宮頸癌診治中的幾個熱點問題_West China Medical Journal

Authors：

 勾金海 ,  李征宇

四川大學華西第二醫院婦產科（成都，610041）;

Corresponding?author：

李征宇, Email: qingshanxiagu@tom.com

Keywords：

宮頸癌; 人乳頭瘤病毒; 早期篩查; 保留生育功能手術; 輔助治療

DOI：

10.7507/1002-0179.20140116

Video：

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宮頸癌作為女性生殖道最常見的惡性腫瘤，嚴重威脅女性的身心健康，且近年發病率有所上升。宮頸細胞學檢查及人乳頭瘤病毒檢查是宮頸癌最主要的篩查方法，但如何做到宮頸癌的早期篩查到目前仍無定論。此外，宮頸癌患者的年輕化促使保全患者生育功能的手術方式誕生，但該類手術的適應證及預后都需更深層次地研究。同時近年來關于不同的新型輔助治療策略的研究也取得了不同程度的進展，而如何選擇輔助治療是臨床工作者亟待解決的問題。

Citation： 勾金海, 李征宇. 宮頸癌診治中的幾個熱點問題. West China Medical Journal, 2014, 29(2): 377-381. doi: 10.7507/1002-0179.20140116 Copy

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2.	馬丁,奚玲.宮頸癌流行病學及病因學研究進展[J].實用婦產科雜志,2001,17(2):61-62.
3.	Arbyn M,Bergeron C,Klinkhamer P,et al.Liquid compared with conventional cervical cytology:a systematic review and meta-analysis[J].Obstet Gynecol,2008,111(1):167-177.
4.	Siebers AG,Klinkhamer PJ,Grefte JM,et al.Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors:a randomized controlled trial[J].JAMA,2009,302(16):1757-1764.
5.	zur Hausen H.Oncogenic Herpes viruses[J].Biochim Biophys Acta,1975,417(1):25-53.
6.	Herrero R,Brinton LA,Reeves WC,et al.Sexual behavior,venereal diseases,hygiene practices,and invasive cervical cancer in a high-risk population[J].Cancer,1990,65(2):380-386.
7.	Matsukura T,Sugase M.Pitfalls in the epidemiologic classification of human papillomavirus types associated with cervical cancer using polymerase chain reaction:driver and passenger[J].Int J Gynecol Cancer,2008,18(5):1042-1050.
8.	Walboomers JM,Jacobs MV,Manos MM,et al.Human papillomavirus is a necessary cause of invasive cervical cancer worldwide[J].J Pathol,1999,189(1):12-19.
9.	Munoz N,Bosch FX,de Sanjose S,et al.International agency for research on can-cer multicenter cervical cancer study group.epidemiologic classification of human papillomavirus types associated with cervical cancer[J].N Engl J Med,2003,348(6):518-527.
10.	de Sanjose S,Quint WG,Alemany L,et al.Retrospective international survey and HPV time trends study group.Human papillomavirus genotype attribution in invasive cervical cancer:a retrospective cross-sectional worldwide study[J].Lancet Oncol,2010,11(11):1048-1056.
11.	Plummer M,Schiffman M,Castle PE,et al.ALTS group:a 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion[J].J Infect Dis,2007,195(11):1582-1589.
12.	Rodríguez AC,Schiffman M,Herrero R,et al.Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections[J].J Natl Cancer Inst,2008,100(7):513-517.
13.	Wright TC,Schiffman M.Adding a test for human papillomavirus DNA to cervical-cancer screening[J].N Engl J Med,2003,348(6):489-490.
14.	Schiffman M,Castle PE,Jeronimo J,et al.Human papillomavirus and cervical cancer[J].Lancet,2007,370(9590):890-907.
15.	龍騰飛.宮頸病變篩查策略的效果分析[J].醫學綜述,2011,17(14):2154-2158.
16.	程嬌影,卞美璐,李敏,等.不同子宮頸癌篩查方案應用價值評價[J].中國婦產科臨床雜志,2012,13(2):115-118.
17.	Saslow D,Solomon D,Lawson HW,et al.American cancer society,American society for colposcopy and cervical pathology,and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer[J].Am J Clin Pathol,2012,16(3):175-204.
18.	Shimada M,Kigawa J,Nishimura R,et al.Ovarian metastasis in carcinoma of the uterine cervix[J].Gynecol Oncol,2006,101(2):234-237.
