Prediction of cervical cancer

Cervical cancer is a cancer of dangerous, prognosis of survival of which depends on the stage at which there is a malignant process and prevalence of metastases.

Cervical cancer involves the emergence and further progression of malignant tumors, which may be localized in the vaginal or cervical canal portion. Pathology is characteristic of the representatives of 30-55 years. However, this does not mean that cancer can not develop at a younger or older age. With the qualitative and quantitative changes in life there is a rejuvenation of malignant tumors, including cervical cancer.

Often, cervical cancer has a poor prognosis. However, if early diagnosis and proper treatment, the prognosis of survival can be beneficial. In particular, for the detection and treatment of cervical cancer at stages 0-1 survival prognosis reaches 90-100%. At the last stage of the forecast, mainly unfavorable. According to forecasts, the five-year survival rate is observed in 5-10% of cases.

Pathogenesis

The development of cervical cancer is closely related to the peculiarities of the structure of the cervix. It is noteworthy that the neck is not considered an independent body. This is the lower cervical department, which is characterized by its narrowness.

The cervix is ​​a kind of barrier. Outwardly resembles muscular neck tube. Its length is only a few centimeters. However, the uterus department performs several important functions, in particular, protects the uterus from the harmful microflora, child bearing, engages in labor.

the cervix can be presented in two sections:

• vaginal;
• supravaginal.

Supravaginal department adjacent to the uterus, in connection with what is invisible. In turn, the vaginal part of the investigated gynecologists during a pelvic exam. This site is adjacent to the vagina, in connection with what is visualized in the mirrors.

Vaginal part of the cervix looks like a pale pink smooth surface. The normal vaginal epithelium of the cervix is ​​uniform. Changes in color and texture can talk about the development of pathology. In this case, you must perform additional diagnostics to prevent cervical cancer. The disease is dangerous and significantly influences the prognosis of survival.

The epithelium of the vaginal portion of the cervix is ​​composed of squamous cells. A feature of this type of epithelium is a multilayered structure. Cells of this epithelium are arranged in several layers:

• immature rounded cells with large nucleus in the basal layer;
• maturing flattened cells in the intermediate layer;
• mature flat cells with a small nucleus in the surface layer.

On the surface of the vaginal portion of the cervix are the old cells. When these cellular elements exfoliated epithelium updated.

The cervix is ​​also lined with another type of epithelium, in particular, a single-layered cylindrical. Such epithelium lines the cylindrical surface of the channel, which is located inside the cervix. Cervical canal connects the uterus and vagina, as well as provides protection from harmful sterile cavity generated due flora mucus glands. Cylindrical cell monolayer surface gives the channel a characteristic reddish hue and velvety.

Cervical cancer can develop of multilayered epithelium and glandular tissue.

Often, cervical cancer occurs in the area of ​​transformation, which is the junction of two different epithelia. The transition zone is in the region of the outer mouth which forms the lower edge of the cervical canal.

It is known that cervical cancer, which affects the prognosis of survival, arises as a result of premalignant dysplastic changes. These changes affect the cell structure and the processes of cell differentiation and maturation.

As a result of dysplasia lesions occur in the lower layer of the squamous epithelium. Rounded cells become misshapen, they may experience multiple cores. Gradually preneoplastic process applies to the other layers. When abnormal cells acquire signs of aggressiveness and capacity for intensive division and germination in the surrounding tissue, cancer occurs.

The severity of dysplasia expressed by several degrees.

1. CIN I - precancerous changes affect the lower layer of the epithelium. Often these changes are eliminated by the immune system. Cancer can occur in five years only if the associated disorders, such as immune.
2. CIN II - dysplastic changes cover half of the epithelial thickness. Cervical cancer develops in three years.
3. CIN III - precancerous changes occur throughout the epithelium. The division into layers disappears. In fact, cancer is the zero stage. Upon germination of malignant cells in the stroma of the cancer occurs first stage, which occurs in about a year.

Dysplasia has a favorable survival prognosis provided timely detection and treatment which has both medical and surgical nature.

Mechanisms of development and causes

Precancerous lesions that lead to cervical cancer, there are several factors of its origin. The mechanism of cervical cancer has not been studied, which leads to the emergence and development of various theories. In particular, it is actively developed a genetic theory to explain the development of cervical cancer. there is a gene that is the cause of cervical cancer according to this theory.

