Medical interview | Professor Guan Yutao: This kind of gynecological tumor 1/4 new cases are in my country, and many findings are late stage. Experts guide how to diagnose early and treat

According to the International Cancer Research Center, there are more than 500,000 new cervical cancer cases in the world each year, and new cases in my country accounted for a quarter of the world's annual cases, and the peak peak age is 45-55 years old. Cervical cancer is the only tumor with a clear cause -continuous high -risk HPV infection. Therefore, prevention and treatment of HPV infection can prevent the occurrence of cervical cancer and pre -cancer lesions or delay its disease progress. Screening is the main means to prevent and control cervical cancer. In the past 60 years, due to the popularization of its screening and the upgrade of treatment methods, the mortality rate caused by cervical cancer in China has declined significantly. In this issue, "Medical Daily" specially invited Professor Guan Yutao, director of the Gynecology Department of Ningbo First Hospital, conducted a professional interpretation of the related issues of cervical cancer and HPV virus.

01

"Medical Daily": The culprit that leads to cervical cancer is high -risk HPV continuous infection, so what is HPV?

Professor Guan Yutao: HPV all celebrity papilloma virus, more than 200 sub -types in the HPV family, of which 35 are related to gynecological diseases, and 14 are closely related to gynecological tumors, commonly known as "Fourteen Tai Insurance": 16, 18, 31, 33, 35, 45, 51, 52, 56, 58, 59, 66, 68, of which 16 and 18 are the most common high -risk HPV types in cervical cancer. Infection HPV is not terrible. More than 80%of women have been infected with HPV during their lives, and more than 90%of women can be cleared after HPV infection. The median period of conventional high -risk HPV infection is around September, and the mid -level clearance time of 16 types is 12. April. HPV infection is considered a necessary factor that causes cervical cancer. At present, a considerable proportion of HPV detection rates in patients with cervical epithelial tumor (CIN), 99.8%of patients with cervical cancer have detected high -risk HPVs. Current research data show that 99%of patients with HPV -negative patients will not occur with cervical cancer.

02

"Medical Daily": Will all HPV infections lead to cervical cancer?

Professor Guan Yutao: Women who have normal behaviors in their lives at least 80%of the HPV infection and the age group of the peak infection is 18 to 28 years old. Relying on its own immunity to clear the virus. More than 80%of HPV infections can be removed within a few months (usually 6-9 months, an average of 8 months, and rarely more than one year). 95%of HPV infections can be removed within 2 years. After infection with HPV, it can cause a variety of diseases, such as cervical cancer and condyloma acuminatum. It is worth noting that only if the high -risk HPV is continuously infected can cervical cancer occur.

03

"Medical Daily": What are the ways to spread HPV virus?

Professor Guan Yutao: The pathway of HPV includes the following 5 types: (1) sexual contact (main channel); (2) close contact (mainly skin contact, including but not limited to the skin contact of the perineal, such as mouth -to -mouth kissing, hugging, hugging , Shake hands, etc.); (3) indirect contact (mainly referring to the clothes, daily necessities, utensils, etc. of the infected person). (4) Medical infection; (5) Maternal and baby transmission (infection in close contact during the birth canal). Sexual communication is the main method of communication in HPV. Any factors related to sexual activities are high -risk factors for reproductive tract HPV infections. For example Essence

04

"Medical Daily": So what are the characteristics of cervical cancer, and what are the treatment methods suitable for?

Professor Guan Yutao: The early symptoms of cervical cancer are not obvious, and there will be some symptoms in the later stages, and the late mortality rate is quite high, which seriously affects the patient's life length. Many patients with cervical cancer have symptoms to go to the hospital for examination. The results of the examination are already advanced, resulting in the difficulty of treatment and the poor treatment effect.

The symptoms of cervical cancer are mainly the following: First, patients with bloody leucorrhea or contact bleeding in the early days, mainly occur after sexual life, gynecological examination, and bowel bleeding after defecation. Patients with vaginal bleeding are often irregular, and the amount of bleeding is relatively small in the early stage of the disease. Due to the development of the disease, a large amount of bleeding will be shown in the late stage. Once the tumor erodes the larger blood vessels, it is likely to cause fatal bleeding. Some of the younger patients can express the symptoms of menstrual periods, shortening cycles, and increased menstruation. The elderly patients often have irregular vaginal bleeding after menopause. Secondly, vaginal secretions increase.

