Neoplasia. CA-125 and CA-19.9 were

Neoplasia.
CA-125 and CA-19.9 were most useful in women with adenocarcinoma.
Research has indicated that squamous cell carcinoma {SCG} antigen and CA-125 are useful markers for progression of disease because the markers increased about three months before clinical evidence of disease recurrence.257
DNA subtyping has been conducated to evaluate HPVassociated lesions and holds promise of enhancing screening for cervical malignancies.186,258
Antibodies against HPV 16 have been found in the sera of women with cervical cancer.
In one study, forty-four percent of SIL lesions {CIN 11/111} were found by HPV testing, although cytology was negative.
However 25% of SIL {CIN11/111} lesion were not detected by the HPV tests.
The researchers concluded that HPV testing could augment, but not replace current cytologic testing.259
Specimens from over 1000 women with cervical cancer from 22 countries were collected in order to determine if the association between genital HPV infection and cervical cancer is consistent worldwide.
HPV DNA was detected in 93% of the malignancies.
HPV 16 was found most frequently in all countries with the exception of Indonesia where HPV 18 was most commom.
Less common types of HPV differed by geographic location.
The development of vaccines targeted at genital HPVs cold help reduce the incidence of cervical cancer worldwide.198
Classification and staging—invasive disease
Cervical cancer is staged clinically. With confirmation obtained from examinations completed with the patient under anesthesia.
This allows for a more accurate staging including visualization of the upper vagina and palpation of parametrial and lateral side wall tissues.186
Evalution under anesthesia usually occurs at the same time as the planned surgical intervention or when radiation implants are inserted.
The clinical stage is not changed if disease recurs.
The initial staging is one of the best prognostic indicators.
Approximate 5-Year survival rates are: stange 1,
PART4
Therapeutic Approaches and Nursing Care—Invasive Disease
Once invasive cervical cancer is diagnosed and the stage is established, treatment is based on the woman’s age, general medical condition, extent of the cancer, and the presence of any complicating abnormalities.
Either surgery or radiation therapy can be used equally effectively for patients with early-stang disease.
With either radiotherapy or surgery, the 5-year survival rate for stage 1 is 85%.261
Radiotherapy can be used for all individuals, whereas surgery is indicated only for women who are considered good surgical candidates.186,262
Key components include being treated in an institution with the appropriate personnel and equipment for either type of treatment and multidisciplinary planning.
In general, patients with stage IIb to IV are treated with radiotherapy
Stage la
Stage la disease {microinvasive carcinoma} has been divided into InI and Ia2 .
Stage In1 should be treated by TAH or TVH if the patient is healthy and does not desire further childbearing.
Conization can be done for those who are poor surgical risks or who wish to preserve fertility, as long as the biopsy margins are free of disease and the patient is followed closely.216,236,263,264
Intracavical cancer stage .
Stange Ia2 disease is treated by TAH or TVH if invasion is less than 3 mm and there is no lymphovascuular involvement.
If the invasion is greater than 3 mm or there is lymphovascular invasion, the disease is managed the same as a stage Ib.
Five-year survival in patients with properly staged Ia cervical cancer is close to 100%.
Conservative measures are recommended to treat stage Ia1 but more aggressive measures are indicated for stage Ia2 because of the higher risk of lymphovascular involvement.
Stage Ib and IIa
In 1995 FIGO divided stage Ib into stage Ib1 {lesions no greater than 4 cm in size} and Ib2 {lesions greater than 4 cm in size}.
The choice of therapy for patients with stage Ib and IIa disease remains controversial, and the choice of surgery or radiation depends on the gynecologist and radiation oncologist involved as well as the woman’s condition and the characterstics of the lesion.
Stage Ib and stage IIa disease can be treared with radical abdominal husterectomy and pelvic lymphadenectomy or with definitive radiation, which may include external beam and/or intracavitaly insertions.
Cure rates for stage Ib using radiation or surgery are almost identical.
Surgery is preferred to radiotherapy by some gynecologic oncologists since ovarian function cam be preserved.
The vagina usually remains more pliable after surgery than with radiation, the overall treatment time is shorter, and long-term radiation complications to pelvic tissue can be avoiding major intraoperative and postoperative compolications, and the patient can receive the therapy as an outpatient.

ผลลัพธ์ (ไทย) 1:

