cervix cancer

子宮頚癌、子宮頸癌、子宮頚部癌、子宮頸部癌

関

cancer of the cervix、cancer of the uterine cervix、cervical cancer、cervical carcinoma、cervical neoplasm、cervix carcinoma、cervix neoplasm、endocervical carcinoma、uterine cervical neoplasm、uterine cervix cancer

WordNet

1. type genus of the family Cancridae (同)genus Cancer
2. the fourth sign of the zodiac; the sun is in this sign from about June 21 to July 22 (同)Cancer the Crab, Crab
3. (astrology) a person who is born while the sun is in Cancer (同)Crab
4. a small zodiacal constellation in the northern hemisphere; between Leo and Gemini
5. any malignant growth or tumor caused by abnormal and uncontrolled cell division; it may spread to other parts of the body through the lymphatic system or the blood stream (同)malignant neoplastic disease
6. necklike opening to the uterus (同)uterine_cervix, cervix_uteri

PrepTutorEJDIC

1. 〈U〉〈C〉『がん』 / 〈U〉〈C〉害悪 / 《Cancer》(星座の)カニ座
2. (器官の)頚(けい)部,(特に子宮の)頚管

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/09/09 16:11:22」(JST)

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Cervical Cancer
Classification and external resources
Histopathologic image (H&E stain) of carcinoma in situ, stage 0.
ICD-10	C53
ICD-9	180
OMIM	603956
DiseasesDB	2278
MedlinePlus	000893
eMedicine	med/324 radio/140
MeSH	D002583

Cervical cancer is a malignant neoplasm arising from cells originating in the cervix uteri. One of the most common symptoms of cervical cancer is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer has progressed to an advanced stage. Treatment usually consists of surgery (including local excision) in early stages, and chemotherapy and/or radiotherapy in more advanced stages of the disease.

Cancer screening using the Pap smear can identify precancerous and potentially precancerous changes in cervical cells and tissue. Treatment of high-grade changes can prevent the development of cancer in many victims. In developed countries, the widespread use of cervical screening programs has dramatically reduced the incidence of invasive cervical cancer.

Human papillomavirus (HPV) infection appears to be a necessary factor in the development of almost all cases (90+%) of cervical cancer. HPV vaccines effective against the two strains of this large family of viruses that currently cause approximately 70% of cases of cervical cancer have been licensed in the U.S, Canada, Australia, and the EU. Since the vaccines only cover some of the cancer-causing ("high-risk") types of HPV, women should seek regular Pap smear screening, even after vaccination.

The cervix is the narrow portion of the uterus where it joins with the top of the vagina. Most cervical cancers are squamous cell carcinomas, arising in the squamous (flattened) epithelial cells that line the cervix. Adenocarcinoma, arising in glandular epithelial cells is the second most common type. Very rarely, cancer can arise in other types of cells in the cervix.

Signs and symptoms

Cervix in relation to upper part of vagina and posterior portion of uterus.

The early stages of cervical cancer may be completely asymptomatic. Vaginal bleeding, contact bleeding, or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere.

Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy bleeding from the vagina, bone fractures, and/or (rarely) leakage of urine or faeces from the vagina (rarely).

Causes

Infection with some types of human papilloma virus (HPV) is the greatest risk factor for cervical cancer, followed by smoking. Other risk factors include human immunodeficiency virus. Not all of the causes of cervical cancer are known, however, and several other contributing factors have been implicated.

Human papillomavirus

Human papillomavirus is the cause of 70% of cervical cancer globally.

Women who have many sexual partners (or who have sex with men who have had many other partners) have a greater risk.

Of the 150-200 types of HPV known, 15 are classified as high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82), 3 as probable high-risk (26, 53, and 66), and 12 as low-risk (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108). Types 16 and 18 are generally acknowledged to cause about 70% of cervical cancer cases. Together with type 31, they are the prime risk factors for cervical cancer.

