Milliez J
Service de Gynécologie Obstétrique, Hôpital Saint Antoine, Paris.
Bull Acad Natl Med. 1997 Oct;181(7):1415-31.
Non surgical prevention of uterine cervical cancer relies on regular performance of Pap smears and colposcopy. Screening for cervical dysplasia allows their treatment by laser vaporisation or cone biopsy, according to their grade, and therefore the prevention of invasive carcinoma. Unfortunately, 40% of the female population does not comply to cervical screening and Pap smears entail 20% false negative results. Prevention of endometrial carcinoma is even far more difficult in that endometrial smears are seldom practised. Periodic surveillance of women receiving oestrogenic hormonal therapy, addition of progesterone in order to eventually protect the endometrium, hysteroscopic detection of irregular endometrial hyperplasia, represent the only tools available today.
子宫颈癌的非手术预防依赖于定期进行巴氏涂片检查和阴道镜检查。对宫颈发育异常进行筛查,可根据其分级通过激光汽化或锥形活检进行治疗,从而预防浸润癌。不幸的是,40%的女性人群未遵守宫颈筛查,且巴氏涂片检查有20%的假阴性结果。子宫内膜癌的预防甚至更加困难,因为很少进行子宫内膜涂片检查。对接受雌激素激素治疗的女性进行定期监测、添加孕激素以最终保护子宫内膜、通过宫腔镜检查发现不规则的子宫内膜增生,是目前仅有的可用手段。