Precancerous lesion of cervical cancer
If cervical cancer is found early, the cure rate is almost 100%. More specifically, compared with other cancers, cervical cancer has a very clear cause. Lai Qionghui, vice president of Linkou Chang Gung Memorial Hospital and an authoritative physician of gynecological cancer, said that almost 65,438+0,000% of cervical cancer is infected by human papillomavirus (HPV), which causes cervical precancerous lesions and eventually turns into cancer.
Precancerous lesions found from smear examination, although not considered as cancer, have begun to produce abnormalities and are at risk of becoming cancer. According to the number and severity of cell variation, it can be divided into three stages: mild, moderate and severe. Lai Qionghui said that in general, it is good to follow up lightly, but if you are infected with a high-risk human papillomavirus type, you can do cryotherapy and laser treatment to remove mutated cells.
The so-called high-risk human papillomavirus types include 16 and 18, which account for 70% of the causes of cervical cancer, and 52 and 58, which are particularly prevalent in Taiwan Province province. These four kinds together account for 90% of cervical cancer infection categories and can be considered for treatment. If you have reached moderate or severe precancerous lesions, you can discuss with your doctor whether to operate and check for pathology or infection.
Staging of cervical cancer: Can I keep my uterus?
Lai Qionghui said that the treatment of cervical cancer depends on whether there is metastasis. If there is metastasis, no more surgery can be done, only chemotherapy and radiotherapy can be done. If there is no metastasis, it depends on how deep the tumor itself invades the cervix. "Because the position of the cervix is very special, the front is the bladder and the back is the rectum. If the invasive thickness has reached the bladder, it is useless to force separation. The cancer cells may have disappeared. 」
Generally speaking, this kind of tumor will be larger than 4 cm, which is more than stage B2 of cervical cancer. Even if positron emission tomography does not capture metastatic cancer cells, there may be invisible metastasis. Lai Qionghui said, "The examination has certain restrictions, so it is best to perform cervical and uterine eradication surgery, beyond the first stage B2. 」
But for many young women, or mothers who want to have children, they still want to keep the uterus. Lai Qionghui said that if the diagnosis is still before B 1, that is, A 1, A2, B 1 of1,a part of the cervix can be removed and the uterus can be preserved.
However, if it is A2 and B 1 phase, whether the uterus should be preserved or not should be removed, because it is impossible to see whether there is metastasis, which will only increase the probability of abdominal adhesion, and the operation risk is high, so postoperative care should be cautious. The probability of 1 A 1 stage lymphatic metastasis is less than 1%. Considering the risk of operation, clearance is generally not recommended, but regular follow-up is needed to observe whether there is lymphatic metastasis.
Cervical smear "must be followed"
Although Taiwan Province Province has been carrying out Pap smear examination for 20 years, and everyone is familiar with the slogan of "six minutes to save life", Lai Qionghui lamented that "only 89% of people with abnormal Pap smears will continue to follow up or only follow up when they have symptoms, and they are not particularly concerned about or do not know much about abnormalities. Although the follow-up ratio is already high, it is not all. 」
Lai Qionghui said that the detection rate of human papillomavirus in cervical smear can reach 97%, but among the new cases of cervical cancer every year, 4% people have never done cervical smear; In fact, only 80% people will do cervical smear, and there is no regular follow-up. Only 70% has been done in 5~6 years, which is still not enough.
Lai Qionghui said, "Therefore, it is very good to promote HPV vaccine, because almost 100% is infected by human papillomavirus, so if the cervical smear is insufficient from the source, cervical cancer will hardly occur. 」