宫颈癌:印度三级医疗保健中心的经验

Sachin Vijay Naiknaware
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摘要

导言:宫颈癌是印度妇女癌症死亡的第二大原因,全球因宫颈癌死亡的人数中有 25% 发生在印度。全球 70-80% 的宫颈癌是由人类乳头瘤病毒(HPV)引起的,主要是基因型 16 和 18。有资料表明,社会经济地位较低的妇女、受教育程度较低的妇女和子女较多的妇女的宫颈癌发病率较高。方法:在一家教学机构中,选取 200 例在肿瘤科手术室和病房登记的宫颈癌病例,对所有变量和治疗方案进行前瞻性随访,并对并发症、发病率、症状缓解、疾病复发或治愈情况进行随访。制作了详细的病例记录表,包括患者的所有详细信息,对患者进行了详细检查,包括体格检查和窥器检查,并进行了相应的调查,以确定疾病的分期,根据疾病的分期采用不同的治疗方法,如手术、放疗、化疗以及必要时联合使用上述治疗方法。研究结果在我们的研究中,大多数患者的年龄在 40-51 岁之间,发病时处于疾病晚期(55%)。窥器检查中最常见的发现是菜花状增生,阴道有白色分泌物(79%)是最常见的症状,其次是绝经后出血(51%)和性交后出血(36%)。结论:宫颈癌是可以预防的:宫颈癌是一种可以预防的疾病,但遗憾的是还没有得到预防,因此需要采取宫颈癌一级和二级预防措施。
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Cancer Cervix: An Experience at Tertiary Healthcare Centre in India
Introduction: Cervical cancer is the second leading cause of cancer deaths among women in India and 25% of all global deaths due to cervical cancer occurs in India. Globally 70-80%of cervical cancers are attributed to human papilloma virus (HPV) mainly genotype 16 and 18. It is been documented that cervical cancer incidence is greater among lower socio-economic status women, less educated women and in those having larger number of children’s. Methodology: 200 case of cancer cervix registered at oncology opd and ward were selected and followed up prospectively in a teaching institution for all the variables and treatment protocols and followed up for complications, morbidity, and symptomatic relief and recurrence or cure of disease. A detailed case pro forma was made including all details of patients, patients were examined in details including physical and speculum examination and investigated accordingly to find out the stage of disease, various treatment modalities were used according to stage of disease as surgery, radiotherapy, chemotherapy and combination of above treatment modalities where required. Results: In our study majority of patients were in the age group of 40-51years and having an advanced disease stage (55%)at presentation.cauliflower type of growth was most common finding on per speculum examination, white discharge per vaginum(79%) was the most common presenting symptom followed by postmenopausal bleeding (51%)and postcoital bleeding(36%). Conclusion: Cancer cervix is preventable disease but unfortunately not yet prevented, action is needed both for primary and secondary prevention of cervical cancer.HPV vaccination is now globally accepted as a safe and effective means of primary prevention of cervical cancer.
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