宫颈人乳头瘤病毒感染的药物治疗

宫颈癌是妇科三大恶性肿瘤之一。根据GLOBOCAN 2008数据统计,在中国女性所有恶性肿瘤中,发病比占6.3%,死亡比占4.6%。宫颈癌的发生与宫颈HPV感染存在密切关系。2012年NCCN指南提出30岁的女性推荐HPV DNA检查与细胞学检查结合用于宫颈癌的筛查。单纯HPV检测阳性时,患者可以选择继续观察随访。但事实上,妇科医生在临床诊疗过程中发现很多病人心理上无法接受对疾病不进行任何处理。而一些过度治疗方案包括LEEP,冷刀锥切,宫颈局部激光治疗等又有可能会造成宫颈机能不全,继发宫颈管狭窄,早产及低体重出生儿等不良结果。若积极处理的话有多种治疗方案可供选择。但是对于有生育要求的女性在治疗方案的选择上应该尤为慎重。本文对目前相关治疗方案的治疗效果及其能否阻止宫颈病变的进展等方面进行总结。旨在解决临床医生和患者共同关注的问题。

Medication for Cervical Human Papillomavirus Infection

Cervical cancer is one of the most frequent cancers in gynecology disease. According to GLOBOCAN 2008, the cervical cancer prevalence was 6.3% and the mortality was 4.6% of all the cancer in Chinese women. Human papillomavirus (HPV) is associated with the development of cervical cancer. 2012, National Comprehensive Cancer Network (NCCN) guidelines recommended combination of HPV DNA and cytology test for women older than 30 years old. Women may resume routine screening when simply HPV test positive. In fact, most patients would not accept revist observation without any therapy. Surgeries such as loop electrosurgical excision procedure (LEEP)/cold knife conization or laser ablation will damage the function of the cervix and cause cerval stenosis, preterm delivery and low birh weight. There are some appropriate treatments. We should be cautious about chosing an option especially for women aspiring to have children. Our review summarized the effectiveness of these therapies and answered whether they can prevent progression of cervical intraepithelial neoplasia (CIN). Aimat figuring out common concerns for gynecologists and patients.