19.	Nakanishi T,Wakai K,Ishikawa H,et al.A comparison of ovarian metastasis between squamous cell carcinoma and adenocarcinoma of the uterine cervix[J].Gynecol Oncol,2001,82(3):504-509.
20.	Hu T,Wu L,Xing H,et al.Development of criteria for ovarian preservation in cervical cancer patients treated with radical surgery with or without neoadjuvant chemotherapy:a multicenter retrospective study and meta-analysis[J].Ann Surg Oncol,2013,20(3):881-890.
21.	王莉英,崔金全,鄭英.宮頸癌根治術時行卵巢移植術或移位術的遠期療效[J].中國腫瘤臨床,2000,27(3):213-215.
22.	李艷芳,李孟達.宮頸癌患者卵巢轉移與保留問題的探討[J].中國現代手術學雜志,2004,8(1):60-63.
23.	Koh WJ,Greer BE,Abu-Rustum NR,et al.Cervical cancer[J].J Natl Compr Canc Netw,2013,11(3):320-343.
24.	Ribeiro Cubal AF,Ferreira Carvalho JI,Costa MF,et al.Fertility-sparing surgery for early-stage cervical cancer[J].Int J Surg Oncol,2012:936534.
25.	Klemm P,Tozzi R,K?hler C,et al.Does radical trachelectomy influence uterine blood supply?[J].Gynecol Oncol,2005,96(2):283-286.
26.	Alazzam M,Gillespie A,Hewitt M.Robotic surgery in the management of cervical carcinoma[J].Arch Gynecol Obstet,2011,284(4):937-943.
27.	Rob L,Charvat M,Robova H,et al.Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer[J].Int J Gynecol Cancer,2007,17(1):304-310.
28.	Milliken DA,Shepherd JH.Fertility preserving surgery for carcinoma of the cervix[J].Curr Opin Oncol,2008,20(5):575-580.
29.	Rob L,Skapa P,Robova H.Fertility-sparing surgery in patients with cervical cancer[J].Lancet Oncol,2011,12(2):192-200.
30.	Yabuki Y,Sasaki H,Hatakeyama N,et al.Discrepancies between classic anatomy and modern gynecologic surgery on pelvic connective tissue structure:harmonization of those concepts by collaborative cadaver dissection[J].Am J Obstet Gynecol,2005,193(1):7-15.
31.	H?ckel M,Horn LC,Manthey N,et al.Resection of the embryologically defined uterovaginal (Müllerian) compartment and pelvic control in patients with cervical cancer:a prospective analysis[J].Lancet Oncol,2009,10(7):683-692.
32.	Neoadjuvant Chemotherapy for Cervical Cancer Meta-Analysis collaboration (NACCCMA) collaboration.Neoadjuvant chemotherapy ofr localyy advamced arvix cancer[J].Cochrane Database syst Rev,2004(2):CD001774.
33.	Benedetti-Panici P,Greggi S,Colombo A,et al.Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer:results from the Italian multicenter randomized study[J].J Clin Oncol,2002,20(1):179-188.
34.	陳慧君,吳緒峰.新輔助化療在宮頸癌治療中的應用[J].藥品評價,2012,9(9):13-17.
35.	Whitney CW,Sause W,Bundy BN,et al.Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage ⅡB-ⅣA carcinoma of the cervix with negative para-aortic lymph nodes:a gynecologic oncology group and southwest oncology group study[J].J Clin Oncol,1999,17(5):1339-1348.
36.	Morris M,Eifel PJ,Lu J,et al.Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer[J].N Engl J Med,1999,340(15):1137-1143.
37.	Rose PG,Bundy BN,Watkins EB,et al.Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer[J].N Engl J Med,1999,340(15):1144-1153.
38.	Keys HM,Bundy BN,Stehman FB,et al.Cisplatin,radiation,and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma[J].N Engl J Med,1999,340(15):1154-1161.
39.	Peters WA,Liu PY,Barrett RJ,et al.Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix[J].J Clin Oncol,2000,18(8):1606-1613.
40.	Thomas GM.Improved treatment for cervical cancer-concurrent chemotherapy and radiotherapy[J].N Engl J Med,1999,340(15):1198-1200.

