Ciwon daji na Mahaifa

Ciwon daji na **mahaifa**, wanda kuma aka sani da **ciwon mahaifa**, ya kunshi nau'i biyu na ciwon daji da ke tasowa daga kyallen jikin mahaifa . Ciwon daji na endometrial yana fitowa daga rufin mahaifa, kuma sarcoma na mahaifa yana samuwa daga tsokoki ko nama na tallafi na mahaifa. Ciwon daji na endometrial yana da kusan kashi 90% na duk cututtukan daji na mahaifa a Amurka. Alamomin ciwon daji na endometrial sun haɗa da canje-canje a cikin zubar jini na farji ko jin zafi a ƙashin ƙugu . Alamomin sarcoma na mahaifa sun haɗa da zubar da jini na farji wanda ba a saba gani ba ko kuma taro a cikin farji .

Abubuwan hadari ga ciwon daji na endometrial sun hada da kiba, ciwo na rayuwa, nau'in ciwon sukari na 2, shan kwayoyin da ke dauke da estrogen ba tare da progesterone ba, tarihin amfani da tamoxifen, marigayi menopause, da tarihin iyali na yanayin. Abubuwan haɗari ga sarcoma na uterine sun haɗa da kafin maganin radiation zuwa ƙashin ƙugu. Binciken ciwon daji na endometrial yawanci ya dogara ne akan biopsy endometrial . Ana iya zargin ganewar asali na sarcoma na mahaifa bisa ga alamomi, jarrabawar pelvic, da kuma hoton likita .

Ana iya warkar da ciwon daji na endometrial sau da yawa yayin da sarcoma na uterine yawanci yana da wuyar magani. Jinya na iya haɗawa da hadin tiyata, radiation far, chemotherapy, hormone far, da kuma niyya far . Sama da kashi 80% na mata suna rayuwa fiye da shekaru 5 bayan ganewar asali.

A cikin 2015 kimanin mata miliyan 3.8 ne abin ya shafa a duniya kuma ya yi sanadiyar mutuwar mutane 90,000. Ciwon daji na endometrial ya zama ruwan dare gama gari yayin da sarcomas na mahaifa ke da wuya. A cikin Amurka, ciwon daji na mahaifa yana wakiltar kashi 3.5% na sabbin cututtukan daji. Yawanci suna faruwa a cikin mata masu shekaru 45 zuwa 74 tare da matsakaicin shekarun ganewar asali na 63.

## Nau'ukan
Sharuddan ciwon daji na mahaifa da ciwon mahaifa na iya nufin nau'o'in ciwon daji daban-daban da ke faruwa a cikin mahaifa, wato:

### [[Endometrial Kansa|Ciwon daji na Endometrial]]

* Ciwon daji na *endometrial* ya samo asali ne daga sel a cikin gland na endometrium (rufin uterine). Wadannan sun hada da na kowa kuma wanda za'a iya magancewa *da kyau-bambance-bambancen endometrioid adenocarcinoma,* da kuma mafi munin *ciwon daji na papillary serous carcinoma* da *kwayar mahaifa bayyananne* .
* *Müllerian ciwace-ciwacen daji* (wanda aka fi sani da carcinosarcomas na mahaifa) wasu ciwace-ciwacen kwayoyin cuta ne na endometrial wanda ke nuna bambancin glandular ( carcinomatous ) da stromal ( sarcomatous ).

### Sarcomas na mahaifa

*  ya samo asali ne daga muscular Layer na mahaifa (ko myometrium ). Daga bayanin kula, leiomyosarcomas sun bambanta da uterine leiomyomas, waɗanda ba su da kyau a cikin mahaifa.
* Sarcomas na *endometrial stromal* ya samo asali ne daga kyallen da aka haɗa na endometrium, kuma ba su da yawa fiye da carcinomas na endometrial.

## Alamomi
Duk nau'in ciwon daji na mahaifa na iya nunawa tare da zubar da jini na al'ada na al'ada. Rashin al'ada na iya haɗawa da canji na tsawon lokaci ko adadin jinin haila da sabon jini tsakanin al'ada ko bayan al'ada. Hannun sabon ko ƙara yawan matsa lamba ko ciwo na iya nuna ci gaban ƙari a cikin mahaifa.  Kowane ɗayan waɗannan binciken yana ba da damar ƙarin aiki daga likita.

