宫颈癌的防治研究进展乔友林—培训课件.pptVIP

* 大家 XXX 好！ 谢谢， Dr. Liu 邀请我来参加这次学习班。 刚才介绍了我的情况， 我讲的题目是….. * * . * Pap smear 至1941年开始用于宫颈癌初筛，为降低其危害作出了巨大贡献,Sens.=70-75%, Spec.=75-85% 存在的问题是：准确度低和结果不能重复,假阴性面临医疗纠纷 * * * In the China, the death rates of cervical cancer have declined by about 68% in the last 20 yrs; In some county, rates remain unchanged; In some areas, young patients are increasing. This red line is mortality of yangcheng, shanxi province. And yellow line is lueyang, gansu province, it declined dramatically. * As you can see on this slide, there are several known risk factors that influence one’s likelihood of being infected with Human papillomavirus and of progressing to cervical cancer. Of special importance is: (1) HPV positively and specific type; Anogenital-specific HPV types can be classified as either “low risk”, meaning non-cancer associated, or “intermediate/high risk” - often termed the carcinogenic HPVs. This later group has the potential to promote progression to cervical cancer. (2) Persistent HPV infection; While most HPV infections are transient, evidence suggests that carcinogenic types persist longer, thereby increasing a woman’s risk of progressing to HSIL. Women with invasive cancer have the same HPV type as those with HSILs, except that they are on average a decade older.4 Carcinogenic HPV types in women approximately 35 years of age are likely to reflect persistent, high-risk infections.5 * (1) Italian Nun study - typical Epi (2) HSV (3) As mentioned earlier, it has been established in the medical community that HPV is the cause of cervical cancer. Numerous studies in such renowned publications as the JNCI have confirmed this long held belief. One such example is a study published in 1995 conducted by Bosch et al.2 (FORWARD TO NEXT SLIDE TO GIVE DETAILS ON BOSCH DATA). In 1996, both The WHO/EUROGIN (European Research Organization on Genital Infection and Neoplasia) and the NIH Consensus Conference on Cervical Cancer recognized HPV infection as the cause of cervica