Most patients with cervical cancer have increased vaginal discharge to vaginal vagina, which is a common symptom of cervical cancer. It is mainly due to the stimulation of early cancer tissue stimulation due to the stimulation of the cervix, which causes the secretion function, produces mucous leucorrhea, and the color is white or bloody, and the smell appears. With the continuous development of cancer cells, the leucorrhea has become turbid, such as rice -like water or pus and blood -like leucorrhea, and has a special smell. Third, pain appears. The pain is mainly the advanced symptoms of cervical cancer, but early in the early stage may also have sexual pain or mild abdomen tingling. Because young women's sexual life is in a period of activity, estrogen levels and sexual intercourse are relatively high, it is more likely to have the first symptoms of sexual pain. Mainly because the cancer tumor of the cervix has been infiltrated or compressed to the pelvic nerves, such as closed nonders, sacrum nerves, pelvic walls, or large blood vessels that may cause severe pain; it may be because the cervical canal has already been The cancer tumor is blocked, causing the secretions in the uterine cavity to not be discharged smoothly, and the long -term accumulation of uterine pus is accumulated, causing pain in the lower abdomen. In addition, when the cervical cancer tissue affects the connective tissue of the pelvic cavity, compress the ureter or rectal, and sciatica, there may also be urinary tract symptoms, such as frequent urination, urgency, poor urination, and pyelone accumulation. Severe weight loss, varying degrees of anemia, persistent or intermittent fever, systemic failure, and evil qualities. The treatment of cervical cancer needs to be determined based on the specific clinical diagnosis, age, fertility requirements, and systemic conditions of the patient. For the ⅠA1 stage, keep the fertility function of the cervical cone cut, emphasizing that the cutting edge needs to be at least 3 mm negative distance. Recommended cold knife cone cutting, also feasible circular electrical cutting (Leep). Surgical treatment can be surgery before IA2-IIA, phase IIB and IV may not surgery, feasible radiotherapy or synchronous chemotherapy.

05

"Medical Daily": When is the best time for cervical cancer screening?

The best time for cervical cancer screening is after 21 years old, especially married or sexual life. Regular cervical screening can effectively prevent cervical cancer. The best screening time is about 3 to 7 days after the month. Avoid sexual life within a week before the cervical screening. Too worry.

Generally speaking, it takes a longer time from high -risk HPV infection to pre -cancer lesions, and then develop to cervical cancer. Because of its slow development, there is enough time to screen and block cervical cancer. In addition, cervical cancer is the only first malignant tumor that can be comprehensively prevented by vaccination. At present, the protection rate of vaccines is above 70%to 80%. HPV vaccines are divided into two -valent (16, 18), four -valent (6, 11, 16, 18), nine valences (6, 11, 16, 31, 33, 52, 58 ), Each type contains a virus type that prevents HPV16/18. HPV16/18 is related to cervical cancer of more than 70%, so any type of vaccine can prevent more than 70%of cervical cancer, which can increase to 90%. After the infection of HPV, the vaccine can still prevent other infected virus types. Therefore, it is still recommended to have the conditions to inject HPV vaccines in time. Due to the many types of HPV, cervical cancer screening is still required after injection.

WHO outlines three key measures at the "Accelerating Global Strategy of Cervical Cancer": vaccination, screening and treatment. When these tools that are known to prevent cervical cancer are used to the extreme, we can really embark on the path of eliminating cervical cancer.

Expert Introduction

Professor Guan Yutao

Ningbo First Hospital

Deputy Chief Physician, Ph.D., Postdoctoral, Ningbo Top Talents, Master's Tutor

Youth Member of the Gynecology and Cancer Professional Committee of the Chinese Research Hospital

Member of the Gynecology and Cancer Professional Committee of China Medical Education Association

Tumor Reproductive Youth Member of the China Eugenics Science Association

Member of the Gynecological Cancer Professional Committee of Zhejiang Medical Association

Deputy Chairman of the Obstetrics and Gynecology Branch of Ningbo Medical Association

Member of the Guangdong Physician Association of Pot Found Disease Prevention and Treatment

Member of the Gynecology Committee of the Ceremony of the Gynecology of Guangdong Province

Member of the Gynecology and Cancer Professional Committee

Doctoral post -doctoral station was at Sun Yat -sen University. Professor Lin Zhongqiu, a well -known top gynecological tumor expert in my country, and Professor Wang Gang, a well -known gynecologist expert. Good at gynecological and malignant tumors diagnosis and treatment, especially good at gynecological tumors and non -invasive treatment. The surgical video competition has won the first place in East China and the third place in the country. It has been invited to participate in the national surgery demonstration and received wide praise. Take a number of subject research, and have published several academic papers

Capture: Hu Haiyan

Edit: Wang Lina

Review: Qin Miao

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