切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (02) : 148 -153. doi: 10.3877/cma.j.issn.1673-5250.2015.02.002

所属专题: 文献

专家述评

意外发现的宫颈癌及其宫旁广泛切除术
林仲秋1,*,*(), 卢淮武1   
  1. 1. 510120 广州,中山大学孙逸仙纪念医院
  • 收稿日期:2015-01-10 出版日期:2015-04-01
  • 通信作者: 林仲秋

Unexpected discovery of cervical cancer and radical parametrectomy

Zhongqiu Lin1(), Huaiwu Lu1   

  1. 1. Department of Gynecological Oncology, SUN Yat-Sen Memorial Hospital, SUN Yat-Sen University, Guangzhou 510120, Guangdong Province, China
  • Received:2015-01-10 Published:2015-04-01
  • Corresponding author: Zhongqiu Lin
  • About author:
    Corresponding author: Lin Zhongqiu, Email:
引用本文:

林仲秋, 卢淮武. 意外发现的宫颈癌及其宫旁广泛切除术[J]. 中华妇幼临床医学杂志(电子版), 2015, 11(02): 148-153.

Zhongqiu Lin, Huaiwu Lu. Unexpected discovery of cervical cancer and radical parametrectomy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(02): 148-153.

意外发现的宫颈癌(UDCC)在临床上比较少见,宫旁广泛切除术是无高危因素UDCC患者的首选治疗手段,但手术难度较大并存在某些争议。笔者围绕UDCC的预防、处理原则、手术时机选择,对广泛宫旁切除术的新突破、手术技巧及存在的争议进行述评,旨在为UDCC的临床研究提供参考。

Unexpected discovery of cervical cancer (UDCC) is uncommon. Radical parametrectomy is the preferred treatment for UDCC patients with out pathological high-risk factors. However, the operation is difficult and still under controversy. We will focus on the principles of prevention and treatment of UDCC, choice of opportune time for radical parametrectomy in patients with UDCC, reviewing the new breakthroughs in the study of radical parametrectomy, and surgical skills, controversies of radical parametrectomy.

