Endometrial Kansa

Ciwon daji na **endometrial ciwon daji** ne da ke tasowa daga endometrium ( rufin mahaifa ko mahaifa). Sakamakon rashin girma na sel wanda ke da ikon mamayewa ko yada zuwa wasu sassan jiki.  Alamar farko ita ce mafi yawan zubar jinin al'ada ba tare da haɗuwa da haila ba . Sauran alamomin sun haɗa da jin zafi tare da fitsari, jin zafi yayin jima'i, ko ciwon ƙashin ƙugu . Ciwon daji na endometrial yana faruwa mafi yawanci bayan menopause(Bayan daukewar jinin alada).

Kusan 40% na lokuta suna da alaƙa da kiba . Ciwon daji na endometrial kuma yana da alaƙa da yawan bayyanar isrogen, hawan jini da ciwon sukari . Ganin cewa shan estrogen kadai yana ƙara haɗarin ciwon daji na endometrial, shan duka estrogen da progestogen a hade, kamar yadda a yawancin kwayoyin hana haihuwa, yana rage haɗarin. Tsakanin kashi biyu zuwa biyar na al'amuran suna da alaƙa da kwayoyin halittar da aka gada daga iyaye. Ciwon daji na endometrial wani lokaci ana kiransa da “ Cancer mahaifa ” ko da yake ya bambanta da sauran nau'in kansar mahaifa kamar kansar mahaifa, sarcoma na mahaifa, da cututtukan trophoblastic . Mafi yawan nau'in ciwon daji na endometrial shine ciwon daji na endometrioid, wanda ke da fiye da 80% na lokuta. Ciwon daji na endometrial yawanci ana gano shi ta hanyar biopsy endometrial ko ta hanyar ɗaukar samfura yayin hanyar da aka sani da dilation da curettage . Binciken Pap ba yawanci isa ya nuna ciwon daji na endometrial ba. Ba a buƙatar yin bincike na yau da kullun a cikin waɗanda ke cikin haɗarin al'ada ba.

Babban zaɓin magani don ciwon daji na endometrial shine hysterectomy na ciki (jimlar cirewa ta hanyar tiyata na mahaifa), tare da cire tubes na Fallopian da ovaries a bangarorin biyu, wanda ake kira salpingo-oophorectomy na biyu. A cikin lokuta masu ci gaba, ana iya ba da shawarar maganin radiation, chemotherapy ko maganin hormone .  Idan an gano cutar a farkon matakin, sakamakon yana da kyau,  kuma jimlar shekaru biyar na rayuwa a Amurka ya fi 80%.

A cikin 2012, ciwon daji na endometrial ya faru a cikin 320,000&nbsp;mata kuma ya haifar da 76,000&nbsp;mutuwa. Wannan ya sa ya zama na uku mafi yawan sanadin mutuwa a cikin cututtukan daji waɗanda ke shafar mata kawai, bayan ciwon daji na ovarian da mahaifa.  Ya fi zama ruwan dare a kasashen da suka ci gaba kuma shi ne cutar kansar da aka fi sani da bangaren haihuwa na mata a kasashen da suka ci gaba.  Adadin ciwon daji na endometrial ya karu a cikin ƙasashe da yawa tsakanin shekarun 1980 zuwa 2010. An yi imanin hakan ya faru ne saboda karuwar yawan tsofaffi da karuwar yawan kiba.

## Alamomi
Zubar da jini ko tabo a cikin mata bayan menopause yana faruwa a kashi 90% na ciwon daji na endometrial. Jini yana da yawa musamman tare da adenocarcinoma, yana faruwa a kashi biyu bisa uku na duk lokuta. Rashin hawan hawan haila ko tsayi mai tsayi, nauyi, ko yawan zubar jini a cikin mata kafin lokacin al'ada yana iya zama alamar ciwon daji na endometrial.

