妇产科学-CerviclCancer.ppt

Cervical Cancer Obstetrics Gynecological Hospital of FuDan University Hong Sun Cervical intraepithelial neoplasia CIN CIN refers to a lesion that may progress to invasive carcinoma. The diagnosis of CIN according to the pathologist. significant features Cellular immaturity Cellular disorganization Nuclear abnormalities Increased mitotic activity Cervical Anatomy Squamous epithelium covers the exocervix Columnar epithelium lines the endocervical canal The point at squamous and columnar epithelium meet is called the squamocolumnar junction. Transformation zone Original squamocolumnar junction Active squamocolumnar junction Bethesda system LSIL（low-grade squamous intraepithelial lesion） CIN I。 HSIL（high-grade squamous intraepithelial lesion）CIN II and III 。 ASC-US or ASC-H Diagnosis The Papanicolaou Test Colposcopy Findings Cervical Biopsy and endocervical curettage Treatment of CIN Cryotherapy CIN I , CIN II Small lesion Ectocervical location only Negative ECC findings No endocervical gland involvement on biopsy Laser Large lesions Irregular cervix Extension of disease to the vagina Extensive glandular involvement Conization Limits of the lesion cannot be visualized with colposcopy. The SCJ is not seen at colposcopy. ECC histologic finding are positive for CIN II or CIN III. Lack of correlation between cytology, biopsy, and colposcopy results Microinvasion suspected Invasive cancer cannot be rule out . Hysterectomy Microinvasion CIN III at limits of conization specimen Poor compliance with follow-up Other gynecologic problems requiring hysterectomy Cervical cancer Cancers of the Female Reproductive Tract:Worldwide Statistics1 Preventable cancer Long preinvasive state Available cervical cytology screening program Effec