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Statements

Subject Item
n2:RIV%2F00216208%3A11110%2F14%3A10286077%21RIV15-MSM-11110___
rdf:type
n11:Vysledek skos:Concept
rdfs:seeAlso
http://www.prolekare.cz/linkout/50521
dcterms:description
Objective: To summarize new data which can help in decision on tailoring treatment of cervical precancerosis. Design: Review article. Setting: Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and Hospital Na Bulovce in Prague; Oncogynaecological Center, First Faculty of Medicine, Charles University and General University Hospital in Prague. Results: Precancerous lesions of the cervix are represented by squamous cervical intraepithelial neoplasias (CIN) and glandular adenocarcinomas in situ (AIS). The usual treatment of cervical precancerosis is conisation. However, some complications, particularly subsequent adverse pregnancy outcomes, follow all surgical treatments of cervix. The treatment could be postponed in women who wish to conceive and who suffer from CIN with a low risk of transformation to invasive cancer. The presence of modifying factors can help to stratify CIN lesions according to their malignant potential. The determination of detected HPV genotypes may help in this decision, because the fate of CIN 2/3 depends on the genotype of associated HPV infection. Cervical lesions associated with HPV 16, 18 or 45 are at a much higher risk of rapid progression to invasive cancers than lesions associated with other HR HPV genotypes. Surgical treatment of CIN 2/3 in women with a desire for future child-bearing can be postponed in cases non-associated with HPV 16, 18 and 45, on a case by case basis. Attempts are made to improve evaluation of the lesions by using biological and molecular markers, especially p16INK4a staining. Younger age, ongoing pregnancy, favourable colposcopic findings, negative p16INK4a staining and immunocompetency are independent factors supporting the choice of conservative management. Adenocarcinoma in situ management substantially differs from the management of CIN. Objective: To summarize new data which can help in decision on tailoring treatment of cervical precancerosis. Design: Review article. Setting: Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and Hospital Na Bulovce in Prague; Oncogynaecological Center, First Faculty of Medicine, Charles University and General University Hospital in Prague. Results: Precancerous lesions of the cervix are represented by squamous cervical intraepithelial neoplasias (CIN) and glandular adenocarcinomas in situ (AIS). The usual treatment of cervical precancerosis is conisation. However, some complications, particularly subsequent adverse pregnancy outcomes, follow all surgical treatments of cervix. The treatment could be postponed in women who wish to conceive and who suffer from CIN with a low risk of transformation to invasive cancer. The presence of modifying factors can help to stratify CIN lesions according to their malignant potential. The determination of detected HPV genotypes may help in this decision, because the fate of CIN 2/3 depends on the genotype of associated HPV infection. Cervical lesions associated with HPV 16, 18 or 45 are at a much higher risk of rapid progression to invasive cancers than lesions associated with other HR HPV genotypes. Surgical treatment of CIN 2/3 in women with a desire for future child-bearing can be postponed in cases non-associated with HPV 16, 18 and 45, on a case by case basis. Attempts are made to improve evaluation of the lesions by using biological and molecular markers, especially p16INK4a staining. Younger age, ongoing pregnancy, favourable colposcopic findings, negative p16INK4a staining and immunocompetency are independent factors supporting the choice of conservative management. Adenocarcinoma in situ management substantially differs from the management of CIN.
dcterms:title
Tailoring surgical treatment of cervical precancerosis Tailoring surgical treatment of cervical precancerosis
skos:prefLabel
Tailoring surgical treatment of cervical precancerosis Tailoring surgical treatment of cervical precancerosis
skos:notation
RIV/00216208:11110/14:10286077!RIV15-MSM-11110___
n3:aktivita
n17:I
n3:aktivity
I
n3:cisloPeriodika
5
n3:dodaniDat
n15:2015
n3:domaciTvurceVysledku
n4:8445613 n4:5750016 n4:3630501 n4:1572431 n4:4540921 n4:7576226
n3:druhVysledku
n16:J
n3:duvernostUdaju
n8:S
n3:entitaPredkladatele
n18:predkladatel
n3:idSjednocenehoVysledku
49268
n3:idVysledku
RIV/00216208:11110/14:10286077
n3:jazykVysledku
n14:eng
n3:klicovaSlova
p16INK4a; human papillomavirus genotype; tailoring treatment; conisation; adenocarcinoma in situ; cervical intraepithelial neoplasia
n3:klicoveSlovo
n6:conisation n6:tailoring%20treatment n6:adenocarcinoma%20in%20situ n6:p16INK4a n6:cervical%20intraepithelial%20neoplasia n6:human%20papillomavirus%20genotype
n3:kodStatuVydavatele
CZ - Česká republika
n3:kontrolniKodProRIV
[6D433B8631E1]
n3:nazevZdroje
Česká gynekologie
n3:obor
n7:FK
n3:pocetDomacichTvurcuVysledku
6
n3:pocetTvurcuVysledku
6
n3:rokUplatneniVysledku
n15:2014
n3:svazekPeriodika
79
n3:tvurceVysledku
Cibula, David Sláma, Jiří Bolehovská, Petra Driák, Daniel Halaška, Michael Sehnal, Borek
s:issn
1210-7832
s:numberOfPages
6
n5:organizacniJednotka
11110