Uterine cervix sarcoma

　　Uterine cervix sarcoma occurs in the muscle and stromal tissue of the uterine cervix, with a high degree of malignancy, being a mesenchymal tumor that can originate from the cervix muscle layer, endometrial stroma, connective tissue, epithelium, or blood vessels, and can also be a mixed tumor composed of the aforementioned multiple components, which is only 1/10 to 1/15 of uterine body sarcoma. The etiology is not clear and may be related to the following factors:

　　1. Relationship with oral contraceptives and estrogensLong-term oral contraceptives (>15 years) increase the risk of sarcoma, mainly smooth muscle sarcoma. Long-term use of non-contraceptive estrogens also increases the risk of sarcoma, mainly müllerian mixed tumors. There are also reports in the literature that some smooth muscle sarcomas contain estrogen and progesterone receptors, indicating estrogen-dependent tumors, and the estrogen level in the blood is also higher than that in the normal control group.

　　2. Relationship with Body Mass IndexEpidemiological studies have found that women with a high body mass index have an increased incidence of sarcomas, including various types of uterine sarcomas, and the estrogen level is increased in these patients. There are multiple mechanisms involved, including the conversion of androstenedione in peripheral adipose tissue, an increase in non-protein-bound estrogen, and a decrease in the degradation and metabolism of estradiol.

　　3, Race: The incidence of sarcoma in black people is higher than that in the control group.

　　4, Socio-economic status: Smooth muscle sarcoma is rare in women with a higher socio-economic status, and müllerian mixed tumor is seen in women with a lower socio-economic status.

　　5, Tumor-related genes: Literature reports that 32% to 56% of cervical sarcomas have mutations in the p53 gene, and 24% to 32% are detected with mutations in the k-ras gene.

　　6, Radiotherapy: There are reports that after several decades of local radiotherapy for cervical cancer, the local area of the cervix is prone to sarcoma.

　　Due to the rapid development and rapid growth of the sarcoma, patients often have abdominal distension and hidden pain. The occurrence of complications in cervical sarcoma, mainly related to the site of tumor invasion, pelvic mass in advanced cases can infiltrate the pelvic wall and become infected.

　　Abnormal vaginal bleeding is the main manifestation of cervical sarcoma. Before menopause, patients mainly present with increased menstrual volume, prolonged menstrual period, and irregular vaginal bleeding. After menopause, patients may present with post-menopausal vaginal bleeding, with an incidence rate of 45.1% to 70%. Abdominal pain is also one of the common symptoms of the disease, as the sarcoma develops rapidly and grows quickly, patients often have abdominal distension and hidden pain. Vaginal discharge increases, which can be serous or bloody. If infection is present, it can be purulent or malodorous. When the mass grows and compresses the bladder or rectum, it can manifest as frequent urination, urgency, urinary retention, difficulty in defecation, and tenesmus.

　　Due to the high malignancy of cervical sarcoma and the lack of specific clinical manifestations, it is necessary to take preventive measures against the cause. Women, especially those in high-risk groups, should undergo regular physical examinations to achieve early diagnosis, early treatment, and follow-up work.

　　Cervical sarcoma is a rare malignant female reproductive tract tumor with a high degree of malignancy. The following are the laboratory examinations for this disease.

　　1, Laboratory examination

　　Secretion examination, tumor marker examination.

　　2, Color Doppler ultrasound examination

　　Cervical sarcoma can manifest as uterine artery engorgement and the formation of new blood vessels around and in the central area of the tumor, with dilated blood flow, and an increase in uterine artery blood flow. On Doppler ultrasound, it shows high diastolic blood flow and low resistance, with an average RI significantly lower than that of fibroids.

　　3, Colposcopy and hysteroscopy examination

　　4, Diagnostic curettage

　　Cervical curettage is a method for early diagnosis of uterine sarcoma, but it should be noted that positive tissue section examination can confirm the diagnosis, while negative results cannot exclude the diagnosis. Diagnostic curettage has little diagnostic value for uterine smooth muscle sarcoma, with a low positive rate.

　　The diet of cervical sarcoma patients is the same as that of uterine smooth muscle, and it is advisable to eat dandelion, melon, black plum, oyster, turtle, sea horse, etc. Patients should pay attention to avoid smoking, drinking, and spicy and刺激性 food. Avoid things that cause inflammation, such as rooster. Avoid greasy, fried, moldy, and preserved foods. The following is a food therapy recipe for this disease.

　　1, Silver ear and lotus root starch soup

　　Silver ear 25 grams, lotus root starch 10 grams, and appropriate amount of rock sugar. After the silver ear is soaked and softened, add appropriate amount of rock sugar and simmer until烂. Add lotus root starch and serve.

　　Effect: It has the effects of clearing heat, moistening dryness, and stopping bleeding.

　　Indications: Menstrual bleeding, bright red blood color.

　　2. Double Fresh Soup

　　Boil 120 grams of fresh lotus root slices and 120 grams of fresh scirpus root in water to make a decoction, drink as tea.

　　Effects: Nourish yin and cool blood, remove blood stasis and stop bleeding.

　　Indications: Menstrual bleeding, blood heat and blood stasis type.

　　3. Cancer Egg

　　Boil 2 eggs, 5 wall lizards of traditional Chinese medicine, and 9 grams of rhizoma curcumae in 400 grams of water. Peel the eggs after they are cooked and continue to boil, discard the medicine and eat the eggs. Take 1 dose each night.

　　Effects: Dissipate nodules and relieve pain, dispel wind and calm惊.

　　Indications: Qi stagnation and blood stasis type.

　　Cervical sarcoma currently advocates comprehensive treatment, with surgery as the main treatment and radiotherapy as an auxiliary, with chemotherapy applied systemically or intra-abdominally before and after surgery. If there are clinical symptoms and B-ultrasound highly suggestive of cervical sarcoma, great attention should be paid during surgery. The main treatment measures for this disease are as follows.

　　1. Surgical treatment:Stage I to IIa cervical sarcoma should be treated with radical hysterectomy, pelvic lymph node dissection, and omentectomy, but it is not routine. There are reports that 10% to 37% of cases may have omental metastasis, which is a common site of metastasis. Tumors larger than this can be treated with total pelvic radiotherapy before surgery to reduce the tumor size, block the vascular and lymphatic beds through fibrosis, facilitate surgical resection, reduce iatrogenic dissemination, and improve survival rates.

　　2. Radiotherapy: The role of radiotherapy in cervical sarcoma is not very clear, most scholars believe that it is less sensitive, but endometrial stromal sarcoma is relatively sensitive. Nevertheless, radiotherapy can be considered for the following situations:

　　1. For some large tumors, preoperative radiotherapy can improve the resection rate.

　　2. Postoperative pelvic irradiation can have a certain effect on preventing local recurrence.

　　3. Radiotherapy can be added after surgery for lesions that cannot be completely resected.

　　4. For recurrent lesions limited to the pelvis or abdomen, radiotherapy should be added after resection of the metastatic focus.

　　5. For those who are not suitable for surgery, radiotherapy can be used alone.

　　3. Chemotherapy:As one of the main comprehensive treatment methods, in recent years, it is more and more advocated to use a combination of various drugs, apply 1-2 courses before surgery to reduce the tumor size for easier surgical resection, and the purpose of adjuvant chemotherapy after surgery is mainly to prevent distant metastasis.