课件：北大医学院妇科宫颈病变和宫颈癌.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * This is a diagram which which is designed to demonstrate the degree of similarity at the DNA level of one HPV type to another. HPV types which are close together on the diagram have a very similar genome whereas those which are further apart are less related. Based on their genetic sequences the anogenital HPV types can be divided into two general groups. These are “low-risk” HPV types and “high-risk” types. The low-risk types include HPV types 6 and 11 which are the viruses that most commonly cause genital warts. Notice how close together on the diagram HPV 6 and 11 are - this indicates that they are almost identical in DNA sequence. The high-risk HPV types include HPV 16 and 18 which are the types most commonly found in cervical cancers. Notice that the high-risk HPV types fall into three general groups. On group includes HPV 16 as well as HPV 35, 31, 33, 58, and 52. This group is called the A9 clade. Another group includes HPV 18, 45, 39, 68, 34, 26, and 51. This is the A7 clade. These groupings are important because it is quite possible that a vaccine directed against HPV 16 may cross-protect against other members of the A9 clade and a vaccine against HPV 18 may cross-protect against the rest of the viruses in the A7 clade. * * * * * * * * * * * * * * * * * * * * This is a histological section from a CIN 2,3 lesion. Thee are immature basaloid-type cells that extend into the upper half of the epithelium. The cells have dense hyperchromatic nuclei and high nuclear:cytoplasmic rations. * * * * * This is another pelvic exenteration for cervical squamous cell carcinoma. The irregular grey-brown tumor extends toward bladder and up into the uterus. * * * * * * * * * * * * * * ＷＥＩ * 子宫颈癌手术中的及几个焦点问题 肿瘤治疗的 规范化、个体化、人性化 保留卵巢问题：可以保留 保留子宫问题：年轻患者宫颈广泛切除 延长阴道，保持性生活质量 子宫颈癌的腹腔镜手术：早期 ＷＥＩ * 子宫颈广泛切除术 （Radical trachelectomy，RT） 在20世纪80年代后期由法国的Dargent教授最早开始 1994年首次发表 ＷＥＩ * 早期宫颈癌患者保留生育功能-保留子宫:RT适应症 患者有生育要求； 无