《妇产科学》宫颈上皮内瘤样病变-教学课件（非AI生成）.ppt

转归好转.CIN1:60%消退恢复正常.CIN2:大部分转为CIN1或正常持续不变.进展为浸潤癌.*小结1动态过程2HPV3细胞学检查(ASCLSILHSIL)4组织学检查(CINΙⅡⅢ)5三阶梯方案6治疗恰当****方法法*KeyPointTheCINgradingsystemclassifiesdysplasiainto3categoriesbasedonhistologicalchanges.AlthoughCINcausedbyHPVinfectionoftenclearswithouttreatment,thelikelihoodofprogressiontoinvasivecancerisgreaterinmoreseveregrades(CIN2/3).BackgroundTheCINgradingsystemclassifiesdysplasiainto3categoriesbasedonhistologicalchanges:CIN1includesmilddysplasiaandcondyloma(anogenitalwarts),CIN2includesmoderatedysplasia,andCIN3includesseveredysplasiaandcarcinomainsitu(CIS).1Theselesionsaregradedbasedontheextentofabnormalproliferationofthebasallayerofthecervicalepithelium.Inmilddysplasia(CIN1),proliferationoccursuptothelowerthirdoftheepithelium.Inmoderatedysplasia(CIN2),proliferationoccursuptotheuppertwothirds;andinseveredysplasia/CIS(CIN3),theentireepitheliumisabnormal.1Whenstratifiedintothevariousgradesofseverity,thecompositedatafromareviewindicatethattheapproximatelikelihoodofregressionofCIN1is60%,persistenceis30%,progressiontoCIN3is10%,andprogressiontoinvasionis1%.ThecorrespondingapproximationsforCIN2are40%,40%,20%,and5%,respectively.Thelikelihoodof

CIN3regressingis33%andprogressingtoinvasiongreaterthan12%.2References1.BonnezW.Papillomavirus.In:RichmanDD,WhitleyRJ,HaydenFJ,eds.ClinicalVirology.2nded.Washington,DC:AmericanSocietyforMicrobiologyPress;2002:557–596.2.OstorAG.Naturalhistoryofcervicalintraepithelialneoplasia:Acriticalreview.IntJGynecolPathol.1993;12:186–192.宫颈上皮内瘤样变

CIN

不可忽视的宫颈癌前病变*概述宫颈上皮内瘤变（CIN）是子宫颈癌的癌前病变，包括子宫颈轻度、中度、重度不典型增生及原位癌。*反映了宫颈癌发生中连续发展的过程，即由宫颈不典型增生(轻→中→重)→原位癌→早期浸润癌→浸润癌的一系列病理变化**相关因素1HPV16/182异常性行为及分娩次数*临床表现1.多数病例无自觉症状。2.白带增多、接触性出血及不规则阴道出血。3