摘要:目的: 调查新疆地区维吾尔族与汉族子宫颈癌及癌前病变发病情况,分析宫颈癌高发原因。 方法 : 2000年1月至2005年12月新疆自治区人民医院妇产科门诊及病房行宫颈细胞学检查的维吾尔族、汉族妇女进行筛查,对宫颈病变阳性者(CINI以上)行病理组织学检查,对结果进行对比分析、综合评价。 结果 : 宫颈涂片人数共计23 205例,其中维吾尔族6 999例、汉族16 206例。宫颈病变阳性者237例,经阴道镜下病理活组织检查证实CINI以上(包括CINI、CINII、CINIII、原位癌、鳞癌、腺癌)病变人数173例,最小年龄31岁,原位癌(维吾尔族)、最大年龄76岁,宫颈磷癌(汉族)。维吾尔族105例(6069%)、汉族68例(3931%)。每年阳性例数中维吾尔族均高于汉族,其中2000年、2001年、2004年、2005年有极显著性差异(P lt;001),2002年、2003年有显著性差异(P lt;005),维吾尔族、汉族在各年龄组中的发病情况无显著性差异(P gt;005)。 结论 : 新疆地区宫颈癌及癌前病变的高发原因是由地区环境、医疗条件、医学发展、救助措施等因素综合作用的结果。Abstract: Objective: To investigate the incidence of cervical cancer and cervical precancerous lesion of uigur nationality and han nationality, in addition, to analysis the cause of cervical cancer’s high incidence. Methods : At first screen cervical cytology of Uigur and Han outpatient and inpatient of department of gynecology and obstetrics in the People’s Hospital of Xinjiang Uigur Autonomous Region from January 1, 2000 to December 31, 2004Secondly biopsy for those patients that cervix pathological change shows positive, then contrast analysis and comprehensive evaluation. Results : Cervix smears are 23205 samples. Uigur nation has 6999 samples and Han nation has 16206 samples. There are 237 patients whose cervix pathological changes shows positive. Among them 173 samples were over CINⅠ(include CINⅠ,CINⅡ,CIN Ⅲ,carcinoma in situ, squamous carcinoma and adenocarcinoma) through colposcopy. The youngest was 31 and diagnosed carcinoma in situ(Uigur), the eldest was 76 and diagnosed squamous carcinoma(Han).The samples of Uigur is 105(6069%) and Han is 68(3931%).The positive samples in Uigur is higher than Han each year, the incidence has extremely significant difference among 2000,2001 and 2004(P lt;001), while it has significant difference between 2002 and 2003 (P lt;005), but in each age group it has no significant difference between Uigur and Han (P gt;005). Conclusion : The high incidence of cervical cancer and cervical precancerous lesion in xinjiang is contribute to environment, medical condition, medical development and aid measures coaffect.
目的:观察抗菌素联合疗法结合BMP红外光治疗宫颈糜烂的疗效和作用机理。方法:用抗菌素职合疗法结合BMP红外光治疗宫颈糜烂92例与83例单用BMP红外光作对比。结果:治疗组痊愈率97.83%,对照组为73.49%,两组比较有显著性差异(Plt;0.005)。治疗组副反应明显低于对照组,创面愈合时间与对照组比较有显著性差异(Plt;0.005)。结论:抗菌素联合治疗法结合BMP红外光治疗宫颈糜烂能提高治愈率,减少副反应,加速创面愈合。
Objective To investigate the expression of COX-2 in human cervical cancer and explore their relationship between the COX-2 expression and the clinicopathologic characteristic of cervical cancer. Methods The published studies were searched in the CBMdisc (1979 to 2009), CNKI (1979 to 2009), VIP (1989 to 2009) and WANFANG Database (1982 to 2009), and other relevant journals were also hand searched, to identify all the relevant case-control trials. The quality of the included studies was assessed. The Cochrane Collaboration’s software RevMan 4.2.10 was used to test the heterogeneity, overall effect and publication bias of the combined studies. Results A total of 9 studies were recruited. As for the positive rate of COX-2 expression, significant differences was tested between cervical cancer vs. normal cervical tissues, lymph node metastasi vs. non-lymph node metastasi, clinical stages I-II vs. clinical stages III-IV, cell differentiation G1 vs. cell differentiation G2-G3 and cervical squamous cell carcinoma vs. adenocarcinoma with OR (95%CI) at 28.03 (9.53 to 82.50), 5.16 (3.36 to 7.93), 0.53 (0.33 to 0.84), 3.11 (1.86 to 5.22) and 5.00 (2.68 to 9.35) respectively. Conclusions According to the domestic evidence, higher COX-2 expression might be associated with cervical cancer. However, more high quality case-control studies are expected for further study.
