Rema P
Division of Gynaeoncology, Regional Cancer Centre, Trivandrum, Kerala India.
Indian J Surg Oncol. 2019 Mar;10(1):156-161. doi: 10.1007/s13193-018-0842-7. Epub 2018 Nov 29.
Outstanding research in the last few decades led to newer insights into the management of gynecological cancers. In the preventive arena, the efficacy and safety of HPV vaccination are well accepted and is now in addition to bi- and quadrivalent vaccines; there is a nonavalent vaccine against nine oncogenic HPV strains. Recent studies also looked into the dosaging schedules and age of vaccination against HPV to improve the vaccine efficacy and coverage. HPV testing is now approved as a primary screening test for cervical cancer in women aged more than 30 years with better sensitivity than the traditional cytology. Opportunistic salpingectomy for ovarian cancer prevention and neoadjuvant chemotherapy for advanced ovarian cancers are accepted practices. The role of personalized medicine in ovarian cancer and comprehensive genomic analysis of endometrial cancers are also covered in this review.
过去几十年的杰出研究为妇科癌症的管理带来了新的见解。在预防领域,HPV疫苗接种的有效性和安全性已得到广泛认可,目前除了二价和四价疫苗外,还有一种针对九种致癌HPV毒株的九价疫苗。最近的研究还探讨了HPV疫苗接种的剂量方案和接种年龄,以提高疫苗效力和覆盖率。HPV检测现已被批准作为30岁以上女性宫颈癌的主要筛查检测方法,其灵敏度高于传统细胞学检测。预防性输卵管切除术预防卵巢癌以及晚期卵巢癌的新辅助化疗已被广泛应用。本综述还涵盖了个性化医疗在卵巢癌中的作用以及子宫内膜癌的综合基因组分析。