首页 我的
张云杰
张云杰 主治医师
天使皮肤科医生集团 皮肤科

宫颈癌的基本情况

宫颈癌是常见的妇科恶性肿瘤之一, 发病率在我国女性恶性肿瘤中居第二位, 仅次于乳腺癌。据统计, 每年约有50万左右的宫颈癌新发病例, 占所有癌症新发病例的5%, 其中的80%以上的病例发生在发展中国家。我国每年约有新发病例13万, 占世界宫颈癌新发病例总数的28%。天使皮肤科医生集团皮肤科张云杰

患病的高峰年龄为40-60岁左右。近年来大量研究表明,宫颈癌的发病年龄呈年轻化趋势。宫颈癌发病率分布有地区差异,农村高于城市,山区高于平原,发展中国家高于发达国家。因此,有必要规范宫颈癌的诊断与治疗。另一方面,宫颈癌的发生可通过对癌前病变的检查和处理得以有效控制。西方国家的经验显示,宫颈癌的发生率在密切筛查的人群中减少了70%-90%。为了降低我国宫颈癌的发病率,做到早诊早治,本指南补充了宫颈癌前病变的诊治原则,希望能降低宫颈病变的危害,同时减少国家对宫颈癌的诊治支出。


参考文献

1. Jemal A, Siegel R, Ward E, et al. Cancer Statistics, 2007. CA Cancer J Clin 2007;57: 43-66. 

2. Howe HL, Wu X, Ries LA, et al. Annual report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic/Latino populations. Cancer 2006;107(8):1711-1742.

3. Sherman ME, Wang SS, Carreon J, Devesa SS. Mortality trends for cervical squamous and adenocarcinoma in theUnited States. Relation to incidence and survival. Cancer 2005;103(6):1258-1264.  4. Parkin DM, Bray F, Ferlay J. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.

5. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24(14):2137-2150. 

6. Villa LL, Costa RL, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomized double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005;6:271-278.

7. Ault KA; Future II Study Group. Effect of prophylactic human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3, and adenocarcinoma in situ: a combined analysis of four randomised clinical trials. Lancet 2007;369(9576):1861-1868.

8. FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 2007;356(19):1915-1927.

9. Arbyn M, Dillner J. Review of current knowledge on HPV vaccination: an appendix to the European Guidelines for Quality Assurance in Cervical Cancer Screening. J Clin Virol 2007;38(3):189-197. Epub 2007 Jan 25.

10. American College  of Obstetricians and Gynecologists.ACOG practice bulletin. Diagnosis and treatment of cervical carcinomas. Number 35, May 2002. Int J Gynaecol Obstet 2002;78:79-91. 

11. Chi DS. Laparoscopy in gynecologic malignancies. Oncology 1999;13:773-782. 

12. Benedet JL, Bender H, Jones H 3rd, et al. FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 2000;70:209-262. 

13. Landoni F, Maneo A, Colombo A, et al. Randomized study of radical surgery vs. radiotherapy for stage Ib-IIa cervical cancer. Lancet 1997;350:535-540. 

14. Rose PG, Ali S, Watkins E, et al. Long-term follow-up of a randomized trial comparing concurrent single agent cisplatin, cisplatin-based combination chemotherapy, or hydroxyurea during pelvic irradiation for locally advanced cervical cancer: a Gynecologic Oncology Group Study. J Clin Oncol 2007;25(19):2804-2810. Epub 2007 May 14.

15. Monk BJ, Tewari KS, Koh W-J. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions. J Clin Oncol 2007;25:2952-2965. 

16. Pearcey R, Miao Q, Kong W, et al. Impact of adoption of chemoradiotherapy on the outcome of cervical cancer in Ontario: results of a population-based cohort study. J Clin Oncol 2007;25(17):2383-2388.

17. Haie-Meder C, Fervers B, Fondrinier E, et al. SOR guidelines for concomitant chemoradiotherapy for patients with uterine cervical cancers: evidence update bulletin 2004. Ann Oncol 2005;16:1100-1108. 

18. Koliopoulos G, Sotiriadis A, Kyrgiou M, et al. Conservative surgical methods for FIGO stage IA2 squamous cervical carcinoma and their role in preserving women's fertility. Gynecol Oncol 2004;93:469-473.

19. Bernardini M, Barrett J, Seaward G, et al. Pregnancy outcomes in patients after radical trachelectomy. Am J Obstet Gynecol 2003;189:1378-1382. 

20. Boss EA, van Golde RJ, Beerendonk CC, et al. Pregnancy after radical trachelectomy: A real option? Gynecol Oncol 2005;99:S152-6. Epub 2005 Sep 2. 

21. Plante M, Renaud MC, Hoskins IA, Roy M. Vaginal radical trachelectomy: a valuable fertility-preserving option in the management of early-stage cervical cancer. A series of 50 pregnancies and review of the literature. Gynecol Oncol 2005;98(1):3-10.

22. Marchiole P, Benchaib M, Buenerd A, et al. Oncological safety of laparoscopic-assisted vaginal radi cal trachelectomy (LARVT or (LARVH). Gynecol Oncol

Dargent's operation): A comparative study with laparoscopic-assisted vaginal radical hysterectomy2007;106(1):132-141. Epub 2007 May 9.

23. Shepherd JH, Spencer C, Herod J, Ind TE. Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer-cumulative pregnancy rate in a series of 123 women. BJOG 2006;113(6):719-724. 

24. Landoni F, Zanagnolo V, Lovato-Diaz L, et al. Ovarian metastases in early-stage cervical cancer (IA2-IIA): a multicenter retrospective study of 1965 patients (a Cooperative Task Force study). Int J Gynecol Cancer 2007;17(3):623-628. Epub 2007 Feb 16. 

25. Shimada M, Kigawa J, Nishimura R, et al. Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol 2006;101(2):234-237. Epub 2005 Nov 21.

26. Keys HM, Bundy BN, Stehman FB, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med 1999;340:1154-1161.

27. Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 1999;340:1137-1143.

 

本文为转载文章,如有侵权请联系作者删除。

真诚赞赏,手留余香
张云杰
张云杰 主治医师
天使皮肤科医生集团 皮肤科
问医生 问医生 去挂号 去挂号
App 内打开