最后审阅: 2 七月 2021
最后更新: 04 三月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 异常阴道出血
  • 性交后出血
  • 骨盆或背部疼痛
  • 性交疼痛
  • 宫颈肿物
  • 宫颈出血

其他诊断因素

  • 粘液样或脓性白带
  • 膀胱、肾脏或肠梗阻
  • 骨痛

危险因素

  • 人类乳头状瘤病毒 (HPV) 感染
  • 年龄组
  • HIV 感染
  • 过早性生活(小于18岁
  • 多名性伴侣
  • 吸烟
  • 免疫抑制
  • STI 病史
  • 口服避孕药的使用
  • 多产
  • 未做过包皮环切的男性伴侣
  • 微量元素性营养不良
  • 血清叶酸低水平
  • 维生素C和E低水平
  • 饮酒
  • 低等社会经济状况

诊断性检查

首要检查

  • 阴道检查或窥具检查
  • 阴道镜检查
  • 活检
  • 人乳头瘤病毒(HP)检测

需考虑的检查

  • 全血细胞计数 (FBC
  • 肾功能检查
  • 肝功能检查
  • 胸部 X 线检查
  • 静脉肾盂造影
  • 肾脏超声
  • 钡灌肠
  • 直肠镜
  • 膀胱镜检查
  • 盆腔 MRI
  • 全身PET检查
  • 全身PET/CT检查
  • 胸部/腹部/骨盆CT与静脉/口服造影剂

新兴检查

  • p16 和 Ki67 生物标志物的表达

治疗流程

撰稿人

作者

Richard T. Penson, MD, MRCP
Richard T. Penson

Clinical Director

Medical Gynecologic Oncology

Division of Hematology Oncology

Massachusetts General Hospital

Boston

MA

利益声明

RTP reports receiving personal fees from AbbVie, Clovis Oncology, Janssen Oncology (J&J), NewLink Genetics, Sutro Biopharma, Tesaro Inc., and Vascular Biogenics Ltd, research funding provided to the institution for clinical trials from Array BioPharma Inc., AstraZeneca., Genentech, Inc., Regeneron, and Sanofi-Aventis US LLC, and personal fees and research funding provided to the institution for clinical trials from AstraZeneca, Eisai Inc./Merck & Co., Tesaro Inc., Genentech/Roche, Inc., and Vascular Biogenics Ltd, during the conduct of the study. RTP is an author of a number of references cited in this topic.

Larissa J. Lee, MD
Larissa J. Lee

Assistant Professor

Department of Radiation Oncology

Brigham and Women’s Hospital

Boston

MA

利益声明

LJL receives research funding from the Koch Institute at the Massachusetts Institute of Technology and the Dana-Farber Cancer Institute. LJL is also the principal investigator of an immunotherapy and radiation trial sponsored by AstraZeneca. LJL received sponsored travel from AstraZeneca for an immunotherapy symposium and has an international patent filing for quantitative tumour oxygen measurements in cervical cancer.

鸣谢

Dr Richard T. Penson and Dr Larissa J. Lee would like to gratefully acknowledge Dr Neil S. Horowitz and Dr Anthony H. Russell, previous contributors to this topic.

利益声明

NSH and AHR declare that they have no competing interests.

同行评议者

Linda Yang, MD

Fellow

Minimally Invasive Gynecologic Surgery

Magee Women's Hospital

University of Pittsburgh Medical Center

PA

利益声明

LY declares that she has no competing interests.

Deirdre Lyons, MB, BCh, BAO, MRCOG

Consultant in Obstetrics & Gynaecology

Lead Clinician in Colposcopy

Imperial College Healthcare NHS Trust

London

UK

利益声明

DL declares that she has no competing interests.

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