Castle Philip E, Murokora Dan, Perez Carlos, Alvarez Manuel, Quek Swee Chong, Campbell Christine
Albert Einstein College of Medicine, Bronx, NY, USA.
Uganda Women's Health Initiative, Kampala, Uganda.
Int J Gynaecol Obstet. 2017 Jul;138 Suppl 1:20-25. doi: 10.1002/ijgo.12191.
Precancerous cervical lesions precede the development of invasive cervical cancer by 10-20 years, making cervical cancer preventable if these lesions are detected and effectively treated. Treatment has evolved in the last few decades and now includes ablative options that can be performed in lower-resource settings where surgical excision is not feasible or routinely available. Gas-based cryotherapy, which freezes cervical tissue to induce localized necrosis, is the most commonly used ablative treatment. However, its implementation in low-resource settings is difficult because the refrigerant gas can be difficult to procure and transport, and is expensive. New cryotherapy devices that do not require an external supply of gas appear promising. Thermal coagulation, which burns cervical tissue to induce necrosis, has become more widely available in the last few years owing to its portability and the feasibility of using battery-powered devices. These two ablative treatments successfully eradicate 75%-85% of high-grade cervical lesions and have minor adverse effects.
宫颈癌前病变先于浸润性宫颈癌发展10至20年，因此，如果这些病变能够被检测到并得到有效治疗，宫颈癌是可以预防的。在过去几十年中，治疗方法不断发展，现在包括一些消融治疗选项，这些治疗可以在资源匮乏地区进行，在这些地区手术切除不可行或无法常规开展。基于气体的冷冻疗法，即冷冻宫颈组织以诱导局部坏死，是最常用的消融治疗方法。然而，在资源匮乏地区实施该方法很困难，因为制冷剂气体难以采购和运输，而且价格昂贵。不需要外部供气的新型冷冻治疗设备似乎很有前景。热凝疗法，即烧灼宫颈组织以诱导坏死，由于其便携性以及使用电池供电设备的可行性，在过去几年中已得到更广泛应用。这两种消融治疗方法成功根除了75%至85%的高级别宫颈病变，且副作用较小。
