宫颈高级别上皮内病变治疗的选择
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摘要
基于宫颈癌筛查的普及化,宫颈上皮内病变治疗技术的发展,宫颈病变往往在癌前病变时被发现,并予以治疗,大大降低了宫颈癌的发病率,目前对于国内外对于低级别宫颈上皮内病变的治疗倾向于随访,而对于高级别上皮内病变(high-grade squamous intraepithelial lesion,HSIL)的治疗倾向于手术治疗,有研究表明对于育龄期女性的宫颈手术治疗可能会影响其妊娠结局。近期,国外研究于宫颈鳞柱交界区发现一群特殊的细胞群,其可能与宫颈高级别上皮内病变有关,清除鳞柱交界区细胞以防止宫颈上皮内病变的残留及复发、宫颈癌的进展。现本文对高级别宫颈上皮内病变治疗相关问题综述如下,为育龄期女性HSIL的治疗提出新思路。
引文
[1]陈慧,周思园,孙振球.常见妇科三大恶性肿瘤的流行及疾病负担研究现状[J].中国现代医学杂志,2015,25(06):108-112.
[2]Loopik D L,Doucette S,Bekkers R L M,et al.Regression and Progression Predictors of CIN2 in Women Younger Than 25 Years[J].Journal of Lower Genital Tract Disease,2016,20(3):213-217.
[3]Munro A,Powell R,Cohen P,et al.Spontaneous regression of CIN2 in women aged 18-24 years:a retrospective study of a state-wide population in Western Australia[J].Acta Obstet Gynecol Scand,2016,95(3):291-298.
[4]Godfrey M A L,Manolis N,Garner J E,et al.Conservative management of cervical intraepithelial neoplasia grade 2(CIN2)in women under 30 years of age:A cohort study[J].European Journal of Obstetrics&Gynecology and Reproductive Biology,2018,228:267-273.
[5]Lee M H,Finlayson S J,Gukova K,et al.Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women[J].Journal of Lower Genital Tract Disease,2018,22(3):212-218.
[6]冯美宁,高娟,刘洁.60例宫颈上皮内瘤样病变疗效分析[J].实用预防医学,2012,19(09):1363-1364.
[7]刘亚利,王晓黎,刘青.子宫颈上皮内瘤变保守治疗的临床研究[J].中国妇幼保健,2007(05):573-575.
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[9]齐彬,等.宫颈电凝治疗宫颈上皮内瘤变2级103例12个月的随访结果[J].中国微创外科杂志，2012,12(11):1006-1008.
[10]王静,郑冬梅.宫颈多点活组织检查联合物理治疗宫颈上皮内瘤变118例[J].中国医刊.2012,47(08):71-72.
[11]孙璐璐,等.子宫颈环形电切术与CO_2激光汽化治疗宫颈上皮内瘤变2级的价值医学[J].协和医学杂志,2011,2(02):129-133.
[12]Singh A,Agarwal V.LEEP Verses Cryotherapy in CIN[J].Journal of Obstetrics&Gynaecology of India,2011,61(4):431-435.
[13]Park Y K,Park C H.Clinical efficacy of photodynamic therapy[J].Obstetrics&Gynecology Science,2016,59(6).
[14]刘韵,权效珍,覃小敏.光动力学治疗子宫颈持续性HPV感染临床疗效对比[J].安徽医药.2016,20(01):102-105.
[15]梁春燕.宫颈上皮内瘤变宫颈环形电切术后对妊娠结局影响的meta分析[D].广西医科大学,2014.
[16]Ueda M,Ueki K,Kanemura M,et al.Diagnostic and therapeutic laser conization for cervical intraepithelial neoplasia[J].Digest of the World Core Medical Journals,2006,101(1):143-146.
[17]Kanayama.Outcomes of Laser Conization for Cervical Intraepithelial Neoplasia 2-3 and Microinvasive Cervical Cancer:[J].World J Oncol,2014,5(2):62-67.
[18]Hongmei Z,Shurong H,Lin Z,et al.Effects of cervical conisation on pregnancy outcome:a meta-analysis[J].Journal of Obstetrics and Gynaecology,2018:1-8.
[19]Herfs M,Yamamoto Y,Laury A,et al.A discrete population of squamocolumnar junction cells implicated in the pathogenesis of cervical cancer[J].Proc Natl Acad Sci U S A,2012,109(26):10516-10521.
[20]Herfs M,Vargas S O,Yamamoto Y,et al.A novel blueprint for‘top down’differentiation defines the cervical squamocolumnar junction during development,reproductive life,and neoplasia[J].The Journal of Pathology,2013,229(3):460-468.
[21]Mills A M,Paquette C,Terzic T,et al.CK7 Immunohistochemistry as a Predictor of CIN1 Progression:A Retrospective Study of Patients From the Quadrivalent HPV Vaccine Trials[J].American Journal of Surgical Pathology,2017,41(2):143-152.
[22]Herfs M,Somja J,Howitt B E,et al.Unique recurrence patterns of cervical intraepithelial neoplasia after excision of the squamocolumnar junction[J].International Journal of Cancer,2015,136(5):1043-1052.
[23]Mirkovic J,Howitt B E,Roncarati P,et al.Carcinogenic HPV infection in the cervical squamo-columnar junction[J].Information Storage&Retrieval,2015,7(5):211-215.
