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首页> 外文期刊>Obstetrics, gynaecology and reproductive medicine >Colposcopy and cervical intraepithelial neoplasia
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Colposcopy and cervical intraepithelial neoplasia

机译:阴道镜检查与宫颈上皮内瘤变

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摘要

Cervical cancer is both preventable and curable. It has a long natural history with a prolonged pre-cancerous phase that is easily detectable and treatable. Exfoliative cytology has been the mainstay for screening of cervical intra-epithelial neoplasia (CIN). Assessment of women presenting with abnormal cervical cytology and the selection of those requiring treatment relied mainly on colposcopic impressions of the cervical transformation zone and the histological appraisal of directed punch biopsies. The need to maximise clinical resources, achieve quicker and more effective management of patients, limit postoperative complications and preserve reproductive function has led to the popularity of local excisional methods for cervical premalignancy. Although the cure rates for all local ablative and excisional methods are more than 90% after one treatment, the excisional methods provide a more reliable histopathological diagnosis and the patient can be treated at the initial visit. The recognition that persistent infection with oncogenic human papillomavirus (HPV) causes cervical cancer has led to the development of new HPV tests/bio-markers and prophylactic vaccines against HPV. The HPV DNA test that targets the viral DNA has been introduced as a test of cure after CIN treatment and as a triage tool in women presenting with borderline or low-grade findings at cytology. HPV DNA test will be introduced in primary screening in the future. The national HPV immunisation programme was initiated in the NHS in September 2008. The vaccines are safe, well tolerated and highly efficacious in HPV naive women.
机译:宫颈癌是可以预防和治愈的。它具有悠久的自然历史,癌前期延长,很容易被发现和治疗。脱落细胞学检查一直是筛查宫颈上皮内瘤变(CIN)的主要手段。对表现出宫颈细胞学异常的妇女的评估以及需要治疗的妇女的选择主要取决于阴道镜对子宫颈转化区的印象以及定向打孔活检的组织学评估。需要最大限度地利用临床资源,更快,更有效地治疗患者,限制术后并发症并保持生殖功能,已导致宫颈癌前局部切除方法的普及。尽管一种治疗后所有局部消融和切除方法的治愈率均超过90%,但切除方法可提供更可靠的组织病理学诊断,并且可以在初诊时就诊。对致癌性人类乳头瘤病毒(HPV)持续感染会导致宫颈癌的认识导致人们开发了新的HPV检测/生物标记和针对HPV的预防性疫苗。针对病毒DNA的HPV DNA测试已被引入作为CIN治疗后的治愈测试,并作为在细胞学上出现边缘性或低级发现的女性的分类工具。 HPV DNA测试将在未来的初筛中引入。全国HPV免疫计划于2008年9月在NHS中启动。该疫苗对HPV初次接种的妇女是安全,耐受性良好和高效的。

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