At this point, it proved HPV influence on the development of cervical cancer and prognosis of survival. When studying the smears of women with cancer in 95% of cases 16 or 18 is detected HPV type. It is these subtypes of viruses are the cause of cervical cancer.

papilloma virus has more than one hundred varieties. Some of them have-producing effect and cause the development of warts and genital warts. Other viruses can also cause cell mutations, since they have a transformative impact. However, in the presence of a strong immunity High risk types of HPV does not cause cervical cancer. The virus is eliminated at the expense of internal reserves of the body within a few months. However, the prolonged presence of dangerous subtypes of HPV in the body indicates the presence of disturbances in the body and the risk of cancer.

Among other factors, which are considered as provoking reasons, allocate:

• smoking;
• inflammatory processes in the pelvis;
• genital infections;
• early sexual activity;
• promiscuous sexual relations;
• carcinogenic effect of smegma;
• adverse environmental conditions;
• background cervical diseases such as pseudo, leukoplakia.

As the prevention of cervical cancer need time to visit the gynecologist and treat diseases of the reproductive system.

Forms and stages

Prediction of survival in uterine cancer depends largely on onkoprotsessa species. There is a classification of cervical cancer, which differentiate types of pathology according to different criteria.

Types of cervical cancer can be divided into two large groups.

1. cervical squamous cell carcinoma diagnosed in the overwhelming number of cases. The tumor is a species is formed by a flat multilayered epithelium.
2. cervical adenocarcinoma It formed from cervical glands. This is a rare kind of cancer of the cervix, which is called adenocarcinoma.

Glandular cancer difficult to diagnose because it is localized in the cervical canal. In this connection, the survival prognosis may be poorer.

Squamous cell carcinoma is:

• Stratum;
• neorogovevayuschy.

When neorogovevayuschy variant of squamous cell cervical cancer survival prognosis is more favorable.

On survival prognosis in cervical cancer affects the direction of the growth of tumors. If the tumor grows deep into the tissues, diagnosis is often delayed, which adversely affects the prognosis of survival.

There are the following options for tumors growth:

• exophytic;
• endophytic;
• mixed.

Intensity of infection in the malignant tumor tissue can be different. This greatly affects the risk of metastasis and prognosis of survival.

Distinguish the following types of cancer depending on the extent of tissue invasion.

1. Preinvasive cancer (in situ) It corresponds to the zero stage of the cancer and dysplasia of the third degree. In this case, there is a malignant tumor that has not grown into the stroma. Prediction of survival with timely treatment is favorable. Healing occurs in 90-100% of cases.
2. microinvasive cancer - a step A1 in which the invasion of tumors into tissue of 3 mm.
3. invasive cancer determined if the invasion depth of greater than 3 mm. Prediction of survival depends on the degree of progression onkoprotsessa. When metastasis occurs survival prognosis worsens.

Prediction of survival in cervical cancer related to the degree of cell differentiation.

1. Moderately differentiated cancer diagnosed in a significant number of cases. Symptoms of metastasis and is usually seen in the third stage. Prediction of survival due to the step in which the pathology is detected.
2. highly differentiated cancer It has a favorable prognosis of survival. Neoplasm grows slowly, the risk of metastasis remains at a low level even at advanced stages. The tumor is no different aggressiveness.
3. poorly differentiated cancer It has an extremely poor prognosis of survival. Education metastasize early due to rapid growth. In addition, the tumor is characterized by aggressiveness.

Stage cervical cancer involves the following steps.

1. The occurrence of cervical lesions. A1 - invasion depth of 3 mm. A2 - germination cells to 5 mm. B1 - involving tissue to 4 cm. B2 - distribution of tumors to a depth of 4 cm.
2. The spread of the tumor in the body of the uterus. A - the involvement of the uterus with no parameters. B - coverage of malignant serous membrane process.
3. Defeat pelvic wall. A - the spread of cancer cells in the lower part of the vagina. In - involving the pelvic wall.
4. The formation of metastases. A - the spread of the tumor in the bladder, bowel area. In - the appearance of distant metastasis.

survival prognosis directly associated with the stage. If the zero and the first stage of survival prognosis is favorable, the last stage of the five-year life expectancy observed in not more than 10%.

manifestations

Cervical cancer is not characterized by the features that would directly point to the development of malignant tumors. This is not the best way affects the prognosis of survival.

The clinical picture consists of the following manifestations.

1. Abnormal discharge. Menstruation becomes longer and more abundant. Women can observe spotting, which are acyclic character. Secretions are anointing character or color of meat slops in the case of tumor lysis. If there is lymph capillaries, occur whites.
2. Pain and discomfort. Pain Syndrome appears with growth neoplasm, which can compress the surrounding tissue. Pain accompany defecation and urination. During sexual intercourse occurs soreness and discomfort.
3. leg swelling. The occurrence of edema associated with metastasis to the lymph nodes. Swelling may be unilateral in nature.
4. Common manifestations. At advanced stages of cancer arise general malaise symptoms. Cancer patients experience fatigue, nausea, vomiting. Often, there is no appetite and fever. It notes the rapid weight loss.