1. Shanta V,Krishnamurthi S,Gajalakshmi CK,et al.Epidemiology of cancer of the cervix:global and National perspective[J].J Indian Med Assoc,2000,98(2):49-52.
2. 馬丁,奚玲.宮頸癌流行病學及病因學研究進展[J].實用婦產科雜志,2001,17(2):61-62.
3. Arbyn M,Bergeron C,Klinkhamer P,et al.Liquid compared with conventional cervical cytology:a systematic review and meta-analysis[J].Obstet Gynecol,2008,111(1):167-177.
4. Siebers AG,Klinkhamer PJ,Grefte JM,et al.Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors:a randomized controlled trial[J].JAMA,2009,302(16):1757-1764.
5. zur Hausen H.Oncogenic Herpes viruses[J].Biochim Biophys Acta,1975,417(1):25-53.
6. Herrero R,Brinton LA,Reeves WC,et al.Sexual behavior,venereal diseases,hygiene practices,and invasive cervical cancer in a high-risk population[J].Cancer,1990,65(2):380-386.
7. Matsukura T,Sugase M.Pitfalls in the epidemiologic classification of human papillomavirus types associated with cervical cancer using polymerase chain reaction:driver and passenger[J].Int J Gynecol Cancer,2008,18(5):1042-1050.
8. Walboomers JM,Jacobs MV,Manos MM,et al.Human papillomavirus is a necessary cause of invasive cervical cancer worldwide[J].J Pathol,1999,189(1):12-19.
9. Munoz N,Bosch FX,de Sanjose S,et al.International agency for research on can-cer multicenter cervical cancer study group.epidemiologic classification of human papillomavirus types associated with cervical cancer[J].N Engl J Med,2003,348(6):518-527.
10. de Sanjose S,Quint WG,Alemany L,et al.Retrospective international survey and HPV time trends study group.Human papillomavirus genotype attribution in invasive cervical cancer:a retrospective cross-sectional worldwide study[J].Lancet Oncol,2010,11(11):1048-1056.
11. Plummer M,Schiffman M,Castle PE,et al.ALTS group:a 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion[J].J Infect Dis,2007,195(11):1582-1589.
12. Rodríguez AC,Schiffman M,Herrero R,et al.Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections[J].J Natl Cancer Inst,2008,100(7):513-517.
13. Wright TC,Schiffman M.Adding a test for human papillomavirus DNA to cervical-cancer screening[J].N Engl J Med,2003,348(6):489-490.
14. Schiffman M,Castle PE,Jeronimo J,et al.Human papillomavirus and cervical cancer[J].Lancet,2007,370(9590):890-907.
15. 龍騰飛.宮頸病變篩查策略的效果分析[J].醫學綜述,2011,17(14):2154-2158.
16. 程嬌影,卞美璐,李敏,等.不同子宮頸癌篩查方案應用價值評價[J].中國婦產科臨床雜志,2012,13(2):115-118.
17. Saslow D,Solomon D,Lawson HW,et al.American cancer society,American society for colposcopy and cervical pathology,and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer[J].Am J Clin Pathol,2012,16(3):175-204.
18. Shimada M,Kigawa J,Nishimura R,et al.Ovarian metastasis in carcinoma of the uterine cervix[J].Gynecol Oncol,2006,101(2):234-237.
19. Nakanishi T,Wakai K,Ishikawa H,et al.A comparison of ovarian metastasis between squamous cell carcinoma and adenocarcinoma of the uterine cervix[J].Gynecol Oncol,2001,82(3):504-509.
20. Hu T,Wu L,Xing H,et al.Development of criteria for ovarian preservation in cervical cancer patients treated with radical surgery with or without neoadjuvant chemotherapy:a multicenter retrospective study and meta-analysis[J].Ann Surg Oncol,2013,20(3):881-890.
