Ovarian cancer

Introduction to ovarian cancer Ovarian cancer is one of the common tumors of female reproductive organs, and its incidence is second only to cervical cancer and uterine cancer, accounting for about 4% of female systemic malignancies. However, due to the death of ovarian cancer, it is the first in all kinds of gynecological tumors, posing a serious threat to women's lives. The cause of ovarian cancer is unclear, and its onset may be related to age, fertility, blood type, mental factors and environment. basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of infection: non-infectious Complications: peritonitis

Ovarian cancer etiology

Cancer cells (30%):

In the process of formation of cancer cells, the proliferating cancer cells need to consume a large amount of nutrients, which destroys the body's immunity and resistance.

The site of the viscera where the lesion occurred (40%):

Because of the different organs in the organs of the lesion, the organs or organs in which the lesions occur, destroy the function of which organs. Then there was pain, difficulty in swallowing, vomiting, lack of diet, fullness, cough, bleeding, stagnant water, ascites, fever, dysfunction of the urine, sweating, falling sensation, osteonecrosis, etc. Disordered disorder. Cancer not only destroys the body's own visceral function, but also destroys the body's immune function, leading to visceral function failure, resulting in death.

Ovarian cancer prevention

Focus on early detection of tumors, whether benign or malignant early patients, often no obvious symptoms, benign tumors and malignant potential, should conduct regular screening, in order to early detection of ovarian malignant tumors, should pay attention to the following points:

(1) All solid ovarian masses, or cysts larger than 6 cm, should be surgically removed immediately.

(2) Before menarche and postmenopausal women, there are ovarian masses, which should be considered as tumors. Women of childbearing age have small accessory cystic masses. Those who have not seen the reduction for 2 months are considered as tumors. Surgery at any time.

(C) pelvic inflammatory mass, especially suspected pelvic tuberculosis or endometriosis lumps, after treatment is ineffective, can not rule out the tumor should be surgical exploration.

(D) endometrial adenomatous hyperplasia or endometrial adenocarcinoma after menopause, should pay attention to the presence or absence of tumors in the ovary, and timely surgical treatment.

(5) When performing pelvic surgery, the bilateral ovaries should be carefully examined for signs of disease. In addition to the indications for ovarian disease itself, when the age is over 45 years old, the disease of the uterus should be hysterectomy. It is recommended to remove the bilateral attachment at the same time. .

Ovarian cancer complications Complications peritonitis

1, pedicle torsion is more common, one of the gynecological acute abdomen, more common in the tumor pedicle length, medium size, large mobility, center of gravity biased to one side of the cystic tumor, mostly occurs in the sudden changes in body position, early pregnancy or postpartum, After the pedicle is reversed, the venous return of the tumor is blocked, causing congestion, purple-brown, and even rupture of blood vessels. Tumor necrosis, infection, and acute pedicle rotation may cause severe pain in the lower abdomen. In severe cases, it may be accompanied by nausea. , vomiting, and even shock, the muscles of the affected side of the abdominal wall are tight, the tenderness is significant, and the tension of the mass is large. Once the diagnosis is made, the tumor should be surgically removed immediately. Do not turn the twisted pedicle back during surgery. The clip is cut to prevent the thrombus from falling into the blood circulation.

2. Tumor rupture may cause spontaneous rupture due to ischemic necrosis of the cyst wall or tumor erosion through the wall of the capsule; or traumatic rupture due to squeezing, childbirth, gynecological examination and puncture. After rupture, the cystic fluid flows into the abdominal cavity and stimulates the peritoneum. Can cause severe abdominal pain, nausea, vomiting, and even shock, examination of abdominal wall tension, tenderness, rebound tenderness and other signs of abdominal stimulation, the original mass shrinks or disappears, after diagnosis, should be immediately exploratory laparotomy, cyst removal, clean the peritoneum.

3, infection is less common, more secondary to tumor pedicle torsion or rupture, etc., the main symptoms are fever, abdominal pain, elevated white blood cells and varying degrees of peritonitis, should actively control infection, elective surgery.

4, malignant ovarian benign tumor malignant more occurs in older, especially menopausal, the tumor rapidly increased in a short period of time, patients with abdominal distension, loss of appetite, examination of tumor volume significantly increased, fixed, more ascites, suspected malignant Changes should be dealt with in a timely manner.

Ovarian cancer symptoms common symptoms progressive weight loss exercise amenorrhea fatigue appetite loss menopausal ascites postmenopausal endometrial thickening pain ovarian dysfunction cachexia

(a) symptoms

1. Most of the ages occur in women with perimenopausal period. Those over 35 years old have multiple ovarian epithelial cancers, while those under 35 years old often have germ cell malignant tumors.

