复旦大学上海医学院妇产科学系2009级五年制妇产科学课件 Cervical Tumor 宫颈肿瘤.ppt

Surgical treatment Ib-IIa Radiotherapy Chemotherapy Combined therapy Treatment for invasive cervical cancer Cervical cacner（Ⅰb-Ⅱa)RH+PLND+/- PAD 1. 标准的手术方式：广泛全子宫切除+盆腔淋巴清扫术; 2.盆腔淋巴结清扫术 腹股沟深淋巴结 髂淋巴结 闭孔淋巴结 3.腹主动脉旁淋巴结取样的指征： 可疑的腹主动脉旁及髂总淋巴结 大块附件病灶及增大的盆腔淋巴结 浸润肌层全层的低分化肿瘤 Post-surgical treatment(high risk factors) poor differentiated deep myometrial invasion LVSI LN positive positive margin Advanced stage（Ⅱb，Ⅲ，Ⅳ) Radiotherapy (RT) NACT + Radiotherapy Concurrent chemo-radiotherapy； Combined RT and CT Trachelectomy Fertility sparing Ib 4cm Evaluation of infertility factor Procedure of trachelectomy Complications Outcome Primary prevention 1. Health care 2. Sexual behavior 3. Dual protection 4. HPV vaccines 4. Cancer screening 5. Treat precursors Prevention Secondary prevention 1.Early screening 2. Early treatment Take home message HPV (HR) CINs FIGO stage Surgery: Radical hysterectomy and PLND Post-operation treatment: high risk factors RT and CT Fertility sparing trachelectomy HPV Vaccine OB/GYN Hospital of Fudan University THANKS * * * * * * * * * * * * * Cervical Tumor 宫颈肿瘤   Xin LUObstetrics and Gynecology Hospital  Fudan University Contents CIN HPV Histology Pathology Diagnosis Treatment Cervical Cancer General information Pathology Spread pattern FIGO staging Clinical signs Diagnosis and differential diagnosis Principle for treatment Prevention Key words Human Papillomavirus (HPV) Radical Hysterectomy (RH) Radiotherapy (RT) Chemotherapy (CT) Neoadjuvant chemotherapy (NACT) Concurrent chemo-radiotherapy (CCCR) Radical Trachelectomy 人乳头瘤状病毒 广泛全子宫切除术 放射治疗 化学治疗 新辅助化疗 同步放化疗 宫颈根治术 Female Reproductive Anatomy Transformation Zone Cervical Cancer 子宫颈癌 World report: Account for 1/3 female malignancies New cases: 529 800 Death: 275 100