Cervical Cancer

Most common malignancy of GT!! Definition: Epithelial Malignancy originated from the cervix CIN: Cervical Intraepithelial Neoplasia Epidemiology: Incidence: 3.89/100,000 Elderly women, mean age 52.2y Social: sex behavior, vaginal delivery, smoking, contraceptive method, nutrition, economic status, race, geographical environment Biology: HPV, HSV, HIV Clinical Progressing: Multiple Stages CIN I CIN II CIN III Cancer Histological Classification: Squamoscell cancer Adenocarcinoma Metastasis: Invasion Lymphatic Blood Manifestation: Symptoms: constipation, dysuria, urinary retentron, pelvic pain Signs and subtype: Contact bleeding , Bloody dischaging Tumor markers The STAGING of Cervical Cancer: FIGO 2009 I: limited to uterus Ia: Only viewed under microscope, any naked eyes viewed disease is Ib Ia1: depth <3mm, width7mm Ia2: depth 3-5mm, width7mm Ib: any naked eyes viewed disease or >Ia2 Ib1: D4cm, Ib2: D>4cm II: extended out of uterus IIa: without parametrium invasion IIa1: D4cm, vagina<1/3 IIa2: D>4cm, vagina<1/3 III: pelvis wall invasion IIIa: vagina>1/3, no pelvis invasion IIIb: pelvis side wall involved IVa: bladder, rectum invasion IVb: distant metastasis

Diagnosis: Pap Smear, HPV Lugols test Acetate White test Cervicalgraphy Coloscopy Intrinsic fluorescence check Bioposy Cold Knife CONIZATION Differential Diagnosis: Inflammation Tuberculosis Endometriosis Treatment: Surgery Radiation Chemotherapy Surgical treatment CIN: CIN I: follow or medical treatment CIN II: physical treatment/LEEP CIN III: conization Surgical treatment: Out facial Hys.class I Modify Weitherm Hys.class II Weitherm Hys.class III Wilded Hysclass IV Pelvic externationclass V Pelvic /aortic lymphodenectomy Radiation therapy: Prognosis: I 90% II 80% III 60% IV 40%