Neoplasia CA-125 และ CA 19.9 มีประโยชน์มากในผู้หญิงที่มีมะเร็งชนิดต่อมงานวิจัยระบุว่า ตรวจหา carcinoma เซลล์ squamous {SCG } และ CA-125 เป็นเครื่องหมายที่เป็นประโยชน์สำหรับความก้าวหน้าของโรคเนื่องจากเครื่องหมายที่เพิ่มขึ้นประมาณสามเดือนก่อนหลักฐานทางคลินิกของโรค recurrence.257ดีเอ็นเอลูกผสมสามแล้ว conducated ไป HPVassociated ได้ และมีสัญญาของการคัดกรองสำหรับ malignancies.186,258 ปากมดลูกเพิ่มตรวจพบแอนตี้กับ HPV 16 ในนโยบายของผู้หญิงกับมะเร็งปากมดลูกในการศึกษาหนึ่ง สี่สิบสี่เปอร์เซ็นต์ของภาษาศาสตร์ได้ {น 11/111 } พบ โดยมะเร็งปากมดลูก การทดสอบแม้ว่าเซลล์วิทยาเป็นลบอย่างไรก็ตาม ไม่พบ 25% ของแผลภาษาศาสตร์ {CIN11/111 } โดยมะเร็งปากมดลูกทดสอบนักวิจัยสรุปว่า การทดสอบมะเร็งปากมดลูกอาจเพิ่ม แต่แทน testing.259 ปัจจุบัน cytologicไว้เป็นตัวอย่างจากผู้หญิง 1000 กับมะเร็งปากมดลูกจาก 22 ประเทศถูกรวบรวมไว้เพื่อกำหนดความสัมพันธ์ระหว่างอวัยวะเพศการติดเชื้อ HPV และมะเร็งปากมดลูกว่าสอดคล้องกันทั่วโลก ตรวจพบ HPV DNA ใน 93% ของ malignancies ที่มะเร็งปากมดลูก 16 พบบ่อยที่สุดในประเทศทั้งหมดยกเว้นอินโดนีเซียที่ 18 มะเร็งปากมดลูกเป็นส่วนใหญ่สามัญมะเร็งปากมดลูกชนิดทั่วไปน้อยแตกต่างตามตำแหน่งทางภูมิศาสตร์การพัฒนาความรู้อวัยวะเพศ HPVs เย็นช่วยลดอุบัติการณ์ของมะเร็งปากมดลูก worldwide.198จัดประเภทและจัดเตรียมตัวโรคที่รุกรานมะเร็งปากมดลูกมีการแบ่งระยะทางคลินิก มีการยืนยันที่ได้รับจากสอบเสร็จ มีผู้ป่วยภายใต้ยาชาThis allows for a more accurate staging including visualization of the upper vagina and palpation of parametrial and lateral side wall tissues.186Evalution under anesthesia usually occurs at the same time as the planned surgical intervention or when radiation implants are inserted.The clinical stage is not changed if disease recurs.The initial staging is one of the best prognostic indicators.Approximate 5-Year survival rates are: stange 1,PART4Therapeutic Approaches and Nursing Care—Invasive DiseaseOnce invasive cervical cancer is diagnosed and the stage is established, treatment is based on the woman’s age, general medical condition, extent of the cancer, and the presence of any complicating abnormalities.Either surgery or radiation therapy can be used equally effectively for patients with early-stang disease.With either radiotherapy or surgery, the 5-year survival rate for stage 1 is 85%.261Radiotherapy can be used for all individuals, whereas surgery is indicated only for women who are considered good surgical candidates.186,262Key components include being treated in an institution with the appropriate personnel and equipment for either type of treatment and multidisciplinary planning.In general, patients with stage IIb to IV are treated with radiotherapy Stage la Stage la disease {microinvasive carcinoma} has been divided into InI and Ia2 .Stage In1 should be treated by TAH or TVH if the patient is healthy and does not desire further childbearing.Conization can be done for those who are poor surgical risks or who wish to preserve fertility, as long as the biopsy margins are free of disease and the patient is followed closely.216,236,263,264Intracavical cancer stage .Stange Ia2 disease is treated by TAH or TVH if invasion is less than 3 mm and there is no lymphovascuular involvement.If the invasion is greater than 3 mm or there is lymphovascular invasion, the disease is managed the same as a stage Ib.Five-year survival in patients with properly staged Ia cervical cancer is close to 100%.Conservative measures are recommended to treat stage Ia1 but more aggressive measures are indicated for stage Ia2 because of the higher risk of lymphovascular involvement. Stage Ib and IIaIn 1995 FIGO divided stage Ib into stage Ib1 {lesions no greater than 4 cm in size} and Ib2 {lesions greater than 4 cm in size}.The choice of therapy for patients with stage Ib and IIa disease remains controversial, and the choice of surgery or radiation depends on the gynecologist and radiation oncologist involved as well as the woman’s condition and the characterstics of the lesion.Stage Ib and stage IIa disease can be treared with radical abdominal husterectomy and pelvic lymphadenectomy or with definitive radiation, which may include external beam and/or intracavitaly insertions.Cure rates for stage Ib using radiation or surgery are almost identical.Surgery is preferred to radiotherapy by some gynecologic oncologists since ovarian function cam be preserved.The vagina usually remains more pliable after surgery than with radiation, the overall treatment time is shorter, and long-term radiation complications to pelvic tissue can be avoiding major intraoperative and postoperative compolications, and the patient can receive the therapy as an outpatient.

ผลลัพธ์ (ไทย) 3:

neoplasia .
ca-125 ca-19.9 และมีประโยชน์ที่สุดในผู้หญิงกับภายหลัง
การวิจัยได้แสดงให้เห็นว่า squamous เซลล์ { SCG } แอนติเจนและ ca-125 เป็นเครื่องหมายสำหรับความก้าวหน้าของโรค เพราะเครื่องหมายเพิ่มขึ้นประมาณสามเดือนก่อนทางคลินิกของโรค 257
หลักฐานซ้ำอีก