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1、CERVICALCANCER...Diagnosis＆TreatmentCERVICALCANCER...ThemostcommonmalignancyingynecologicaloncologyIncidence:7.8/100,000Mortality:2.7/100,000Diagnosis:biopsyMainmodalityoftreatment:surgeryandradiationGoaloftreatment:cure,exceptstage4bSpecialCase38yrs,G3/P1,nurseC/O:postcoitalbleedingfor2monthsMenstr
2、uationregularwith30dayscycleand5daysduration.Abnormaldischargewithbadsmell.LMP:12daysagoPapsmear:squamouscellcancerPV:Vulva:Normal,Vaginal:yellowishdischargewithbloodystained,Cervix:growthwithulcerationandcontactbleeding.Uterus:N/S,mobile.Parametrium:thickeningnottopelvicsidewallonbothsideCERVICALCA
3、NCER…..Howcanwemakeadiagnosis?Howcanweevaluatethepatient?Howcanwemanagethepatient?Howshouldweexplaintothepatient?Canwepreventcervicalcancer?Howcanwemakeadiagnosis?SYMPTOMSAbnormalvaginalbleedingpostcoitalbleeding*contactbleedingAbnormalvaginaldischargeAsymptomatic,justabnormalpapsmearSYMPTOMSTheclas
4、sicsymptomisintermittent,painlessmetrorragiaorspottingonlypostcoitallyorafterdouching.Probablythefirstsymptomofearlycancerofthecervixisathin,watery,blood-tingedvaginaldischargethatfrequentlygoesunrecognizedbythepatients.Asthemaligancyenlarges,thebleedingepisodesbecomeheavierandmorefrequent,andtheyla
5、stlonger.SYMPTOMSLatesymptomorindicatorsofmoreadvanceddiseaseincludethedevelopmentofpainreferredtotheflankorleg.Manypatientsc/odysuria,hematuriaorrectalbleedingorobstipationresultingfrombladderorrectalinvasion.Distantmetastasisandpersistentedemaofoneorbothlowerextremitiesasaresultoflymphaticandvenou
6、sblockagebyextensivepelvicwalldiseasearelatemanifestationofprimarydiseaseandfrequentmanifestationsofrecurrentdisease.Howcanwemakeadiagnosis?SIGNSVagina:mucous,fornixCervix:erosiongrowthulcerationbarrel-shapedUterus:size,mobilityParamet:thickeningGrossappearenceThreecategoriesofgrosslesionshavetradit
7、ionallybeendescribed.Themostcommonistheexophyticlesion,whichusuallyarisesontheectocervixandoftergrowstoformalarge,friable,polypoidmass,arisesontheendocervicalcanal,creatingbarrel-shapedlesion.Littlevi