Genital warts, which are a form of benign tumor of epithelial cells, are also caused by various strains of HPV. However, these serotypes are usually not related to cervical cancer. It is common to have multiple strains at the same time, including those that can cause cervical cancer along with those that cause warts. The medically accepted paradigm, officially endorsed by the American Cancer Society and other organizations, is that a patient must have been infected with HPV to develop cervical cancer, and is hence viewed as a sexually transmitted disease (although many dispute that, technically, it is the causative agent, not the cancer, that is a sexually transmitted disease), but most women infected with high risk HPV will not develop cervical cancer. Use of condoms reduces, but does not always prevent transmission. Likewise, HPV can be transmitted by skin-to-skin-contact with infected areas. In males, there is no commercially available test for HPV, although HPV is thought to grow preferentially in the epithelium of the glans penis, and cleaning of this area may be preventative.^{[citation needed]}

Diagnosis

Cervical cancer seen on a T2 weighted saggital MR image of the pelvis.

Biopsy

While the pap smear is an effective screening test, confirmation of the diagnosis of cervical cancer or pre-cancer requires a biopsy of the cervix. This is often done through colposcopy, a magnified visual inspection of the cervix aided by using a dilute acetic acid (e.g. vinegar) solution to highlight abnormal cells on the surface of the cervix. Medical devices used for biopsy of the cervix include punch forceps or SpiraBrush CX.

Colposcopic impression, the estimate of disease severity based on the visual inspection, forms part of the diagnosis.

Further diagnostic and treatment procedures are loop electrical excision procedure (LEEP) and conization, in which the inner lining of the cervix is removed to be examined pathologically. These are carried out if the biopsy confirms severe cervical intraepithelial neoplasia.

This large squamous carcinoma (bottom of picture) has obliterated the cervix and invaded the lower uterine segment. The uterus also has a round leiomyoma up higher.

Micrograph of a (cervical) adenosquamous carcinoma, a type of cervical cancer. H&E stain.

Precancerous lesions

Cervical intraepithelial neoplasia, the potential precursor to cervical cancer, is often diagnosed on examination of cervical biopsies by a pathologist. For premalignant dysplastic changes, the CIN (cervical intraepithelial neoplasia) grading is used.

The naming and histologic classification of cervical carcinoma percursor lesions has changed many times over the 20th century. The World Health Organization classification system was descriptive of the lesions, naming them mild, moderate or severe dysplasia or carcinoma in situ (CIS). The term, Cervical Intraepithelial Neoplasia (CIN) was developed to place emphasis on the spectrum of abnormality in these lesions, and to help standardise treatment. It classifies mild dysplasia as CIN1, moderate dysplasia as CIN2, and severe dysplasia and CIS as CIN3. More recently, CIN2 and CIN3 have been combined into CIN2/3. These results are what a pathologist might report from a biopsy.

These should not be confused with the Bethesda System terms for Pap smear (cytopathology) results. Among the Bethesda results: Low-grade Squamous Intraepithelial Lesion (LSIL) and High-grade Squamous Intraepithelial Lesion (HSIL). An LSIL Pap may correspond to CIN1, and HSIL may correspond to CIN2 and CIN3, however they are results of different tests, and the Pap smear results need not match the histologic findings.

Cancer subtypes

Histologic subtypes of invasive cervical carcinoma include the following: Though squamous cell carcinoma is the cervical cancer with the most incidence, the incidence of adenocarcinoma of the cervix has been increasing in recent decades.

• squamous cell carcinoma (about 80-85%^{[citation needed]})
• adenocarcinoma (about 15% of cervical cancers in the UK)
• adenosquamous carcinoma
• small cell carcinoma
• neuroendocrine tumour
• glassy cell carcinoma
• villoglandular adenocarcinoma

Non-carcinoma malignancies which can rarely occur in the cervix include

• melanoma
• lymphoma

Note that the FIGO stage does not incorporate lymph node involvement in contrast to the TNM staging for most other cancers.

