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系统性红斑狼疮患者的子宫颈一期腺癌——一例临床病例

Stage one adenocarcinoma of uterine cervix in a patient with systemic lupus erythematosus - a clinical case.

作者信息

Tantchev Latchezar, Yordanov Angel, Marinov Veselin, Kotzev Andrey

机构信息

Obstetrics and Gynaecology Clinic, Acibadem City Clinic Hospital "Tokuda", Sofia, Bulgaria.

Department of Gynaecological Oncology, Medical University of Pleven, Bulgaria.

出版信息

Prz Menopauzalny. 2020 Dec;19(4):188-191. doi: 10.5114/pm.2020.101950. Epub 2021 Jan 7.

Abstract

INTRODUCTION

The systemic lupus erythematosus (SLE) is a comparatively rare chronic autoimmune disease in women of reproductive age, the pathogenesis and therapy of which also conditions the increased risk of development of malignant diseases.

CASE REPORT

We present a clinical case of a 38-year-old female patient with lupus and stage 1B1 adenocarcinoma of uterine cervix, in which robotic radical hysterectomy with pelvic lymph node dissection has been successfully performed. The strict primary and secondary prophylaxis for pathological changes of uterine cervix are of essential significance for patients with lupus.

CONCLUSIONS

SLE is a chronic autoimmune disease, which is frequently treated with immunosuppressors, and affects most often women in reproductive age. The combination of these conditions is associated with higher risk of infecting with HPV and occurrence of pre-cancer and cancer of uterine cervix. Based on these reasons women with SLE must undergo strict screening follow-up and vaccination against high-risk strains of HPV. In the cases of cancer of uterine cervix diagnosed in initial stage, the striving towards minimal traumatism and better quality of life of patient - and, at the same time, towards achievement of optimal radicality - directs to the choice of minimally invasive operative method such as the robotic surgery.

摘要

引言

系统性红斑狼疮(SLE)是育龄期女性相对罕见的慢性自身免疫性疾病,其发病机制和治疗也导致恶性疾病发生风险增加。

病例报告

我们呈现一例38岁患有狼疮且为宫颈1B1期腺癌的女性患者的临床病例,该患者成功接受了机器人辅助根治性子宫切除术及盆腔淋巴结清扫术。对狼疮患者而言,严格的子宫颈病变一级和二级预防至关重要。

结论

SLE是一种慢性自身免疫性疾病,常使用免疫抑制剂治疗,且最常影响育龄期女性。这些情况的组合与感染人乳头瘤病毒(HPV)以及发生子宫颈癌前病变和宫颈癌的较高风险相关。基于这些原因,SLE女性必须接受严格的筛查随访并接种针对高危型HPV的疫苗。在宫颈癌早期诊断的病例中,追求最小创伤和患者更好的生活质量,同时实现最佳根治性,促使选择如机器人手术这样的微创术式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b3/7812535/24429491b8b5/MR-19-42764-g001.jpg

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