目的:探讨聚焦超声治疗慢性宫颈炎的安全性和有效性。方法:回顾性分析2003年1月至2006年12月我院门诊诊断治疗的慢性宫颈炎患者,行聚焦超声治疗后并于3月内随访的574例患者,分析其安全性及有效性。结果:574例中,痊愈 378例(65.9%),显效155例(27.0%),总有效率96.7%。治愈率与糜烂面积及深浅程度有关(Plt;0.05)。超声治疗后部分患者出现阴道少量流液及血性分泌物。结论:聚焦超声应用于慢性宫颈炎的治疗安全有效,疗效确切,不良反应及并发症小,值得推广。
目的：探讨宫颈微小偏离性腺癌的诊断与治疗。方法：按照WHO(2003)宫颈腺癌分类标准，回顾性分析我院收治的8例宫颈微小偏离性腺癌的临床病理资料。结果：宫颈微小偏离性腺癌占同期收治宫颈浸润腺癌的4.73％，临床表现为水样白带和/或生殖道出血、宫颈肥大变硬和赘生物，阴道B超检查示宫腔积液，宫颈细胞学诊断较困难，常需深部活检组织诊断。结论：诊断应结合临床表现，影像学检查，宫颈细胞学。当高度怀疑时应取深部组织或宫颈锥切组织诊断，早期诊治预后较好。
Objective To investigate the efficacy and safety of neo-adjuvant chemotherapy for stage ⅠB2-ⅡB cervical cancer. Methods From June 2012 to December 2014, 66 patients with stage ⅠB2-ⅡB cervical cancer were selected and treated by PT (cisplatin/ carboplatin and taxol/docetaxel) as neo-adjuvant chemotherapy prior to surgery. Neo-adjuvant chemotherapy response and toxicity were collected and analyzed. Results The extinctive condition of tumor by neo-adjuvant chemotherapy: the complete remission rate was 10.6% (7/66), partial remission rate was 59.1% (39/66), and the total effective rate was 69.7%. The main toxicities were myelosuppression (59.1%, 39/66) and gastrointestinal reactions (33.3%, 22/66). The toxicities could be tolerated or relieved by prevention and treatment. The effective rate of chemotherapy for cervical squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma was 72.6%, 33.3% and 0%, respectively, with significant differences among the three types (P<0.05). The effective rate of chemotherapy for high, medium and low differentiated cervical cancer was 100.0%, 77.3% and 55.9%, respectively, with significant differences among the three degrees (P<0.05). Conclusions Neo-adjuvant chemotherapy is proved to be a safe and effective complementary treatment for most patients with locally advanced cervical cancer. Due to the limitation of sample size, the correlations between therapeutic effect and tumor differentiation degree and between therapeutic effect and pathological type need further study.
ObjectiveTo assess the efficacy and safety of focused ultrasound (FU) and microwave therapy (MW) for cervical ectopy (CE). MethodsWe searched the following databases:PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data from inception to 30th August 2014. Two reviewers (Tang XL and Gao Z) independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using RevMan 5.2.0 software. ResultsA total of 33 randomized controlled trials (RCTs) involving 1 759 patients were included. All the included studies were considered to be at high risk of bias. The results of meta-analysis showed that:compared with MW, FU could significantly reduce the risk of vaginal bleeding (RR=0.09, 95%CI 0.05 to 0.17, P<0.000 01) and vaginal discharge (RR=0.10, 95%CI 0.04 to 0.24, P<0.000 01), increase cure rate (RR=1.10, 95%CI 1.05 to 1.15, P<0.000 1) and total effective rate (RR=1.04, 95%CI 1.02 to 1.06, P=0.000 5). However, there was no difference in decreasing recurrence rate (RR=0.13, 95%CI 0.02 to 1.00, P=0.05). ConclusionCurrent available evidence suggest that FU is safer and more effective than MW for treating CE. Due to the limitation of quality of included studies, more high quality RCTs are needed to verify the above conclusion.