2, painful malignant ovarian tumor may be due to changes in the tumor, such as hemorrhage, necrosis, rapid growth caused by a considerable degree of sustained pain, found in the examination of local tenderness.

3, irregular menstruation see irregular uterine bleeding, postmenopausal bleeding.

4, the late stage of weight loss is progressive weight loss.

(two) signs

1. Bilateral lower abdominal mass malignant ovarian tumors accounted for 75% of bilateral growth, while benign ovarian tumors accounted for only 15%.

2. The mass is fixed as one of the characteristics of ovarian malignant tumors.

3. Ascites Although benign ovarian tumors such as fibroids or papillary cystadenoma can also be associated with ascites, malignant ovarian tumors with ascites are more, and because malignant tumor cells pass through the tumor wall or have metastasized to the peritoneum (visual observation Or microscopic examination), ascites is more bloody.

4. The long-term consumption of cachexia is delayed due to long-term consumption and loss of appetite, and there are symptoms such as progressive weight loss, fatigue, and burnout.

Ovarian cancer examination

(A) B-ultrasound: can determine the size, shape, cystic solidity, location and relationship with the surrounding organs, identify large ovarian cysts and ascites.

(B) X-ray examination of the ovarian mature teratoma abdominal plain film can be seen in the teeth or bone images, intestinal angiography can understand the location, size and relationship of the tumor.

(3) CT and MRI examinations may be selected if necessary.

Diagnosis and diagnosis of ovarian cancer

diagnosis

(1) Early diagnosis

Because there are no typical symptoms and signs in the early stage of ovarian malignant tumors, it is still extremely important to ask about the medical history and serious physical examination and gynecological examination. If the clinical situation is suspicious, it should be diagnosed early by modern imaging examination and generalized tumor marker examination. The so-called suspicious situation may be longer ovarian dysfunction, long-term unexplained digestive tract or urinary tract symptoms, young female ovarian enlargement or menopause after touching the ovary, and the suspected ovarian tumor is rapidly increasing, fixed, hardened, etc. .

(two) positioning diagnosis

In the early stage, the accessory can be touched. Combined with imaging examination, it is not difficult to locate the diagnosis. However, in some cases, the primary tumor has an extra-ovarian metastasis and forms a small nodule in the pelvic cavity. In this case, some special examination methods should be selected to assist the diagnosis. Qualitative), should not rely solely on follow-up and follow the mistakes.

(3) Qualitative diagnosis

Although the diagnostic techniques are changing with each passing day, the vaginal sputum smear examination, uterine rectal puncture fluid examination and ascites cytology examination are still simple, easy, rapid basic examination, suspicious cases, laparoscopy and histological examination The diagnosis can be confirmed immediately. Imaging examination, especially vaginal ultrasound scanning, can help to determine the boundary (range of extent) and internal structure (property) of early ovarian malignant tumors. Endocrine examination can help ovarian gland stromal tumors and Part of the diagnosis of ovarian cancer with ectopic endocrine syndrome, serum tumor markers such as CA125, CEA, SONA, SGA, etc. have high sensitivity to ovarian malignant tumors, but their specificity is poor, so can not rely on a single immunization Learning to determine its type, but a combination of multiple tumor markers, such as simultaneous detection of CA125, CEA, ferritin and tissue polypeptide antigen (TPA), can improve the reliability of qualitative diagnosis.

Differential diagnosis

1, ovarian non-neoplastic cysts such as follicular cysts, corpus luteum cysts, etc., generally less than 5cm in diameter, thin wall, more naturally disappear in 1 to 2 months.

2, uterine fibroids ovarian tumors may be confused with uterine fibroids cystic or subserosal uterine fibroids, B-ultrasound can be clearly diagnosed.

3, early pregnancy uterus increased and soft, there is a history of menopause, hCG value can be diagnosed, B-ultrasound has embryo sac or fetal heart pulsation.

4, chronic urinary retention has a history of dysuria or urinary insufficiency, the mass is located in the middle of the lower abdomen, the boundary is unclear, the mass after the catheterization disappears, can also be identified by B-ultrasound.

5, the attachment inflammatory mass has a history of chronic pelvic inflammatory disease and infertility, the position of the mass is low, there is tenderness, and there is adhesion to the uterus.

6, ascites and tuberculous peritonitis (encapsulated effusion) and large ovarian cysts.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.