetrics and Gynecology, Peking University, Peking University People's Hospital Obstetrics and Gynecology, deputy director of prevention, teaching and research director, deputy director of gynecology. Introduction Book Contents Chapter Epidemiology Chapter II Chapter III of etiology, pathogenesis and progress of basic research, Chapter IV Chapter V of endometrial hyperplasia and pathological characteristics of histological type diagnosis and differential diagnosis of Chapter VI Chapter VII stage Chapter VIII Chapter IX of the transfer characteristics of surgical treatment of radiation therapy Chapter X Chapter XI Chapter XII chemotherapy, endocrine therapy of Chinese medicine treatment of Chapter XIII Chapter XIV Chapter XV of molecular targeted therapy to retain reproductive function after treatment Chapter sixteen of endometrial hormone replacement therapy after treatment follow-up of Chapter XVII Chapter XVIII Chapter XIX prognosis of recurrence and metas
tasis of Chapter twenty-first chapter dealing with end-stage combined diagnosis and treatment of other malignancies, the second Appendix XII-related network res . uterine fibroids diet in Note 1, not eat chili, Ma pepper, raw onions, raw garlic, white wine and other spicy food and drinks. 2, eat nutritious dried foods such as peanuts, sesame seeds, melon seeds. 3, eat lean meat, chicken, eggs, quail eggs, carp, turtles, white fish, cabbage, asparagus, celery, spinach, cucumber, melon, mushrooms, tofu, kelp, seaweed, and fruit. 4, the diet should be light, do not eat lamb, shrimp, crab, eel, salted fish, blackfish and other developed properties. 5, food rationing, not overeating. 6, adhere to the low-fat diet, eat lean meat, eggs, green vegetables, fruit. 7, eat more whole grains such as corn, beans and so on. 8, not eat spicy, wine, frozen and other foods. 9, fasting longan, red dates, donkey-hide gelatin, royal jelly and other hot, blood coagulation and hormone-containing ingredients.
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