For cases treated surgically, information obtained from the pathologist can be used in assigning a separate pathologic stage but is not to replace the original clinical stage.

Staging

Main article: Cervical cancer staging

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings. It allows only the following diagnostic tests to be used in determining the stage: palpation, inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervical conization.

Prevention

Screening

The widespread introduction of cervical screening by the Papanicolaou test, or Pap smear for cervical cancer has been credited with dramatically reducing the incidence and mortality of cervical cancer in developed countries. Pap smear screening every 3–5 years with appropriate follow-up can reduce cervical cancer incidence by up to 80%. Abnormal results may suggest the presence of pre cancerous changes allowing examination and possible preventive treatment. If precancerous disease or cervical cancer is detected early, it can be monitored or treated relatively noninvasively, with little impairment of fertility.

Cervical cancer screening is typically recommended starting at age 21. Recommendations for how often a Pap smear should be done vary from once a year to once every five years, in the absence of abnormal results. Guidelines vary on how long to continue screening, but well screened women who have not had abnormal smears can stop screening about age 60 to 70.

Liquid-based cytology is another potential screening method. Although it was probably intended to improve on the accuracy of the Pap test, its main advantage has been to reduce the number of inadequate smears from around 9% to around 1%. This reduces the need to recall women for a further smear. The United States Preventive Services Task Force supports screening every 5 years in those who are between 30 and 65 years when cytology is used in combination with HPV testing.

Vaccination

There are two HPV vaccines (Gardasil and Cervarix) which reduce the risk of cancerous or precancerous changes of the cervix and perineum by about 93%.

HPV vaccines are typically given to women age 9 to 26 as the vaccine is only effective if given before infection occurs. The vaccines have been shown to be effective for at least 4 to 6 years, and it is believed they will be effective for longer; however, the duration of effectiveness and whether a booster will be needed is unknown. The high cost of this vaccine has been a cause for concern. Several countries have considered (or are considering) programs to fund HPV vaccination.

Condoms

Condoms are thought to offer some protection against cervical cancer. Evidence on whether condoms protect against HPV infection is mixed, but they may protect against genital warts and the precursors to cervical cancer. They also provide protection against other STDs, such as HIV and Chlamydia, which are associated with greater risks of developing cervical cancer.

Condoms may also be useful in treating potentially precancerous changes in the cervix. Exposure to semen appears to increase the risk of precancerous changes (CIN 3), and use of condoms helps to cause these changes to regress and helps clear HPV. One study suggests that prostaglandin in semen may fuel the growth of cervical and uterine tumours and that affected women may benefit from the use of condoms.

Nutrition

Vitamin A is associated with a lower risk as is vitamin B12, vitamin C, vitamin E, and beta-carotene.

Treatment

The treatment of cervical cancer varies worldwide, largely due to large variances in disease burden in developed and developing nations, access to surgeons skilled in radical pelvic surgery, and the emergence of "fertility sparing therapy" in developed nations. Because cervical cancers are radiosensitive, radiation may be used in all stages where surgical options do not exist.

Microinvasive cancer (stage IA) may be treated by hysterectomy (removal of the whole uterus including part of the vagina). For stage IA2, the lymph nodes are removed as well. Alternatives include local surgical procedures such as a loop electrical excision procedure (LEEP) or cone biopsy. For 1A1 disease, a cone biopsy (aka cervical conization) is considered curative.

If a cone biopsy does not produce clear margins (guarantee that the tissue next to the treated area if free from cancer), one more possible treatment option for patients who want to preserve their fertility is a trachelectomy. This attempts to surgically remove the cancer while preserving the ovaries and uterus, providing for a more conservative operation than a hysterectomy. It is a viable option for those in stage I cervical cancer which has not spread; however, it is not yet considered a standard of care, as few doctors are skilled in this procedure. Even the most experienced surgeon cannot promise that a trachelectomy can be performed until after surgical microscopic examination, as the extent of the spread of cancer is unknown. If the surgeon is not able to microscopically confirm clear margins of cervical tissue once the patient is under general anesthesia in the operating room, a hysterectomy may still be needed. This can only be done during the same operation if the patient has given prior consent. Due to the possible risk of cancer spread to the lymph nodes in stage 1b cancers and some stage 1a cancers, the surgeon may also need to remove some lymph nodes from around the uterus for pathologic evaluation.

