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子宮頸癌病程演進自然史

~1 Year. 暫 時 性 感 染. HPV 感 染. 2 – 5 Years. 4 – 5 Years. 9 –1 5 Years. 癌前病變 第一級 CIN 1. 癌前病變 第二，三級 CIN 2/3. 持 續 性 感 染. Over 2 Years. 子宮頸 侵襲癌. 子宮頸癌病程演進自然史. 正常子宮頸. 1. Adapted from Pagliusi SR, Aguado MT. Vaccine . 2004;23:569 – 578. 子宮頸細胞學檢查( PAP smear) 之專門術語. Normal 1 正常.

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子宮頸癌病程演進自然史

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  1. ~1 Year 暫 時 性 感 染 HPV 感 染 2–5 Years 4–5 Years 9–15 Years 癌前病變 第一級 CIN 1 癌前病變 第二，三級 CIN 2/3 持 續 性 感 染 Over 2 Years 子宮頸 侵襲癌 子宮頸癌病程演進自然史 正常子宮頸 1. Adapted from Pagliusi SR, Aguado MT. Vaccine. 2004;23:569–578.

  2. 子宮頸細胞學檢查(PAP smear)之專門術語 Normal1正常 ASCUS2 未能確定之非典型鱗狀上皮細胞 HSIL3重度鱗狀上皮內病變 LSIL3 輕度鱗狀上皮內病變 1. Spitzer M, Johnson C. Philadelphia, Pa: WB Saunders Company; 2002:41–72. 2. Apgar BS, Zoschnick L. Am Fam Physician. 2003;68:1992–1998. 3. Cannistra SA, Niloff JM. N Engl J Med. 1996;334:1030–1038. 4. Solomon D, Davey D, Kurman R, et al, for the Forum Group Members and the Bethesda 2001 Workshop. JAMA. 2002;287:2114–2119.

  3. Basal cell Basal membrane 子宮頸組織學檢查之專門術語 • Cervical intraepithelial neoplasia (CIN)1子宮頸上皮內贅瘤 • CIN 1:輕度子宮頸上皮內贅瘤 0-1/3 • CIN 2:中度子宮頸上皮內贅瘤 1/3-2/3 • CIN 3:重度子宮頸上皮內贅瘤 2/3-3/3 子宮頸原位癌 子宮頸侵襲癌 • 子宮頸上皮內贅瘤是由於HPV感染造成，有自然痊癒之可能2 1. Bonnez W. In: Richman DD, Whitley RJ, Hayden FJ, eds. Washington, DC: American Society for Microbiology Press; 2002:569–612. 2. Ostor AG. Int J Gynecol Pathol. 1993;12:186–192.

  4. CIN as Seen in Colposcopy Colposcopy findings confirmed by histology1 • CIN 1: Mild dysplasia; includes condyloma (anogenital warts)2 • CIN 2: Moderate dysplasia2 • CIN 3: Severe dysplasia; cancer in situ (CIS); FIGO Stage 02,3 CIN 1 CIN 2 CIN 3 Photo courtesy of Dr. J. Monsonego Photo courtesy of Dr. J. Monsonego From IARC, 2003.4 1. Wright TC Jr, Cox JT, Massad LS, et al, for the ASCCP-Sponsored Consensus Congress. JAMA. 2002;287:2120–2129. 2. Bonnez W. In: Richman DD, Whitley RJ, Hayden FJ, eds. Washington, DC: American Society for Microbiology Press; 2002:557–596. 3. Canadian Cancer Society. Cervical Cancer: What you need to know. Available at: http://www.cancer.ca/vgn/images/portal/cit_86751114/63/40/151140772cw_library_wyntk_cervical_en.pdf. Accessed March 13, 2006. 4. Sellors JW, Sankaranarayanan R, eds. Lyon, France: International Agency for Research on Cancer; 2003.

  5. Normal CIN 1 CIN 2 CIN 3 Basal cell layer Histolopathology: CIN1 • CIN 1 輕度子宮頸上皮內贅瘤 ≒ LSIL 輕度鱗狀上皮內病變 • CIN 2,3中,重度子宮頸上皮內贅瘤 ≒ HSIL 重度鱗狀上皮內病變 Cytology findings confirmed by histology4 1. Frappart L, Fontaniere B, Lucas E, Sankaranarayanan R, eds. Lyon, France: International Agency for Research on Cancer; 2004. 2. Bonnez W. In: Richman DD, Whitley RJ, Hayden FJ, eds. Washington, DC: American Society for Microbiology Press; 2002:557–596. 3. Canadian Cancer Society. Cervical Cancer: What you need to know. Available at: http://www.cancer.ca/vgn/images/portal/ cit_86751114/ 63/40/151140772cw_library_wyntk_cervical_en.pdf. Accessed March 13, 2006. 4. Wright TC Jr, Cox JT, Massad LS, et al, for the ASCCP-Sponsored Consensus Congress. JAMA. 2002;287:2120–2129.

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