国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (4): 443-446.

• 综述 • 上一篇    下一篇

早期低危子宫颈癌诊疗进展

赵建国,曲芃芃△   

  1. 300100  天津市中心妇产科医院妇瘤科
  • 收稿日期:2019-12-30 修回日期:2020-04-01 出版日期:2020-08-15 发布日期:2020-08-15
  • 通讯作者: 赵建国,E-mail:killingyousoft@126.com E-mail:qu.pengpeng@hotmail.com
  • 基金资助:
    北京医卫健康公益基金会医学科学研究基金(YWJKJJHKYJJ-B182832)

Advances in Diagnosis and Treatment of Early Low-Risk Cervical Cancer

ZHAO Jian-guo,QU Peng-peng   

  1. Department of Gynecological Oncology,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China
  • Received:2019-12-30 Revised:2020-04-01 Published:2020-08-15 Online:2020-08-15
  • Contact: ZHAO Jian-guo,E-mail:killingyousoft@126.com E-mail:qu.pengpeng@hotmail.com

摘要: 由于宫颈细胞学及人乳头瘤病毒(HPV)联合筛查技术应用,增加了早期宫颈癌的检出率,早期低危子宫颈癌手术治疗效果满意,低危标准包括:宫颈肿瘤最大径线≤2 cm;浸润间质深度≤10 mm;无淋巴脉管间隙浸润。低危子宫颈癌伴有宫旁受累、淋巴结转移及切缘阳性的几率低,总体预后较好。因此认为对低危子宫颈癌患者可以实施保守的手术方法:保留神经的子宫颈癌根治术不影响患者排便、排尿功能,提高了患者术后的生活质量;术前磁共振成像预测术后宫旁受累的敏感度较高,子宫切除术后意外发现的早期低危子宫颈癌患者残留疾病的发生率和辅助治疗的几率非常低,可避免根治性宫旁切除;保留生育功能的手术包括单纯宫颈切除、宫颈锥切术以及根治性宫颈切除术,复发率与根治性子宫切除相当,且妊娠结局良好。对于宫颈微小浸润腺癌,其手术治疗程序应该与鳞癌相同。

关键词: 宫颈肿瘤;, 腺癌;, 肿瘤治疗方案;, 治疗;, 预后;, 早期低危子宫颈癌

Abstract: Due to the application of cervical cytology and HPV combined screening technology, the detection rate of early cervical cancer has been increased, and the surgical effect of early low-risk cervical cancer is satisfactory. The criteria of low-risk cervical cancer included: the maximum diameter of cervical tumor was not more than 2 cm; the depth of infiltrating interstitial was not more than 10 mm; no lymph vascular space invasion. Low-risk cervical cancer with parametrial involvement, lymph node metastasis and margin-positive probability is low, the overall prognosis is better. Therefore, it is suggested that conservative surgery can be used for low-risk cervical cancer patients. The nerve-sparing radical resection of cervical cancer does not affect the defecation and urination function of the patients and improves the quality of life of the patients after operation. The sensitivity of preoperative magnetic resonance imaging in predicting postoperative parametrial involvement is high. Patients with early low-risk cervical cancer found after hysterectomy can avoid radical hysterectomy, and the incidence of residual diseases and the probability of adjuvant treatment are very low. The fertility-sparing procedures include simple trachelectomy, cervical conization, and radical trachelectomy, with a same recurrence rate comparable to radical hysterectomy and favorable pregnancy outcomes. For minimally invasive cervical adenocarcinoma, the surgical treatment procedure should be the same as for squamous cell carcinoma. 

Key words: Uterine cervical neoplasms;, Adenocarcinoma;, Antineoplastic protocols;, Therapy;, Prognosis;, Early low risk cervical cancer