A radical trachelectomy can be performed abdominally or vaginally and there are conflicting opinions as to which is better. A radical abdominal trachelectomy with lymphadenectomy usually only requires a two to three day hospital stay, and most women recover very quickly (approximately six weeks). Complications are uncommon, although women who are able to conceive after surgery are susceptible to preterm labor and possible late miscarriage. It is generally recommended to wait at least one year before attempting to become pregnant after surgery. Recurrence in the residual cervix is very rare if the cancer has been cleared with the trachelectomy. Yet, it is recommended for patients to practice vigilant prevention and follow up care including pap screenings/colposcopy, with biopsies of the remaining lower uterine segment as needed (every 3–4 months for at least 5 years) to monitor for any recurrence in addition to minimizing any new exposures to HPV through safe sex practices until one is actively trying to conceive.

Early stages (IB1 and IIA less than 4 cm) can be treated with radical hysterectomy with removal of the lymph nodes or radiation therapy. Radiation therapy is given as external beam radiotherapy to the pelvis and brachytherapy (internal radiation). Patients treated with surgery who have high risk features found on pathologic examination are given radiation therapy with or without chemotherapy in order to reduce the risk of relapse.

Larger early stage tumors (IB2 and IIA more than 4 cm) may be treated with radiation therapy and cisplatin-based chemotherapy, hysterectomy (which then usually requires adjuvant radiation therapy), or cisplatin chemotherapy followed by hysterectomy.

Advanced stage tumors (IIB-IVA) are treated with radiation therapy and cisplatin-based chemotherapy.

On June 15, 2006, the US Food and Drug Administration approved the use of a combination of two chemotherapy drugs, hycamtin and cisplatin for women with late-stage (IVB) cervical cancer treatment. Combination treatment has significant risk of neutropenia, anemia, and thrombocytopenia side effects. Hycamtin is manufactured by GlaxoSmithKline.

Prognosis

Prognosis depends on the stage of the cancer. With treatment, the 5-year relative survival rate for the earliest stage of invasive cervical cancer is 92%, and the overall (all stages combined) 5-year survival rate is about 72%. These statistics may be improved when applied to women newly diagnosed, bearing in mind that these outcomes may be partly based on the state of treatment five years ago when the women studied were first diagnosed.

With treatment, 80 to 90% of women with stage I cancer and 50 to 65% of those with stage II cancer are alive 5 years after diagnosis. Only 25 to 35% of women with stage III cancer and 15% or fewer of those with stage IV cancer are alive after 5 years.

According to the International Federation of Gynecology and Obstetrics, survival improves when radiotherapy is combined with cisplatin-based chemotherapy.

As the cancer metastasizes to other parts of the body, prognosis drops dramatically because treatment of local lesions is generally more effective than whole body treatments such as chemotherapy.

Interval evaluation of the patient after therapy is imperative. Recurrent cervical cancer detected at its earliest stages might be successfully treated with surgery, radiation, chemotherapy, or a combination of the three. Thirty-five percent of patients with invasive cervical cancer have persistent or recurrent disease after treatment.

Average years of potential life lost from cervical cancer are 25.3 (SEER Cancer Statistics Review 1975-2000, National Cancer Institute (NCI)). Approximately 4,600 women were projected to die in 2001 in the US of cervical cancer (DSTD), and the annual incidence was 13,000 in 2002 in the US, as calculated by SEER. Thus the ratio of deaths to incidence is approximately 35.4%.

Regular screening has meant that pre cancerous changes and early stage cervical cancers have been detected and treated early. Figures suggest that cervical screening is saving 5,000 lives each year in the UK by preventing cervical cancer. About 1,000 women per year die of cervical cancer in the UK.

