Cervical invasion

Cervical invasive carcinoma is a malignant tumor that seriously damages women's health. The mortality rate of this disease is also very high and is showing an upward trend. The disease is related to many factors, including unclean sexual life and promiscuous sex. People with many sexual partners will greatly increase the risk of this disease, and it is also related to infectious factors. Let's take a closer look at cervical invasive ca

relevant circumstances.

Invasive cervical cancer is a malignant tumor that occurs in the epithelium of the cervix. The mortality rate of invasive cervical cancer in my country ranks seventh among malignant tumor deaths. The 5-year survival rate for early-stage invasive cervical cancer is as high as 90%, but only 10% for late-stage cancer. The screening has a definite positive effect on the early diagnosis and treatment of invasive cervical cancer. The incidence of invasive cervical cancer begins to increase gradually after the age of 45, with the peak age of onset being 45 to 55 years old, the second peak age of onset being 35 years old, and the average age of onset being 48 years old.

1. Factors related to marriage, childbearing and sexual life

The incidence of invasive cervical cancer is related to marriage, childbearing and sexual life factors such as early marriage, early childbearing, multiple births, early and frequent sexual life, disordered sexual life, and unclean sexual life. The risk of invasive cervical cancer is related to sexual behavior. Studies have found that tetramethylenediamine, the oxidation product of polyspermine and spermidine in the semen of spouses, is a synergistic factor in the occurrence of invasive cervical cancer. A high concentration of polyamines in the partner's semen may increase the risk of invasive cervical cancer. Since the incidence of invasive cervical cancer is closely related to sexual life, married women should undergo regular screening to diagnose and treat precancerous lesions in a timely manner.

2. Infectious factors

(1) Human papillomavirus (HPV) research has confirmed that HPV is the main cause of invasive cervical cancer. HPV-infected women have an increased risk of developing invasive cervical cancer. HPV infection is a sexually transmitted disease, so people with multiple sexual partners and disordered sexual life are more likely to be infected with HPV. There are more than 60 subtypes of HPV. CIN is mainly caused by HPV types 16, 18, 6, and 11, squamous cell carcinoma is mainly caused by types 16, 18, and 31, and adenocarcinoma is mainly caused by types 18 and 16. Patients with genital warts caused by HPV infection have a five times higher risk of developing invasive cervical cancer than normal people.

(2) Herpes simplex virus (HSV) High levels of HSV-2 antibodies in patients with invasive cervical cancer suggest that this virus is related to the development of invasive cervical cancer. There is no evidence that HSV has a direct carcinogenic effect, but studies suggest that HSV-2 is a synergistic factor in the development of invasive cervical cancer.

(3) Other pathogens Studies have suggested that infections such as human cytomegalovirus, syphilis, Trichomonas, chlamydia, and fungi may also be associated with the development of invasive cervical cancer.

3. Others

The incidence of invasive cervical cancer is also related to cervical erosion, laceration, eversion, endocrine, smegma, smoking, living economic conditions, mental trauma, family cancer history, psychological factors, diet and other factors. Inadequate intake of micronutrients such as vitamin C, A and folic acid is a risk factor for invasive cervical cancer. Smoking is a co-factor in the development of invasive cervical cancer. Those who have smoked continuously for ≥ 4 years have a 4-fold increased risk of invasive cervical cancer. Quitting smoking can reduce the risk.

1. Increased leucorrhea

80% to 90% of patients with invasive cervical cancer have varying degrees of increased vaginal discharge. The characteristics of leucorrhea are similar to those of general inflammation. As the tumor progresses, necrosis and shedding occur, and secondary infection occurs, foul-smelling, bloody and purulent leucorrhea may appear.

2. Vaginal bleeding

80% to 85% of patients experience vaginal bleeding symptoms. It may manifest as contact, intermenstrual, postmenopausal or irregular vaginal bleeding. Contact vaginal bleeding in young women or vaginal bleeding after menopause are clinical symptoms that deserve special attention. Giant cauliflower-shaped exophytic tumors and ulcerous cavitary tumors are prone to heavy vaginal bleeding.

3. Other symptoms

As tumor infiltration progresses, symptoms such as pain in the lower abdomen and lumbosacral region, a feeling of heaviness in the lower abdomen and during defecation, blood in the stool, difficulty in defecation, frequent urination, hematuria, and lower limb edema may occur. Patients in the late stage may also experience cachexia symptoms such as anemia and weight loss.

1) Extrafascial hysterectomy is only suitable for patients with clearly diagnosed stage Ia1 invasive cervical cancer. The pelvic lymph node metastasis rate in stage Ia1 is less than 1%, while that in stage Ia2 may increase significantly. If postoperative examination finds that the lesion has exceeded stage Ia1, other treatments such as postoperative radiotherapy should be further supplemented according to the condition.

(2) Subradical hysterectomy involves removal of the entire uterus, freeing the ureters, and removing 2 to 3 cm of paracervical tissue and 2 to 3 cm of vagina. It is suitable for the treatment of stage Ia invasive cervical cancer. If scattered lesions are fused, there are tumor thrombi in the blood vessels and lymphatic vessels, and the cells are poorly differentiated, extensive hysterectomy or radiotherapy should be performed.

(3) Radical hysterectomy: This surgery includes radical resection of invasive cervical cancer and pelvic lymph node dissection. The scope of surgical resection usually includes: the entire uterus, part of the vagina (more than 3 cm below the fornix or more than 3 cm below the cancer focus), bilateral adnexa or retaining one ovary, uterosacral ligament and cardinal ligament more than 3 cm, vesicocervical ligament and paravaginal tissue, pelvic lymph nodes and surrounding fat tissue at and below the lower part of the common iliac cavity. This is the basic surgical procedure for the treatment of invasive cervical cancer, suitable for stage Ib to IIa invasive cervical cancer.

(4) Ultra-extensive hysterectomy, i.e. extended radical mastectomy or resection of pelvic organs such as bladder and rectum. This surgery is only used for some patients with advanced invasive cervical cancer and central recurrent cancer. This surgery involves a wide range of resection and has a high incidence of complications and mortality, so it must be performed by experienced doctors.