妇产科学：宫颈肿瘤.ppt

Thank You A At the service of women zjwzzxq@163.com * In the majority of cervical cancers, the disease develops through a series of gradual, well-defined, precancerous lesions, usually beginning with human papillomavirus (HPV) infection and progressing through several stages over a long period of time. Precancerous lesions can persist, regress, or progress to an invasive malignancy. During this lengthy, steady progression, abnormal tissue can be detected by the Pap test and removed. The left side of this continuum, shows infection with HPV. Although HPV appears to be necessary for the development of cervical cancer, not all HPV infections develop into cancer. It is not unusual for HPV to cause low-grade dysplasia within months of an infection. Low-grade cervical dysplasia is usually temporary and disappears over time. At least 70 percent of low-grade dysplasia regresses spontaneously or does not progress.1 Some cases, however, progress to high-grade dysplasia. High-grade cervical dysplasia, a precursor to cervical cancer, is much less common than low-grade cervical dysplasia. The development from high-grade dysplasia to invasive cancer usually occurs slowly, over a period of several years. Progression to detectable, precancerous lesions can take as long as 10 years or more. 1The ALTS Group. Human papillomavirus testing for triage of women with cytologic evidence of low-grade squamous intraepithelial lesions: baseline data from a randomized trial. J Natl Cancer Inst 92: 397–402; 2000. Overall source for graphic: Program for Applied Technology in Health (PATH). Natural history of cervical cancer: even infrequent screening of older women saves lives. Seattle, WA: PATH; 2001. * In the majority of cervical cancers, the disease develops through a series of gradual, well-defined, precancerous lesions, usually beginning with human papillomavirus (HPV) infection and progressing through several stages over a long period of time. Precancerous lesions can persist, regress