[24]夏雪,等.宫颈物理治疗对宫颈感染HPV负荷的影响[J].中国计划生育学杂志,2017,25(05):343-345.
[25]Kinney W,Hunt W C,Dinkelspiel H,et al.Cervical excisional treatment of young women:A population-based study[J].Gynecologic Oncology,2014,132(3):628-635.
[2]Loopik D L,Doucette S,Bekkers R L M,et al.Regression and Progression Predictors of CIN2 in Women Younger Than 25 Years[J].Journal of Lower Genital Tract Disease,2016,20(3):213-217.
[3]Munro A,Powell R,Cohen P,et al.Spontaneous regression of CIN2 in women aged 18-24 years:a retrospective study of a state-wide population in Western Australia[J].Acta Obstet Gynecol Scand,2016,95(3):291-298.
[4]Godfrey M A L,Manolis N,Garner J E,et al.Conservative management of cervical intraepithelial neoplasia grade 2(CIN2)in women under 30 years of age:A cohort study[J].European Journal of Obstetrics&Gynecology and Reproductive Biology,2018,228:267-273.
[5]Lee M H,Finlayson S J,Gukova K,et al.Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women[J].Journal of Lower Genital Tract Disease,2018,22(3):212-218.
[6]冯美宁,高娟,刘洁.60例宫颈上皮内瘤样病变疗效分析[J].实用预防医学,2012,19(09):1363-1364.
[7]刘亚利,王晓黎,刘青.子宫颈上皮内瘤变保守治疗的临床研究[J].中国妇幼保健,2007(05):573-575.
[8]Mitchell M F,Tortolero-Luna G,Cook E,et al.A Randomized Clinical Trial of Cryotherapy,Laser Vaporization,and Loop Electrosurgical Excision for Treatment of Squamous Intraepithelial Lesions of the Cervix[J].Obstetrics&Gynecology,1998,92(5):737-744.
[9]齐彬,等.宫颈电凝治疗宫颈上皮内瘤变2级103例12个月的随访结果[J].中国微创外科杂志，2012,12(11):1006-1008.
[10]王静,郑冬梅.宫颈多点活组织检查联合物理治疗宫颈上皮内瘤变118例[J].中国医刊.2012,47(08):71-72.
[11]孙璐璐,等.子宫颈环形电切术与CO_2激光汽化治疗宫颈上皮内瘤变2级的价值医学[J].协和医学杂志,2011,2(02):129-133.
[12]Singh A,Agarwal V.LEEP Verses Cryotherapy in CIN[J].Journal of Obstetrics&Gynaecology of India,2011,61(4):431-435.
[13]Park Y K,Park C H.Clinical efficacy of photodynamic therapy[J].Obstetrics&Gynecology Science,2016,59(6).
[14]刘韵,权效珍,覃小敏.光动力学治疗子宫颈持续性HPV感染临床疗效对比[J].安徽医药.2016,20(01):102-105.
[15]梁春燕.宫颈上皮内瘤变宫颈环形电切术后对妊娠结局影响的meta分析[D].广西医科大学,2014.
[16]Ueda M,Ueki K,Kanemura M,et al.Diagnostic and therapeutic laser conization for cervical intraepithelial neoplasia[J].Digest of the World Core Medical Journals,2006,101(1):143-146.
[17]Kanayama.Outcomes of Laser Conization for Cervical Intraepithelial Neoplasia 2-3 and Microinvasive Cervical Cancer:[J].World J Oncol,2014,5(2):62-67.
[18]Hongmei Z,Shurong H,Lin Z,et al.Effects of cervical conisation on pregnancy outcome:a meta-analysis[J].Journal of Obstetrics and Gynaecology,2018:1-8.
[19]Herfs M,Yamamoto Y,Laury A,et al.A discrete population of squamocolumnar junction cells implicated in the pathogenesis of cervical cancer[J].Proc Natl Acad Sci U S A,2012,109(26):10516-10521.
[20]Herfs M,Vargas S O,Yamamoto Y,et al.A novel blueprint for‘top down’differentiation defines the cervical squamocolumnar junction during development,reproductive life,and neoplasia[J].The Journal of Pathology,2013,229(3):460-468.
[21]Mills A M,Paquette C,Terzic T,et al.CK7 Immunohistochemistry as a Predictor of CIN1 Progression:A Retrospective Study of Patients From the Quadrivalent HPV Vaccine Trials[J].American Journal of Surgical Pathology,2017,41(2):143-152.
[22]Herfs M,Somja J,Howitt B E,et al.Unique recurrence patterns of cervical intraepithelial neoplasia after excision of the squamocolumnar junction[J].International Journal of Cancer,2015,136(5):1043-1052.
[23]Mirkovic J,Howitt B E,Roncarati P,et al.Carcinogenic HPV infection in the cervical squamo-columnar junction[J].Information Storage&Retrieval,2015,7(5):211-215.
[24]夏雪,等.宫颈物理治疗对宫颈感染HPV负荷的影响[J].中国计划生育学杂志,2017,25(05):343-345.
[25]Kinney W,Hunt W C,Dinkelspiel H,et al.Cervical excisional treatment of young women:A population-based study[J].Gynecologic Oncology,2014,132(3):628-635.