表1 早期宫颈癌宫旁转移低危因素
Table 1 Low risk factors of parametrium involvement for cervical cancer
[1]
Park JY, Kim DY, Kim JH, et al. Management of occult invasive cervical cancer found after simple hysterectomy[J]. Ann Oncol, 2010,21(5):994–1000.
[2]
Münstedt K, von Georgi R, Zygmunt M, et al. Shortcomings and deficits in surgical treatment of gynecological cancers: a German problem only?[J]. Gynecol Oncol, 2002,86(3):337–343.
[3]
Choi DH, Huh SJ, Nam KH. Radiation therapy results for patients undergoing inappropriate surgery in the presence of invasive cervical carcinoma[J]. Gynecol Oncol, 1997,65(3):506–511.
[4]
曹泽毅. 宫颈癌诊治发展的新思考[J/CD].中华妇幼临床医学杂志:电子版,2013, 9(2):CD–ROM.
[5]
Leath CA 3rd, Straughn JM, Bhoola SM, et al. The role of radical parametrectomy in the treatment of occult cervical carcinoma after extrafascial hysterectomy[J]. Gynecol Oncol, 2004,92(1):215–219.
[6]
DeCenzo JA, Malo T, Cavanagh D. Factors affecting cone-hysterectomy morbidity. A study of 200 patients[J]. Am J Obstet Gynecol, 1971,110(3):380–384.
[7]
Samlal RA, van der Velden J, Schilthuis MS, et al. Influence of diagnostic conization on surgical morbidity and survival in patients undergoing radical hysterectomy for stage ⅠB and ⅡA cervical carcinoma[J]. Eur J Gynaecol Oncol, 1997,18(6):478–481.
[8]
Kinney WK, Egorshin EV, Ballard DJ, et al. Long-term survival and sequelae after surgical management of invasive cervical carcinoma diagnosed at the time of simple hysterectomy[J]. Gynecol Oncol, 1992,44(1):24–27.
[9]
Frumovitz M, Sun CC, Schmeler KM, et al. Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer[J]. Obstet Gynecol, 2009,114(1):93–99.
[10]
Kodama J, Kusumoto T, Nakamura K, et al. Factors associated with parametrial involvement in stage ⅠB1 cervical cancer and identification of patients suitable for less radical surgery[J]. Gynecol Oncol, 2011,122(3):491–494.
[11]
Kim MK, Kim JW, Kim MA, et al. Feasibility of less radical surgery for superficially invasive carcinoma of the cervix[J]. Gynecol Oncol, 2010,119(2):187–191.
[12]
Wright JD, Grigsby PW, Brooks R, et al. Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy[J]. Cancer, 2007,110(6):1281–1286.
[13]
卢淮武,王丽娟,谢玲玲,等. 宫颈癌ⅠB1期宫旁转移相关因素分析[J]. 中山大学学报:医学科学版,2012,33(5):693–696.
[14]
Kinney WK, Hodge DO, Egorshin EV, et al. Identification of a low-risk subset of patients with stage ⅠB invasive squamous cancer of the cervix possibly suited to less radical surgical treatment[J]. Gynecol Oncol, 1995,57(1):3–6.
[15]
Stegeman M, Louwen M, van der Velden J, et al. The incidence of parametrial tumor involvement in select patients with early cervix cancer is too low to justify parametrectomy[J]. Gynecol Oncol, 2007,105(2):475–480.
[16]
Gemer O, Eitan R, Gdalevich M, et al. Can parametrectomy be avoided in early cervical cancer? An algorithm for the identification of patients at low risk for parametrial involvement[J]. Eur J Surg Oncol, 2013,39(1):76–80.
[17]
Covens A, Rosen B, Murphy J, et al. How important is removal of the parametrium at surgery for carcinoma of the cervix?[J]. Gynecol Oncol, 2002,84(1):145–149.
[18]
卢淮武,刘畅浩,王丽娟,等. 早期宫颈癌前哨淋巴结检测研究进展[J]. 中国实用妇科与产科杂志,2011,27(4):317–320.
[19]
马丁,李双. 2013年美国阴道镜及宫颈病理协会宫颈癌筛查新指南解读和启示[J/CD].中华妇幼临床医学杂志:电子版,2014, 10(5):568–571.
[20]
Strnad P, Robova H, Skapa P, et al. A prospective study of sentinel lymph node status and parametrial involvement in patients with small tumour volume cervical cancer[J]. Gynecol Oncol, 2008, 109(2): 280–284.
[21]
Pluta M, Rob L, Charvat M, et al. Less radical surgery than radical hysterectomy in early stage cervical cancer: a pilot study[J]. Gynecol Oncol, 2009,113(2):181–184.
[22]
Narducci F, Merlot B, Bresson L, et al. Occult invasive cervical cancer found after inadvertent simple hysterectomy: is the ideal management: systematic parametrectomy with or without radiotherapy or radiotherapy only?[J]. Ann Surg Oncol, 2015, 22(4):1349–1352.
[1] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1061-1067.
[2] 谭巧, 苏小涵, 侯令密, 黎君彦, 邓世山. 乳腺髓样癌的诊治进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 366-368.
[3] 杨小菁, 姜瑞瑞, 石玉香, 王静静, 李长天. 乳腺孤立性纤维性肿瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 375-377.
[4] 冯雪园, 韩萌萌, 马宁. 乳腺原发上皮样血管内皮瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 378-380.
[5] 李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.
[6] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[7] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
[8] 杨雪, 张伟, 尚培中, 宋创业, 尚丹丹, 张蔚. 胆囊十二指肠瘘结石经瘘口排出后自愈一例报道[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 707-708.
[9] 许丁伟, 马江云, 李新成, 黄洁. Alagille综合征疑诊为先天性胆道闭锁一例并文献复习[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 681-687.
[10] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[11] 杨红杰, 张智春, 孙轶. 直肠癌淋巴结转移诊断研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 512-518.
[12] 顾睿祈, 方洪生, 蔡国响. 循环肿瘤DNA检测在结直肠癌诊治中的应用与进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 453-459.
[13] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[14] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[15] 周婷, 孙培培, 张二明, 安欣华, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病诊断现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(07): 790-797.
阅读次数
全文


摘要