Alamun da banda zubar jini ba a saba gani ba. Sauran alamomin sun haɗa da bakin ciki fari ko bayyananniyar fitar farji a cikin matan da suka shude. Ciwon da ya ci gaba yana nuna alamun bayyanar cututtuka ko alamun da za a iya gano su akan gwajin jiki . Mahaifa na iya kara girma ko ciwon daji na iya yaduwa, yana haifar da ciwon ciki na ƙasa ko ƙumburi. Jima'i mai radadi ko fitsari mai radadi ko wahalar fitsari ba su da yawa alamun ciwon daji na endometrial.  Haka kuma mahaifar na iya cika da majina (pyometrea ) . Daga cikin matan da ke da waɗannan ƙananan alamun bayyanar cututtuka (fitowar farji, ciwon ƙwai, da maƙarƙashiya), 10-15% suna da ciwon daji.

## Abubuwan haɗari
Abubuwan haɗari ga ciwon daji na endometrial sun haɗa da kiba, ciwon sukari mellitus, ciwon nono, amfani da tamoxifen, ba tare da haihuwa ba, marigayi menopause, babban matakan estrogen, da karuwar shekaru. Nazarin shige-da-fice (nazarin ƙaura), waɗanda ke nazarin canjin haɗarin cutar kansa a cikin yawan jama'a da ke motsawa tsakanin ƙasashen da ke fama da cutar kansa daban-daban, ya nuna cewa akwai wasu abubuwan muhalli don ciwon daji na endometrial.  Waɗannan abubuwan haɗari na muhalli ba su da kyau sosai. 

### Hormones
Yawancin abubuwan haɗari ga ciwon daji na endometrial sun haɗa da manyan matakan estrogens. An kiyasta kashi 40% na lokuta suna da alaƙa da kiba. A cikin kiba, yawan adadin adipose nama yana haɓaka jujjuyawar androstenedione zuwa estrone, estrogen. Matsayin mafi girma na estrone a cikin jini yana haifar da ƙasa ko babu ovulation kuma yana fallasa endometrium zuwa ci gaba da manyan matakan estrogens. Kiba kuma yana haifar da ƙarancin cire isrogen daga jini. Polycystic Ovary Syndrome (PCOS), wanda kuma ke haifar da rashin daidaituwa ko rashin daidaituwa, yana da alaƙa da ƙimar ciwon daji na endometrial saboda dalilai iri ɗaya da kiba. Musamman, kiba, nau'in&nbsp;Ciwon sukari na II, da juriya na insulin sune abubuwan haɗari ga Nau'in&nbsp;Na ciwon daji na endometrial. Kiba yana ƙara haɗarin ciwon daji na endometrial da 300-400%. 

Maganin maye gurbin estrogen a lokacin menopause lokacin da ba daidai ba (ko "masu adawa") tare da progestin wani abu ne mai haɗari. Mafi girma allurai ko tsawon lokaci na maganin isrogen yana da haɗari mafi girma na ciwon daji na endometrial. Mata masu ƙananan nauyi suna cikin haɗari mafi girma daga isrogen mara nauyi. Tsawon lokacin haihuwa-ko dai daga farkon hailar farko ko kuma ƙarshen menopause - shima yana da haɗari. Estrogen ba tare da hamayya ba yana haɓaka haɗarin mutum na ciwon daji na endometrial da 2-10&nbsp;ninka, dangane da nauyi da tsawon jiyya. A cikin maza waɗanda suka ɗauki testosterone kuma ba su sami hysterectomy ba, canzawar testosterone zuwa estrogen ta hanyar androstenedione na iya haifar da haɗarin ciwon daji na endometrial.