## Dalilai da abubuwan haɗari
Ba a san tabbas abin da ke haifar da ciwon daji na mahaifa na iya zama ba, ko da yake an ambaci rashin daidaituwa na hormone a matsayin haɗari. Masu karɓar isrogen, waɗanda aka sani suna nan a saman sel na irin wannan nau'in ciwon daji, ana tsammanin suna hulɗa tare da hormone wanda ke haifar da haɓakar ƙwayar sel, wanda zai iya haifar da ciwon daji. Ba a fahimci ainihin hanyar yadda hakan ke faruwa ba. 

Abubuwan hadari ga ciwon daji na endometrial sun hada da kiba, ciwo na rayuwa, nau'in ciwon sukari na 2, shan kwayoyin da ke dauke da estrogen ba tare da progesterone ba, tarihin amfani da tamoxifen, marigayi menopause, da wasu yanayi na gado ( Lynch syndrome, Cowden syndrome ). Abubuwan haɗari ga sarcoma na uterine sun haɗa da maganin radiation na farko zuwa ƙashin ƙugu, tarihin amfani da tamoxifen, tarihin yara na retinoblastoma, da leiomyomatosis na gado da ciwon daji na renal cell (HLRCC) .

## Bincike
Don kimanta ciwon daji na mahaifa, likita na iya yin jarrabawar mahaifa don duba gabobin pelvic na ciki da gani da kuma jin girma da matsayi na mahaifa da ovaries. Hakanan za'a iya yin " pap smear " don goge gefen mahaifar, mahaifa don tattara sel don gwaji da kuma dubawa a karkashin na'urar hangen nesa. Ana yin Dilatation &amp;amp; Curettage sau da yawa don tattara samfurin suturar mahaifa. Ana kuma yin na'urar duban dan tayi don neman ciwace-ciwace.

## Dubawa da Rigakafi
Hakan ya kasan ce ba a ba da shawarar yin gwajin cutar kansar mahaifa ba sai ga mata masu wasu yanayi na gado wadanda ke kara haɗarin su (Lynch, Cowden, HRCRC).

Gabaɗaya, haɗe-haɗen maganin hana haihuwa na baka da na progestin-kawai suna da kariya daga cututtukan daji na mahaifa. Rage nauyi da/ko tiyatar bariatric ya kasan ce kuma yana rage haɗarin marasa lafiya masu kiba.

## Magani
Maganin ciwon daji na mahaifa na iya bambanta dangane da nau'in ciwon daji da kuma matakan ciwon daji.  A farkon matakai, an fi son aikin tiyata kaɗan.

Don ciwon daji na endometrial, ana amfani da manyan nau'o'in jiyya guda biyar, ciki har da tiyata, radiation far, chemotherapy, hormone far, da kuma niyya far. Mafi yawan hanyoyin magance ciwon daji na endometrial shine tiyata, inda ake cire mahaifa ta hanyar jimlar hysterectomy  Har ila yau, ana iya haɗuwa da hysterectomes tare da cire ovaries da tubes na fallopian, wanda ake kira salpingo-oophorectomy . Bugu da ƙari, maganin hormone wanda ke neman toshe ci gaban ƙwayoyin kansa ana iya amfani dashi a cikin maganin ciwon daji na endometrial. Maganin da aka yi niyya na iya haɗawa da ƙwayoyin rigakafi na monoclonal, masu hana mTOR, da masu hana siginar siginar waɗanda duk ke yin niyya ga ƙwayoyin cutar kansa musamman.

Tun daga 2021, zaɓuɓɓukan jiyya don sarcoma na mahaifa sun haɗa da tiyata, maganin radiation, chemotherapy, da maganin hormone. 