21. 王莉英,崔金全,鄭英.宮頸癌根治術時行卵巢移植術或移位術的遠期療效[J].中國腫瘤臨床,2000,27(3):213-215.
22. 李艷芳,李孟達.宮頸癌患者卵巢轉移與保留問題的探討[J].中國現代手術學雜志,2004,8(1):60-63.
23. Koh WJ,Greer BE,Abu-Rustum NR,et al.Cervical cancer[J].J Natl Compr Canc Netw,2013,11(3):320-343.
24. Ribeiro Cubal AF,Ferreira Carvalho JI,Costa MF,et al.Fertility-sparing surgery for early-stage cervical cancer[J].Int J Surg Oncol,2012:936534.
25. Klemm P,Tozzi R,K?hler C,et al.Does radical trachelectomy influence uterine blood supply?[J].Gynecol Oncol,2005,96(2):283-286.
26. Alazzam M,Gillespie A,Hewitt M.Robotic surgery in the management of cervical carcinoma[J].Arch Gynecol Obstet,2011,284(4):937-943.
27. Rob L,Charvat M,Robova H,et al.Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer[J].Int J Gynecol Cancer,2007,17(1):304-310.
28. Milliken DA,Shepherd JH.Fertility preserving surgery for carcinoma of the cervix[J].Curr Opin Oncol,2008,20(5):575-580.
29. Rob L,Skapa P,Robova H.Fertility-sparing surgery in patients with cervical cancer[J].Lancet Oncol,2011,12(2):192-200.
30. Yabuki Y,Sasaki H,Hatakeyama N,et al.Discrepancies between classic anatomy and modern gynecologic surgery on pelvic connective tissue structure:harmonization of those concepts by collaborative cadaver dissection[J].Am J Obstet Gynecol,2005,193(1):7-15.
31. H?ckel M,Horn LC,Manthey N,et al.Resection of the embryologically defined uterovaginal (Müllerian) compartment and pelvic control in patients with cervical cancer:a prospective analysis[J].Lancet Oncol,2009,10(7):683-692.
32. Neoadjuvant Chemotherapy for Cervical Cancer Meta-Analysis collaboration (NACCCMA) collaboration.Neoadjuvant chemotherapy ofr localyy advamced arvix cancer[J].Cochrane Database syst Rev,2004(2):CD001774.
33. Benedetti-Panici P,Greggi S,Colombo A,et al.Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer:results from the Italian multicenter randomized study[J].J Clin Oncol,2002,20(1):179-188.
34. 陳慧君,吳緒峰.新輔助化療在宮頸癌治療中的應用[J].藥品評價,2012,9(9):13-17.
35. Whitney CW,Sause W,Bundy BN,et al.Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage ⅡB-ⅣA carcinoma of the cervix with negative para-aortic lymph nodes:a gynecologic oncology group and southwest oncology group study[J].J Clin Oncol,1999,17(5):1339-1348.
36. Morris M,Eifel PJ,Lu J,et al.Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer[J].N Engl J Med,1999,340(15):1137-1143.
37. Rose PG,Bundy BN,Watkins EB,et al.Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer[J].N Engl J Med,1999,340(15):1144-1153.
38. Keys HM,Bundy BN,Stehman FB,et al.Cisplatin,radiation,and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma[J].N Engl J Med,1999,340(15):1154-1161.
39. Peters WA,Liu PY,Barrett RJ,et al.Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix[J].J Clin Oncol,2000,18(8):1606-1613.
40. Thomas GM.Improved treatment for cervical cancer-concurrent chemotherapy and radiotherapy[J].N Engl J Med,1999,340(15):1198-1200.

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宮頸癌診治中的幾個熱點問題

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