Differentiate signs onkoprotsessa other manifestations of disease can be using different methods of examination.

survey methods

At advanced stages suspect onkoprotsessa possible by gynecological examination and during the ultrasound. In the early stages of diagnosis can be difficult and is carried out by means of histology and other techniques. Detection of Cervical Cancer carried out by means of several basic techniques.

visual inspection

During a pelvic exam the doctor carefully examines the cervical epithelium in the presence of uneven color, expressions or elevations. If there are signs of atypia for additional diagnostics.

Smear on onkotsitologiyu

Cytological diagnosis is carried out every six months. This is an easy and informative way to detect inflammation and abnormal cells, which indicates a possible pre-cancerous and cancerous process. Specialist produces smear sampling from different parts of the neck part. The smear is applied to the glass. sample was dyed in the laboratory to be examined under a microscope.

colposcopy

A study using a colposcope to evaluate the mucosa under a multiple increase. If the doctor detects visual signs of atypia, performed advanced procedure.

During the extended colposcopy epithelium treated with a solution of Lugol. If certain areas are not stained, you can judge the atypia. Defeat HPV tissue occurs when after treatment with a solution of acetic acid appear whitish spots.

Biopsy

For suspected oncological causes, necessary to carry out histological examination. Run the analysis as possible after the biopsy, in which a doctor performs the fence material. A biopsy is performed only when indicated.

Endocervical curettage

If there are signs of adenocarcinoma, it is necessary to perform endocervical curettage. The resulting material after scraping carefully studied histologically.

Assay for determination of tumor marker is used as an estimate of the effectiveness of treatment. With the help of this study can not determine cervical cancer, since the analysis can be a false positive in the case of certain somatic pathologies.

To detect metastases, in which the survival prognosis is significantly reduced, used MRI, CT, X-ray of the lungs, bone scintigraphy and lymphography.

Methods of treatment

Gynecologists use a combination of several treatments to eliminate pathology. The possibility of cure and survival prognosis depends on many factors:

• Oncology step;
• the presence of metastases;
• comorbidities;
• age and individual characteristics of the patients.

Tactics of treatment may differ in young and elderly patients. Treatment involves the following tactics:

• surgical way;
• exposure;
• chemotherapy.

Typically, doctors use three techniques in combination to increase the effectiveness of treatment and improve survival prognosis.

surgical method

Operation is suitable only for zero, first and second stage. This is due to the fact that in the later stages is usually seen single and multiple metastases. The presence of metastasis requires the use of other methods of treatment.

The volume of surgical intervention due to the prevalence of onkoprotsessa and stage cancer progression. Perhaps the use of two main surgical techniques.

1. Cone biopsy. As part of the intervention performed excision of the affected tissue in the form of a cone. Methods recommended for the zeroth and first stages, if the patient is of reproductive cycle.
2. Hysterectomy. The operation involves the removal of the cervix, uterus, ovaries and sometimes, pipes and regional lymph nodes. Radical intervention prevents spread of the tumor, thereby improving survival prognosis.

In some cases surgery may be contraindicated. In this situation, the intensive radiotherapy.

irradiation

Radiation therapy is used as an independent and comprehensive method. During radiotherapy of the tumor removal is due to the death of cancer cells. Irradiation can be used:

• preoperatively, that is necessary for reducing the magnitude of neoplasms;
• after operation to eliminate cancer cells.

Radiotherapy has two methods of:

• remote, the impact on the whole body;
• intracavitary, with the effect only to the locus of pathology.

Teletherapy It has more side effects. As a result of damaged as pathological and healthy cellular elements.

Irradiation can improve survival prognosis. Radiotherapy is often used as an independent method of treatment.

Chemotherapy

Physicians regard chemotherapy as a secondary method that supplements the main treatment. Chemotherapy detrimental effect on abnormal cells and cancer in general. Through this technique can reduce the severity of the symptoms of cancer and affect the survival prognosis.

Chemotherapy can be successfully used before and after surgery. Treatment involves several courses with different intervals. Procedures can be daily, and performed once a week. The interval between the intake of medication may vary.

Physicians selected chemotherapy drugs individually for each patient. Therapy may be performed with one or more drugs in the form of tablets and injections. A course of treatment is both outpatient and inpatient. In some cases, chemotherapy is poorly tolerated by cancer patients women. In order to prevent the side effects are appointed fitosbory before a course of treatment.