概述
Cervical cancer begins in the cervix, the lower part of the uterus connecting to the vagina. It is largely preventable and highly treatable when detected early. Most cases are caused by persistent infection with high-risk human papillomavirus (HPV) types.
Main histologic types:
- Squamous cell carcinoma (most common)
- Adenocarcinoma
- Adenosquamous carcinoma (rare)
症状
- Abnormal vaginal bleeding (e.g., after intercourse, between periods)
- Unusual vaginal discharge
- Pelvic pain or pain during intercourse
- In advanced cases: leg swelling, back pain, weight loss
病因与风险因素
- Persistent HPV infection (types 16, 18)
- Early sexual activity and multiple partners
- Smoking
- Immunosuppression (e.g., HIV)
- Infrequent or no Pap/HPV testing
- Long-term use of oral contraceptives
诊断方法
- Pap smear (cytology)
- HPV DNA test
- Colposcopy and cervical biopsy
- Imaging: CT, MRI, PET-CT (staging)
- Pelvic examination under anesthesia (for locally advanced disease)
治疗方案
- Early-stage:
- Surgery (conization, trachelectomy, hysterectomy)
- Radiation therapy
- Locally advanced:
- Chemoradiation (cisplatin-based)
- Advanced/metastatic:
- Chemotherapy
- Targeted therapy (e.g., bevacizumab)
- Immunotherapy (e.g., pembrolizumab for PD-L1+ tumors)
预后情况
- Depends on stage at diagnosis
- 5-year survival:
- Stage I: ~90%
- Stage II: ~60–80%
- Stage III–IV: <50%
- Regular screening dramatically improves outcomes
与此类癌症共处
- Fertility-sparing options for early-stage patients
- Sexual and urinary health management
- Psychosocial support
- Surveillance with Pap/HPV testing and imaging
预防与筛查
- HPV vaccination
- Regular Pap smears and HPV testing
- Smoking cessation
- Safe sex practices
FAQs
Q: Can cervical cancer be prevented?
A: Yes, through HPV vaccination and regular screening.
Q: Is it contagious?
A: The cancer is not contagious, but HPV (a virus) is sexually transmitted.
Q: Can I still have children?
A: Fertility may be preserved in early stages with conservative surgery.
相关资源
- Cervical Cancer-Free Coalition
- American Society of Clinical Oncology (ASCO)
- WHO: Cervical Cancer Elimination Initiative
- ClinicalTrials.gov