Epidemiology

Age-standardized death from cervical cancer per 100,000 inhabitants in 2004.

no data   <2.4   2.4-4.8   4.8-7.2   7.2-9.6   9.6-12   12-14.4

14.4-16.8   16.8-19.2   19.2-21.6   21.6-24   24-26.4   >26.4

Worldwide, cervical cancer is second most common and the fifth deadliest cancer in women. It affects about 16 per 100,000 women per year and kills about 9 per 100,000 per year. Approximately 80% of cervical cancers occur in developing countries Worldwide, in 2008, it was estimated that there were 473,000 cases of cervical cancer, and 253,500 deaths per year.

In the United States, it is only the 8th most common cancer of women. The median age at diagnosis is 48. Hispanic women are significantly more likely to be diagnosed with cervical cancer than the general population. In 1998, about 12,800 women were diagnosed in the US and about 4,800 died. In 2008 in the US an estimated 11,000 new cases were expected to be diagnosed, and about 3,870 were expected to die of cervical cancer. Among gynecological cancers it ranks behind endometrial cancer and ovarian cancer. The incidence and mortality in the US are about half those for the rest of the world, which is due in part to the success of screening with the Pap smear. The incidence of new cases of cervical cancer in the United States was 7 per 100,000 women in 2004. Cervical cancer deaths decreased by approximately 74% in the last 50 years, largely due to widespread Pap smear screening. The annual direct medical cost of cervical cancer prevention and treatment prior to introduction of the HPV vaccine was estimated at $6 billion.

In the European Union, there were about 34,000 new cases per year and over 16,000 deaths due to cervical cancer in 2004.

In the United Kingdom, the age-standardised (European) incidence is 8.5/100,000 per year (2006). It is the twelfth most common cancer in women, accounting for 2% of all female cancers, and is the second most common cancer in the under 35s females, after breast cancer. The UK's European age-standardised mortality is 2.4/100,000 per year (2007) (Cancer Research UK Cervical cancer statistics for the UK). With a 42% reduction from 1988-1997 the NHS implemented screening programme has been highly successful, screening the highest risk age group (25–49 years) every 3 years, and those ages 50–64 every 5 years.

In Canada, an estimated 1,300 women will be diagnosed with cervical cancer in 2008 and 380 will die.

In Australia, there were 734 cases of cervical cancer (2005). The number of women diagnosed with cervical cancer has dropped on average by 4.5% each year since organised screening began in 1991 (1991–2005). Regular two-yearly Pap tests can reduce the incidence of cervical cancer by up to 90% in Australia, and save 1,200 Australian women dying from the disease each year.

History

• 400 BCE - Hippocrates: cervical cancer incurable
• 1925 - Hinselmann: invented colposcope
• 1928 - Papanicolaou: developed Papanicolaou technique
• 1941 - Papanicolaou and Trout: Pap smear screening
• 1946 - Ayer: Aylesbury spatula to scrape the cervix, collecting sample for Pap smear
• 1951 - First successful in-vitro cell line, HeLa, derived from biopsy of cervical cancer of Henrietta Lacks
• 1976 - Zur Hausen and Gisam: found HPV DNA in cervical cancer and warts
• 1988 - Bethesda System for reporting Pap results developed
• 2006 - First HPV vaccine FDA approved

Epidemiologists working in the early 20th century noted that cervical cancer behaved like a sexually transmitted disease. In summary:

1. Cervical cancer was common in female sex workers.
2. It was rare in nuns, except for those who had been sexually active before entering the convent. (Rigoni in 1841)
3. It was more common in the second wives of men whose first wives had died from cervical cancer.
4. It was rare in Jewish women.
5. In 1935, Syverton and Berry discovered a relationship between RPV (Rabbit Papillomavirus) and skin cancer in rabbits. (HPV is species-specific and therefore cannot be transmitted to rabbits)