## Hasashen
Hasashen ya bambanta ga nau'ikan ciwon daji na endometrial daban-daban. Abubuwan da ke haifar da tsinkaya a cikin nau'in ciwon daji na mahaifa suna da shekaru a ganewar asali, mataki na ciwon daji, matsayi na ciwon daji, histology, zurfin mamayewa a cikin myometrium, da kuma kasancewar yaduwa zuwa ƙwayoyin lymph na kusa ko wasu yankuna. Ciwon daji na endometrial yawanci yana da kyakkyawan rayuwa na shekaru 5 idan an gano shi da wuri. Gabaɗaya, hasashen ya fi talauci ga sarcomas na uterine idan aka kwatanta da ciwon daji na endometrial.

## Epidemiology

Ciwon daji na mahaifa yana shafar kusan 3.1% na mata yayin rayuwarsu. Ciwon daji na mahaifa ya haifar da mutuwar mutane 45,000 a duniya a cikin 1990, adadin ya karu zuwa mutuwar 58,000 a 2010.  Arewacin Amurka da Arewacin Turai suna da mafi yawan adadin ciwon daji na mahaifa. Asiya, Kudancin Turai, Ostiraliya da Kudancin Amurka suna da matsakaicin farashi, tare da mafi ƙarancin farashi a Afirka da Gabashin Asiya.  Kimanin kashi 81% na mata masu fama da cutar kansar mahaifa suna rayuwa har tsawon shekaru biyar. Wannan adadin ya fi girma tare da ƙarin ciwon daji na gida a kashi 95% na rayuwa tsawon shekaru biyar kuma ƙasa don yaduwar cutar kansa mai nisa, a adadin rayuwa na 16.8% na shekaru biyar. 

### Ƙasar Ingila
Ciwon daji na mahaifa shine na hudu mafi yawan ciwon daji a cikin mata a Burtaniya (kusan mata 8,500 aka gano suna da cutar a cikin 2011), kuma shine na goma mafi yawan sanadin mutuwar ciwon daji a cikin mata (kusan mata 2,000 sun mutu a 2012).

### Amurka
Ciwon daji na mahaifa yana da yawa a cikin Amurka, tare da kusan mata 772,247 da cutar a cikin 2016. Daga cikin waɗancan cututtukan daji na mahaifa, kusan kashi 90% na cututtukan cututtukan daji ne na endometrial.  Wannan shi ne nau'in ciwon daji na hudu da aka fi sani.

A {asar Amirka, ciwon daji na mahaifa shine mafi yawan ciwon daji na gynecologic. Adadin matan da aka gano suna dauke da cutar kansar mahaifa na karuwa akai-akai, inda a shekarar 1999 aka gano 35,040 da kuma 56,808 a shekarar 2016. Adadin da aka daidaita shekarun sabbin shari'o'i a cikin 1999 ya kasance 23.9 a cikin 100,000 kuma ya karu zuwa 27.3 a cikin 100,000 a cikin 2016. Yawan cutar kansar mahaifa ya karu har ma a cikin 2019, tare da kusan sabbin maganganu 61,880.

Adadin abubuwan da suka faru da mutuwa don ciwon daji na mahaifa sun bambanta dangane da launin fata. Adadin ganewar asali shine mafi girma ga fararen mata, tare da sabbin maganganu 28.1 a cikin mutane 100,000. Bakar fata mata suna da irin wannan lamarin tare da sabbin maganganu 27.4 a cikin mutane 100,000. Sauran kabilun suna da kananan abubuwan da suka faru: Matan Hispanic suna da sabbin shari'o'i 24.1 a cikin mutane 100,000, matan Asiya/Pacific suna da sabbin shari'o'i 20.8 a cikin mutane 100,000, kuma matan Indiyawan Amurka/Alaska suna da sabbin shari'o'i 19.7 a cikin mutane 100,000. Dangane da adadin mutuwar ciwon daji na mahaifa, mata baƙar fata sun kasance mafi girma, 8.5 mutuwar a cikin mutane 100,000. Yawan mace-macen sauran kabilun ya ragu matuka. Fararen mata suna da mutuwar 4.4 a cikin mutane 100,000, matan Hispanic suna da mutuwar 3.9 a cikin mutane 100,000, Matan Indiyawa / Alaska na Amurka sun mutu 3.5 a cikin 100,000, kuma matan Asiya/Pacific suna da mutuwar 3.1,000 na mutum 100.

## Manazarta