Management of cervical premalignant lesions
Management of cervical premalignant lesions
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DOI：
10.1016/j.currproblcancer.2018.01.010
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发表时间：
2018-03-01
影响因子：
2.6
通讯作者：
Joshi, Smita
中科院分区：
文献类型：
--
作者：
Basu, Partha;Taghavi, Katayoun;Joshi, Smita
治疗不同级别的宫颈癌前病变(宫颈上皮内瘤变，CIN)是非常有效、简单、安全的。整个宫颈变形区需要采用消融技术(冷冻或热消融)或切除技术(大环切除变形区或冷刀锥切术)；治疗的选择取决于病变的大小、位置和变形区的类型。高级别CIN消融治疗后的治愈率可能略低于切除治疗。消融技术的简单性、低并发症发生率和较低的成本使消融技术成为符合条件的病灶在低资源环境下的首选治疗方法。在组织阴道镜和组织病理学服务具有挑战性的情况下，世界卫生组织推荐了一些简单的算法，比如用醋酸测试进行目测筛查，以及立即对醋酸阳性女性的目检进行消融治疗。这样的策略有效地防止了高级别CIN的后续发展，也确保了筛查阳性妇女对治疗的高度依从性。(C)2018 Elsevier Inc.保留所有权利。
Treatment of cervical premalignant lesions (cervical intraepithelial neoplasia; CIN) of different grades is very effective, simple, and safe. The entire transformation zone of the cervix needs to be treated either by an ablative technique (cryotherapy or thermal ablation) or an excisional technique (large loop excision of transformation zone or cold knife conization); the choice of treatment depends on the size and location of the lesion and the type of the transformation zone. The cure rate after ablative treatment of high-grade CIN may be little lower than that after excisional treatment. The simplicity of the technique, low complication rate, and lesser cost make ablative technique the treatment of choice in the low resourced settings for the eligible lesions. In situations where organizing colposcopy and histopathology services is challenging, simple algorithms like screening with visual inspection with acetic acid test and immediate ablative treatment of the visual inspection with acetic acid-positive women has been recommended by the World Health Organization. Such a strategy is effective in preventing subsequent development of high-grade CIN and also ensures high compliance of the screen positive women to treatment. (C) 2018 Elsevier Inc. All rights reserved.