### Genetics

Hakanan cututtukan kwayoyin halitta na iya haifar da ciwon daji na endometrial. Gabaɗaya, abubuwan gado suna ba da gudummawa ga 2-10% na cututtukan daji na endometrial. Lynch ciwo, wani autosomal rinjaye kwayoyin cuta wanda yafi haifar da ciwon daji na colorectal, kuma yana haifar da ciwon daji na endometrial, musamman ma kafin menopause. Mata masu fama da cutar Lynch suna da 40-60%&nbsp;hadarin tasowa ciwon daji na endometrial, fiye da hadarin bunkasa launin launi (hanji) ko ciwon daji na ovarian.  Ciwon daji na Ovarian da endometrial suna haɓaka lokaci guda a cikin 20% na mutane. Ciwon daji na endometrial kusan koyaushe yana tasowa kafin ciwon hanji, a matsakaici, 11&nbsp;shekaru kafin. Carcinogenesis a cikin ciwo na Lynch ya fito ne daga maye gurbi a cikin MLH1 ko MLH2 : kwayoyin halittar da ke shiga cikin tsarin gyaran gyare-gyaren rashin daidaituwa, wanda ke ba da damar tantanin halitta don gyara kuskure a cikin DNA. Sauran kwayoyin halittar da suka rikide a cikin cutar Lynch sun hada da MSH2, MSH6, da PMS2, wadanda kuma kwayoyin halittar da ba su dace ba ne. Mata masu fama da cutar Lynch suna wakiltar 2-3% na ciwon daji na endometrial; Wasu kafofin sun sanya wannan har zuwa 5%.  Dangane da maye gurbin kwayoyin halitta, matan da ke fama da cutar Lynch suna da haɗari daban-daban na ciwon daji na endometrial. Tare da maye gurbin MLH1, haɗarin shine 54%; tare da MSH2, 21%; kuma tare da MSH6, 16%.

Mata masu tarihin iyali na ciwon daji na endometrial suna cikin haɗari mafi girma. Kwayoyin halitta guda biyu da aka fi danganta su da wasu ciwon daji na mata, BRCA1 da BRCA2, ba sa haifar da ciwon daji na endometrial. Akwai wata alaka a fili da wadannan kwayoyin halitta amma ana danganta ta da amfani da tamoxifen, maganin da kansa zai iya haifar da ciwon daji na endometrial, a cikin nono da kuma ciwon daji na ovarian. Halin halittar da aka gada Cowden ciwo kuma na iya haifar da ciwon daji na endometrial. Mata masu wannan cuta suna da kashi 5-10%&nbsp;Hadarin rayuwa na haɓaka ciwon daji na endometrial,  idan aka kwatanta da 2-3%&nbsp;kasadar ga matan da ba su shafa ba.

An kuma gano bambance-bambancen kwayoyin halitta na yau da kullun don shafar haɗarin ciwon daji na endometrial a cikin manyan nazarin ƙungiyar genome-fadi . An danganta yankuna goma sha shida na genomic tare da ciwon daji na endometrial kuma bambance-bambancen gama gari suna bayyana kusan kashi 7% na haɗarin dangi.

### Sauran matsalolin lafiya
Wasu hanyoyin kwantar da hankali na wasu nau'ikan ciwon daji suna ƙara haɗarin rayuwa na ciwon daji na endometrial, wanda shine tushen 2-3%. Tamoxifen, maganin da ake amfani da shi don magance ciwon nono na estrogen-tabbatacce, an danganta shi da ciwon daji na endometrial a cikin kusan 0.1% na masu amfani, musamman tsofaffi mata, amma fa'idodin rayuwa daga tamoxifen gabaɗaya ya fi haɗarin ciwon daji na endometrial. Kwas ɗin tamoxifen na shekara ɗaya zuwa biyu yana kusan ninka haɗarin ciwon daji na endometrial, kuma tsarin jiyya na shekaru biyar yana ninka haɗarin. Raloxifene, irin wannan magani, bai tada haɗarin ciwon daji na endometrial ba. A baya can ciwon daji na kwai yana da haɗari ga ciwon daji na endometrial, kamar yadda ake yi na rediyo a baya zuwa ƙashin ƙugu. Musamman, ciwace-ciwacen kwayar halitta na ovarian granulosa da thecomas sune ciwace-ciwacen da ke da alaƙa da ciwon daji na endometrial.

Ƙananan aikin rigakafi kuma yana da tasiri a cikin ciwon daji na endometrial. Hawan jini kuma abu ne mai haɗari, amma wannan yana iya kasancewa saboda alaƙarsa da kiba. Zauna akai-akai na tsawon lokaci yana da alaƙa da yawan mace-mace daga ciwon daji na endometrial. Ba a kawar da haɗarin ta hanyar motsa jiki na yau da kullum, kodayake an saukar da shi.

## Tarihi da al'adu
Ciwon daji na endometrial ba a san shi sosai a wurin jama'a ba, duk da yawansa. Akwai ƙananan fahimtar alamun, wanda zai iya haifar da ganewar asali da kuma rayuwa mafi muni.

## Manazarta