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| 名称： | |
| 描述： | |
- 宫颈涂片1
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本帖最后由 于 2006-10-22 20:57:00 编辑
小荷:"第一副图一眼马上感觉是滴虫,可是却在左上角见到了霉菌.
第二\三副图感觉有问题,但是如果报LSIL感觉还是差了一点。
第四副图感觉是交界性的类湿疣病变.我晕啦
"哈, 分析地不错!
没有滴虫,但有霉菌, 此例的目的是展现几个陷阱: LSIL? HPV? 霉菌? HSIL?
宫颈涂片1及2是同一病历, 答案是: NILM, Candida sp. present
Case 1: #1 霉菌
#2,3 inflammation
#4 像 LSIL, HPV, but N/C 比还小, 核周挖空不够, 此图的核周空圈是霉菌所zhi 的inflammation reactive change.
下面的图中#3可能会误诊为HSIL,
名称：图1
描述：图1
名称：图2
描述：图2
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本帖最后由 于 2007-05-04 21:54:00 编辑
| 以下是引用月新 在2006-10-14 23:04:00的发言： 想问一下HAY老师，如果有明显的挖空细胞，可疑为HPV感染时，合并有ASC-H，用不用再报ASC-H？因为已经明确它的病因是HPV。处理如何为好？ |
1. "如果有明显的挖空细胞，可疑为HPV感染时，合并有ASC-H，用不用再报ASC-H？"
应报LSIL(TBS 2001)
处理如何为好？ 3 - 6 个月复查,
2. "在活检时也遇到类似情况，患者有明显的HPV改变，又有轻-中度的不典型增生，这种情况如何报告为好？"
细胞学按TBS标准报HSIL
3. 如何处理是比较合适?
不同地区及不同人的处理会有差异,
here is Canadian guideline:
Treatment of cervical cancer depends on the stage of the disease, size of the tumour as well as the patient's age, overall condition and desire to have children. The earliest form of cervical cancer is carcinoma in situ (stage 0), a non-invasive cancer that can be treated by loop electrosurgical excision procedure (LEEP), conization (removing a cone-shaped piece of the cervix), cryotherapy, laser therapy or hysterectomy. In stage 1 cervical cancer, the tumour invades into the normal tissue but has not spread beyond the cervix itself. Treatment options for this stage include hysterectomy, conization, and internal or external radiation therapy. Cancers that extend beyond the cervix but are still limited to the pelvis (stage 2) may be treated with internal and external radiation combined, hysterectomy followed by radiation, or by radiation and chemotherapy. Treatment of cancers that have spread throughout the pelvis (stage 3) usually involve a combination of internal/external radiation therapy plus chemotherapy. In stage 4 disease, the cancer has spread to other parts of the body and treatment usually consists of radiation, chemotherapy or a combination of the two.
abin译：以下是加拿大处理指南：
宫颈癌的处理取决于疾病的分期、肿瘤大小和患者年龄、一般状况和生育要求。宫颈癌的最早期是原位癌（0期），为一种非浸润性癌，可行LEEP术、锥形切除术、冷冻疗法、激光疗法或子宫切除术。I期宫颈癌，肿瘤侵犯正常组织但没在扩展到宫颈下方。可选择子宫切除术、锥形切除术、阴道内或阴道外放疗。癌组织进展超出宫颈但仍局限于盆腔内为II期，可行阴道内和阴道外联合放疗、放疗后子宫切除术，或放疗加化疗。扩展到整个盆腔时为III期，处理通常包括阴道内/外放疗加放疗。IV期癌扩展到身体其他部位，其处理通常包括放疗、化疗或合并放化疗。