This led to the suspicion that cervical cancer could be caused by a sexually transmitted agent. Initial research in the 1940s and 1950s put the blame on smegma (e.g. Heins et al. 1958). During the 1960s and 1970s it was suspected that infection with herpes simplex virus was the cause of the disease. In summary, HSV was seen as a likely cause because it is known to survive in the female reproductive tract, to be transmitted sexually in a way compatible with known risk factors, such as promiscuity and low socioeconomic status. Herpes viruses were also implicated in other malignant diseases, including Burkitt's lymphoma, Nasopharyngeal carcinoma, Marek's disease and the Lucké renal adenocarcinoma. HSV was recovered from cervical tumour cells.

A description of human papillomavirus (HPV) by electron microscopy was given in 1949, and HPV-DNA was identified in 1963.^{[citation needed]} It was not until the 1980s that HPV was identified in cervical cancer tissue. It has since been demonstrated that HPV is implicated in virtually all cervical cancers. Specific viral subtypes implicated are HPV 16, 18, 31, 45 and others.

In work that was initiated in the mid 1980s, the HPV vaccine was developed, in parallel, by researchers at Georgetown University Medical Center, the University of Rochester, the University of Queensland in Australia, and the U.S. National Cancer Institute. In 2006, the U.S. Food and Drug Administration (FDA) approved the first preventive HPV vaccine, marketed by Merck & Co. under the trade name Gardasil.

Society and culture

According to a survey, only 40% of American women had heard of human papillomavirus (HPV) infection and only 20% had heard of its link to cervical cancer.

References

Further reading

• Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, Zahaf T, Innis B, Naud P, De Carvalho NS, Roteli-Martins CM, Teixeira J, Blatter MM, Korn AP, Quint W, Dubin G (2004). "Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial". Lancet 364 (9447): 1757–65. doi:10.1016/S0140-6736(04)17398-4. PMID 15541448. 
• Peto J, C Gilham, O Fletcher, FE Matthews (2004). "The cervical cancer epidemic that screening has prevented in the UK". Lancet 364 (9430): 249–56. doi:10.1016/S0140-6736(04)16674-9. PMID 15262102. 

External links

• Cervical cancer at the Open Directory Project

UpToDate Contents

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• 1. 浸潤子宮頸癌：疫学、危険因子、臨床症状、および診断 invasive cervical cancer epidemiology risk factors clinical manifestations and diagnosis
• 2. 早期子宮頸癌のマネージメント management of early stage cervical cancer
• 3. 局所進行性子宮頸癌のマネージメント management of locally advanced cervical cancer
• 4. 子宮頸癌生存者に対するアプローチの概要 overview of approach to cervical cancer survivors
• 5. 子宮頸癌のスクリーニング screening for cervical cancer

English Journal

• CCND1 rs9344 polymorphisms are associated with the genetic susceptibility to cervical cancer in Chinese population.

• Wang N, Qian X, Wang S, Gao H, Wang L, Huo Y, Zhang S.SourceDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
• Molecular carcinogenesis.Mol Carcinog.2012 Feb;51(2):196-205. doi: 10.1002/mc.20801. Epub 2011 May 18.
• Cyclin D1, with a common G/A polymorphism in rs9344, is an essential regulator of the G1 phase in cell cycles and plays an important role in several tumor types, and the homology of cyclin D1 with human papillomavirus (HPV)-16 E7 brought our attention to CCND1 gene in cervical cancer. A total of 738
• PMID 21594903

• HPV typing and its relation with apoptosis in cervical carcinoma from Indian population.

