[妇科门诊管理]。

K Bach, J Preyer, A Jensen, J T Epplen, E Kunstmann
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引用次数: 1

摘要

目的:45岁前诊断为子宫内膜癌或卵巢癌的女性患者有可能罹患遗传性非息肉性结直肠癌(HNPCC)。在日常生活中,很难区分HNPCC和散发性癌症,然而,后果是严重的。采用标准化访谈法对医疗实践中对hnpcc患者的管理进行评价。队列与方法:对36名在职妇科医生进行访谈,采用SPSS 12.0软件进行统计分析。结果:妇科医生在考虑家族史、早期诊断及同时或异时性肿瘤时,以遗传性肿瘤综合征居多。45岁以前患有子宫内膜癌或卵巢癌的患者被列为高危患者。根据Bethesda标准,72%的妇科医生会照顾怀疑患有HNPCC的女性患者,尽管其中一半的人不考虑这种诊断。没有充分考虑妇科监测检查。跨学科监测的概念很少被提出。结论:在妇科门诊的日常管理中,应更多地应用目前推荐的对疑似HNPCC患者的监测。由德意志银行赞助。
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[Gynecological outpatient management in HNPCC].

Objective: Female patients with diagnosis of endometrial or ovarian cancer before the age of 45 are suspicious of hereditary non-polyposis colorectal cancer (HNPCC). In the daily routine it is difficult to distinguish between HNPCC and sporadic cancer, however, the consequences are severe. A standardised interview was conducted to evaluate the management of HNPCC-patients in medical practice. COHORT AND METHODS: 36 gynecologists working in medical practice were interviewed, statistical analyses were performed with SPSS 12.0.

Results: Most of the gynecologists refer to a hereditary tumor syndrome in consideration of family history, diagnosis at early age and synchronous or metachronous cancer. Patients with endometrial or ovarian cancer before the age of 45 years were rated as high risk patients. 72 % of the gynecologists take care of female patients suspicious of HNPCC according to the Bethesda criteria, even though half of these do not consider that diagnosis. Gynecological surveillance examinations are not fully taken into account. The interdisciplinary surveillance concept is rarely initiated.

Conclusion: The current surveillance recommendation for patients suspicious of HNPCC should be applied more often in the daily routine of gynecological outpatient management. Sponsored by Deutsche Krebshilfe.

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