1、 original squamous columnar junctionHarald zur Hausen,(bornMarch11,1936,Gelsenkirchen,Ger.),Germanvirologistwhowasacorecipient,withFranoiseBarr-SinoussiandLucMontagnier,ofthe2008NobelPrizeforPhysiologyorMedicine.ZurHausenwasgivenhalftheawardinrecognitionofhisdiscoveryofthehumanpapillomavirus(HPV)and
2、itslinktocervicalcancer.nProtein interacts with in the host cell and promotes its degradation via the ubiquitin dependent pathway.nProtein complexes with retinioblastoma protein(),thereby inactivating it.nRb and p53 are both tumor suppressors,involved in DNA repair and cell death.LMEM2006;116:1167CI
3、N ICIN IICIN III1.三、三、液基细胞学液基细胞学 Pap Smear Thin Prep Pap Test Pap Smear Thin Prep Pap Test Inventor of Pap SmearGreek-American cytologist and pathologist,born ASCUS AtypicalsquamouscellofundeterminedsignificanceLSILlowgradesquamousintraepitheliallesion高度鳞状细胞上皮内病变高度鳞状细胞上皮内病变 HSILHigh-gradesquamousint
4、raepitheliallesionAtypialglandularcellsInsituadenocarcinomaLGSILHGSILNormal MetaplasiaCINCIN诊断诊断 CINCIN诊断诊断 年龄年龄(yr)发生率发生率J Clin Invest 2006;116:1167-1173.1.1.鳞癌鳞癌 Squamous carcinoma Squamous carcinoma -8-8%巨检巨检 外生型外生型 内生型内生型 溃疡型溃疡型 颈管型颈管型1.鳞癌鳞癌 粘液腺癌粘液腺癌 微偏腺癌微偏腺癌 腺鳞癌腺鳞癌四、子宫颈癌病理类型四、子宫颈癌病理类型 Ia1Ia2宫颈癌
5、宫颈癌IBIB期期Ib1Ib2宫颈癌宫颈癌IVIV期期IVaIVb 1.1.症状症状 2.2.体征体征 六六细胞学检查细胞学检查 PapanicolaouPapanicolaou,TCT Thin-prep Cytological Test TCT Thin-prep Cytological Test鳞癌鳞癌腺癌腺癌七、诊断七、诊断1Cytopathology 2004,15,1824Cytopathology 2002,13,171174 七、诊断七、诊断正常宫颈正常宫颈宫颈宫颈CIN II宫颈鳞癌宫颈鳞癌七、诊断七、诊断七、诊断七、诊断九、治疗九、治疗复发风险增加复发风险增加4倍倍复发风险增加复发风险增加2.5倍倍复发风险增加复发风险增加4倍倍 24周孕以后周孕以后 常需等待胎儿成熟后治疗常需等待胎儿成熟后治疗
