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宫颈癌预防的新范式

New Paradigms in Cervical Cancer Prevention.

作者信息

Saraiya Usha B

机构信息

Breach Candy Hospital, Mumbai, India.

Cytology Clinic Cama Hospital Mumbai, Mumbai, India.

出版信息

J Obstet Gynaecol India. 2024 Aug;74(4):295-302. doi: 10.1007/s13224-024-02050-z. Epub 2024 Aug 29.

Abstract

Cervical Cancer prevention is a relatively new concept in Medicine. Since mid-twentieth century, diagnosis of Precancerous phase became possible thus outcome of invasive cervical cancer could be avoided. The dawn of this new era began with the research on HPV infection, being the causative factor. Clinical use of vaccines made it possible to start primary prevention by the year 2006. There has been a paradigm shift in this field and some of the important shifts will be discussed. The 1st paradigm is to better understand "Cancer Prevention". Cytology or the "Pap Smear" as it is commonly known is a simple low cost, low technology test. Combining it with biomarker test gives it more validity. Angiogenesis of cervical neoplasia was based on colposcopy. Angiogenesis inhibitor was discovered on this concept which improved treatment results. Incidence and mortality of cervical cancer shows a global disparity. For this, we have to study the social determinants. Some of the causes leading to high mortality are delay in diagnosis and reaching healthcare facility. UN's SD goal has suggested 30% reduction to be achieved. HPV is the cause of many other cancers apart from cervical cancer which may lead to suffering and mortality. The most deadly genotypes of HPV are 9 which form the NONAVALENT Vaccine. Introduction of vaccine made in India may be a game changer. A new "Ray of Hope" was the introduction of therapeutic vaccines in 2020. It will reduce human suffering and prolong life. As research advances, many more new Paradigms will evolve.

摘要

宫颈癌预防在医学领域是一个相对较新的概念。自20世纪中叶以来,癌前阶段的诊断成为可能,从而可以避免浸润性宫颈癌的发生。这个新时代的曙光始于对人乳头瘤病毒(HPV)感染的研究,HPV感染是致病因素。疫苗的临床应用使得在2006年开始进行一级预防成为可能。该领域已经发生了范式转变,将讨论一些重要的转变。第一个范式是更好地理解“癌症预防”。细胞学检查,也就是通常所说的“巴氏涂片检查”,是一种简单、低成本、低技术含量的检测方法。将其与生物标志物检测相结合可使其更具有效性。宫颈肿瘤的血管生成是基于阴道镜检查。基于这一概念发现了血管生成抑制剂,从而改善了治疗效果。宫颈癌的发病率和死亡率存在全球差异。为此,我们必须研究社会决定因素。导致高死亡率的一些原因包括诊断延迟和就医不及时。联合国可持续发展目标建议实现30%的降幅。HPV除了导致宫颈癌外,还会引发许多其他癌症,可能导致痛苦和死亡。最致命的HPV基因型有9种,它们构成了九价疫苗。印度生产的疫苗的引入可能会带来改变。2020年治疗性疫苗的引入是一道新的“希望之光”。它将减轻人类痛苦并延长寿命。随着研究的进展,还会出现更多新的范式。

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New Paradigms in Cervical Cancer Prevention.宫颈癌预防的新范式
J Obstet Gynaecol India. 2024 Aug;74(4):295-302. doi: 10.1007/s13224-024-02050-z. Epub 2024 Aug 29.

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