• Alam MS, Ali A, Mehdi SJ, Alyasiri NS, Kazim Z, Batra S, Mandal AK, Rizvi MM.SourceGenome Biology Lab, Department of Biosciences, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, New Delhi, 110025, India.
• Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine.Tumour Biol.2012 Feb;33(1):17-22. Epub 2011 Sep 20.
• Definite progress in understanding the etiology of cervical cancer has been achieved, and some types of human papillomavirus have been established as the central cause of cervical cancer worldwide. This study investigates the human papillomavirus infection and its correlation with apoptosis and clin
• PMID 21931994

Japanese Journal

• 子宮頸がん検診受診行動の促進に向けた個別勧奨を組み込んだ健康教育プログラムに関する研究

• 松尾 泉,西沢 義子,松尾 健志
• 母性衛生 55(4), 791-799, 2015-01
• 【目的】子宮頸がん検診受診行動の促進を目的に,医療専門職による健康講座に個別勧奨を組み込んだ健康教育プログラムを実施し効果を明らかにする。【研究方法】A県B市内で生活する女性に対し,仮説検証型介入研究を実施した。対象者は個別勧奨群110名・統制群110名に割付け,知識・態度の付与を目的とする健康講座を受講後,個別勧奨群のみ自作のハガキによる個別勧奨を行った。基本属性・子宮頸がんに関する知識・主観的 …
• NAID 110009901235

• 症例報告 子宮頸管ポリープが発見の契機となった子宮頸部大細胞神経内分泌癌(LCNEC)の一例

• 布施 由紀子,仲村 勝,栗原 朋子 [他]
• 千葉県産科婦人科医学会雑誌 = Chiba journal of obstetrics and gynecology 8(2), 143-146, 2015
• NAID 40020335018

• 放射線療法が奏効した子宮頸部コンジローマ様癌の1例

• 伊藤 宏一,野坂 舞子,久保田 陽子,加藤 浩志,伊田 昌功,辻 芳之,竹村 正
• 産婦人科の進歩 67(2), 107-113, 2015
• 子宮頸部コンジローマ様癌は子宮頸部扁平上皮癌の特殊型であり，発症頻度はまれである．今回，放射線療法が奏効した子宮頸部発生のコンジローマ様癌の1例を経験したので報告する．症例は80歳女性で性器出血を主訴に当院を受診した．腟鏡診で子宮頸部から腟壁に至る腫瘍性病変を認めた．経腟超音波検査では子宮頸部の腫大を認めた．病理組織検査で血管結合織を伴う乳頭状増殖を示し，軽度の核異型を伴ったコイロサイトーシスを認 …
• NAID 130005085385

Related Links

• Cervical Cancer - National Cancer Institute

Definition of cervical cancer: Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure ...

• Cervical Cancer: Facts on Symptoms, Stages and Treatment

Chest X-rays, CT scan, MRI, and a PET scan may be used to determine the stage of cervical cancer. Cancer of the cervix requires different treatment than cancer that begins in other parts of the uterus. Treatment options for. 1 2 ...

Related Pictures

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★リンクテーブル★

リンク元	「cancer of the cervix」「cervix neoplasm」「uterine cervical neoplasm」
関連記事	「cervix」「cancer」

「cancer of the cervix」

　　[★]

子宮頚癌、子宮頸癌、子宮頚がん、子宮頸がん

関

cancer of the uterine cervix、cervical cancer、cervical carcinoma、cervical neoplasm、cervix cancer、cervix carcinoma、cervix neoplasm、endocervical carcinoma、uterine cervical neoplasm、uterine cervix cancer

「cervix neoplasm」

　　[★]

子宮頚部腫瘍、子宮頸部腫瘍、子宮頚部新生物、子宮頸部新生物

関

cancer of the cervix、cancer of the uterine cervix、cervical neoplasm、cervix cancer、uterine cervical neoplasm

「uterine cervical neoplasm」

　　[★]

子宮頚部腫瘍、子宮頸部腫瘍、子宮頚部新生物、子宮頸部新生物

関

cancer of the cervix、cancer of the uterine cervix、cervical neoplasm、cervix cancer、cervix neoplasm

「cervix」

　　[★]

• n.

• 首、頚、頚部、(各種臓器の)頚部

　 　

「cancer」

　　[★]

同

癌腫

関

tumor