宫颈癌分期:有什么变化?

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY
Pradnya Changede
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引用次数: 0

摘要

在印度,宫颈癌是导致癌症相关死亡的第二大常见病因,也是影响妇女的全球第四大常见恶性肿瘤。印度每年的宫颈癌相关死亡人数占全球总数的 25%。临床分期的主要缺点是对肿瘤大小的估计不精确,以及在 FIGO 允许对宫颈癌进行分期的少数研究中确定盆腔和主动脉旁淋巴结受累情况的挑战。2009 年分期方法的使用表明,当许多病例仅根据临床发现进行手术时,她们随后需要进行辅助治疗;因此,这些错误对与治疗相关的发病率产生了负面影响。根据 2018 年修订的国际妇产科联盟(FIGO)指南,对宫颈癌的分期进行了修改。宫颈癌分期的更正最近于 2024 年发布。微小浸润性病例的分期不考虑疾病的水平范围(侧面范围)。根据肿瘤大小的分层,确定了三个亚组:IB1≤2厘米,IB2>2-≤4厘米,IB3>4厘米。宫颈癌的分期在临床诊断的基础上增加了病理和影像学检查。淋巴结(LNs)受累现根据病理学(p)或影像学(r)进行分类,明确规定淋巴结受累通过病理学(p)或影像学(r)进行诊断。增加了 IIIC 期[IIIC1(盆腔结节受累)和 IIIC2(主动脉旁结节受累)],在淋巴结阳性的情况下分配给病例。病理评估优先于放射学和临床结果。血管/淋巴间隙受累不应改变分期。当对分期有疑问时,应选择较低的分期。总的来说,修订后的 FIGO 宫颈癌分期(2024 年)有很多优点,包括纳入影像学和病理学、肿瘤大小和基于 LN 的分类。使用修订版宫颈癌分期对不同人群的宫颈癌分期进行更多研究,将有助于使用该分期进行预后评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Staging of Cervical Cancer: What has Changed?

In India, cervical cancer is the second most common cause of cancer-related fatalities and the fourth most common malignancy worldwide affecting women. India accounts for 25% of all cervical cancer-related deaths worldwide each year. The main drawbacks of clinical staging were the imprecise estimation of tumor size and the challenge of determining the involvement of pelvic and para-aortic lymph nodes with the few studies that FIGO allowed to be done for staging of cancer cervix. The use of 2009 staging approach showed that when many cases were operated based only on clinical findings, they subsequently required adjuvant therapy; hence, treatment-related morbidity was negatively impacted by these errors. Changes have been made to the staging of cervical cancer according to the 2018 revised International Federation of Gynecology and Obstetrics (FIGO) guidelines. Correction to cancer of the cervix staging was published recently in 2024. The horizontal extent (lateral extent) of the disease is not taken into consideration for staging in cases of microinvasive disease. Three subgroups have been identified based on the stratification of tumor size: IB1 ≤ 2 cm, IB2 > 2- ≤ 4 cm, and IB3 > 4 cm. Pathology and imaging modalities are added to clinical diagnosis for staging of cancer cervix. The involvement of lymph nodes (LNs) is now classified based on pathology (p) or imaging (r) which specifies that lymph node involvement is diagnosed using pathology (p) or imaging (r). Stage IIIC has been added [IIIC1 (involvement of pelvic nodes) and IIIC2 (involvement of para-aortic nodes)] is assigned to the case in the event of lymph node positive status. Pathological assessment takes precedence over radiological and clinical findings. The involvement of vascular/lymphatic spaces should not change the staging. The lower staging should be assigned when there is doubt about stage. Overall, the revised FIGO staging of cancer cervix (2024) has a number of advantages, including the inclusion of imaging and pathology, tumor size and LN-based categorization. More studies on staging of cancer cervix in different populations using revised staging of cancer cervix will help to prognosticate use of this staging.

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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
124
期刊介绍: Journal of Obstetrics and Gynecology of India (JOGI) is the official journal of the Federation of Obstetrics and Gynecology Societies of India (FOGSI). This is a peer- reviewed journal and features articles pertaining to the field of obstetrics and gynecology. The Journal is published six times a year on a bimonthly basis. Articles contributed by clinicians involved in patient care and research, and basic science researchers are considered. It publishes clinical and basic research of all aspects of obstetrics and gynecology, community obstetrics and family welfare and subspecialty subjects including gynecological endoscopy, infertility, oncology and ultrasonography, provided they have scientific merit and represent an important advance in knowledge. The journal believes in diversity and welcomes and encourages relevant contributions from world over. The types of articles published are: ·         Original Article·         Case Report ·         Instrumentation and Techniques ·         Short Commentary ·         Correspondence (Letter to the Editor) ·         Pictorial Essay
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