ObjectiveTo systematically review the effectiveness and safety of laparoscopic operation versus laparotomy for stage I-IIa cervical cancer. MethodDatabases including PubMed, EMbase, Web of Knowledge, CBM, WanFang Data and CNKI were searched to collect controlled trials and cohort studies about laparoscopic operation versus laparotomy for stage I-IIa cervical cancer from inception to July 2014. Two reviewers independently screened literature, extracted data, and evaluated the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 3 RCTs, 4 non-randomized controlled trials and 11 cohort studies involving 2 020 patients were included. The results of meta-analysis showed that, compared with laparotomy, laparoscopy operation could reduce intraoperative blood loss (MD=-247.99, 95%CI -408.90 to -87.07, P=0.003) , the incidence of perioperative blood transfusion (OR=0.33, 95%CI 0.21 to 0.52, P<0.000 01) , haemoglobin level before and after surgery (MD=-0.98, 95%CI -0.13 to -0.93, P<0.000 01) , postoperative complication (OR=0.61, 95%CI 0.40 to 0.93, P=0.02) , and shorten postoperative exhaust time (MD=-17.41, 95%CI -32.79 to -2.03, P=0.03) and postoperative hospitalization days (MD=-2.51, 95%CI -3.25 to -1.78, P<0.000 01) . There were no significant differences between two groups in the number of pelvic lymph nodes removed, operative complications, as well as the recurrence rate, mortality and non-recurrence survivals after 2 to 5 years of follow-up. But the operation time of the laparoscopy operation group was longer than that of the laparotomy group. ConclusionsCurrent evidence shows that compared with laparotomy, laparoscopic operation for early stage cervical cancer has less trauma, less blood loss, shorter hospitalization days and less postoperative complications. Due to the limited quantity of the included studies, more studies are needed to verify the above conclusion.
The main purpose of this study is to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) metabolism imaging in accurate staging and prognosis prediction before treatment of cervical cancer. 18F-FDG single photon emission computed tomography (SPECT/CT) was performed before treatment on 27 patients with cervical cancer and was analyzed retrospectively. All the images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B, lymph nodes size and T/B were measured by software. Comparison of the relationship between primary tumor T/B of cervix and clinic pathological factors was performed using SPSS17.0. The diagnosis was established according to pathology results of surgery or/and multi-modalities of imaging and clinical following up. The results showed that the primary tumor T/B value of cervix was 5.9 (3.2). With the increased clinical stage, T/B of primary tumor value was significantly increased (P<0.05). The T/B value in patients ≥Ⅱa stage was significantly higher than those of ≤Ⅰb stage. There were no significant correlations between T/B value and primary tumor size, lymph-node metastasis, and histological type (P>0.05). Thirteen lymph nodes were detected by 18F-FDG imaging in 27 patients with cervical cancer. For diagnosing lymph nodes metastasis, the sensitivity, specificity, accuracy, positive and negative predictive value by 18F-FDG imaging were 75.0%, 78.9%, 77.8%, 60.0% and 88.2%, respectively. The T/B value of all lymph nodes was 6.3 (3.5), in which T/B value of distant metastasis was significantly higher than that of the pelvic metastasis (P<0.05). There were no significant correlations between T/B value and the size of lymph nodes (P>0.05). Uterine body uptaking FDG were discovered in 17 patients and 15 cases were then pathologically proved. Two of 15 cases were cancerous invasion of uterine body, and the other 13 cases were physiological changes of endometrial, and the T/B value of the former was significantly higher than that of the latter (P<0.05). There were positive correlation between invasion of uterine body and lymph nodes metastasis (P<0.05). In conclusion, 18F-FDG imaging has an obvious value for the diagnosis of outside pelvic and distant lymph node metastasis, uterine body infiltrated, and accurate staging. Primary focal T/B value of cervical cancer associates with the clinical stage, which can reflect the risk of patients, and were useful to preliminarily predict the prognosis of cervical cancer.