Adenocarcinoma in situ and early invasive adenocarcinoma of the uterine cervix.
Adenocarcinoma in situ and early invasive adenocarcinoma of the uterine cervix.
复制标题
宫颈原位腺癌和早期浸润性腺癌。
DOI：
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发表时间：
2001
影响因子：
3.4
通讯作者：
Robert E. Bristow
中科院分区：
文献类型：
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作者：
Suzanne Davey Shipman;Robert E. Bristow
随着数据的不断积累，浸润前和早期浸润性宫颈腺性瘤变的临床特征正变得越来越明确。这些病变的细胞学筛查是不精确的，然而，修改目前的分类系统可能会提高整体的准确性。然而，巴氏涂片上所有的腺体异常都需要谨慎的评估和仔细的随访。宫颈锥切术是诊断原位腺癌（ACIS）最明确的方法。由于ACIS被认为是一个多病灶的过程，阴性锥切边缘具有有限的预测价值，保守的管理方案一直难以认可。几项大型研究表明，手术切缘状态可能是比以前认为的更可靠的疾病清除指标。对于希望保持生殖能力的年轻患者，ACIS似乎可以通过冷刀锥切术结合严密监测来安全管理。早期浸润性宫颈腺癌预后良好，最近的资料表明根治性手术可能是不必要的。
As data continue to accumulate, the clinical characteristics of preinvasive and early invasive glandular cervical neoplasia are becoming progressively better defined. Cytologic screening for these lesions is imprecise; however, modifications to current classification systems may improve the overall accuracy. All glandular abnormalities on the Papanicolaou smear, nevertheless, require judicious evaluation and careful follow-up. Cervical conization is the most definitive means of diagnosing adenocarcinoma in situ (ACIS). Because ACIS has been thought to represent a multifocal process, with negative conization margins having limited predictive value, conservative management protocols have been difficult to endorse. Several large studies now indicate that the surgical margin status may be a more reliable indicator of true disease clearance than previously thought. For young patients desiring to maintain reproductive capacity, ACIS appears to be safely managed by cold-knife conization combined with diligent surveillance. Early invasive adenocarcinoma of the uterine cervix is associated with an excellent prognosis, and recent data suggest that radical surgery may be unnecessary.