Hello everyone, I am a clinician who has been practicing for many years. Speaking of cervical cancer, I think there is a well-known star, especially the older generation, who should be very familiar with it, that is, "Mei Yanfang", who was diagnosed with cervical cancer at the age of 39, she rejected the doctor's recommendation to remove the uterus, and died only 1 year later. So as the general public, how to prevent cervical cancer? Today I will use this to do a popular science explanation for you.
<h1 class="pgc-h-center-line" data-track="2" > prevent cervical cancer, let's take a look at this virus first! </h1>
●Cervical cancer is one of the most common malignancies in women worldwide, and data show that nearly 600,000 women have new cervical cancer and more than 300,000 deaths every year. In China, the incidence of cervical cancer ranks third in malignant tumors in women aged 15 to 44. In 2018 alone, nearly 110 000 cases and nearly 50 000 deaths were caused. Studies have found that 99.7% of cervical cancers are associated with HPV (human papillomavirus) infection. This human papillomavirus has many clinical classifications, such as low-risk and high-risk types. Note that this high-risk type is associated with "highly squamous intraepithelial lesions" and "cervical cancer", mainly including 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, a total of 15 types.
●Isn't the low-risk type dangerous? No, but low-risk HPV infection often induces "low-grade squamous intraepithelial lesions" and "genital warts", mainly including 6 types of 6, 11, 42, 43, 44, cp8304. So what are the characteristics of HPV infection? Studies have shown that it is mostly temporary and resolves the infection spontaneously within 8 to 12 months. At present, HPV infection in China is about 16.8%, of course, the infection rate of HPV will also vary according to regional and age differences.
<h1 class="pgc-h-center-line" data-track="26" > the origin of HPV and cervical cancer</h1>
●Cervical cancer It is a cancer that originated in the female cervix, and its significant clinical features are abnormal vaginal bleeding, abnormal vaginal discharge, pelvic pain or painful intercourse. To say that its pathogenesis, in fact, is very complex, such as the microenvironment in the female vagina, changes in hormone levels and so on. But one thing I can clearly tell you, this is of course also clinically verified, that is, chronic persistent HPV infection is a necessary condition for cervical intraepithelial neoplasia and cervical cancer, and there are relevant epidemiological data that 99% of cervical cancer patients can detect HPV infection in cervical shedding cells.
● I will briefly analyze the early coding region (E region) that regulates DNA replication outside the chromosome, and the E5, E6 and E7 of HPV are the main oncogenes that promote host cell proliferation to promote viral amplification. Expression of E5, E6, and E7 oncoins can alter multiple signaling pathways to cause cancer. E5 can sensitize epidermal growth factor receptors to epidermal growth factor to increase the activation of PI3K/Akt and mitoson-activated protein kinase pathways, while E5 can also inhibit specific death receptors (Drs) and exoptoptotic pathways activated by their corresponding ligands; E6 can inactivate tumor proteins p53 and PDZ while stimulating inositol phosphate 3 kinase (PI3K)/protein kinase B (Akt), Wnt, and The Notch pathways E7 can inhibit retinoblastoma proteins and stimulate the PI3K/Akt pathway; E6 and E7 can both deregulate the expression of mi‐croRNA in cells to change the cell's signaling pathways, which may not be understood, but only need to understand that these signaling pathway changes play an important role in the development and maintenance of cancer!!!
<h1 class="pgc-h-center-line" data-track="27" cervical cancer >, how to prevent it? </h1>
● HPV (human papillomavirus) infection rate and type distribution vary according to different regions and different ages, but note that the most carcinogenic hpv genotype is also type 16 and type 18, then we can focus on it in prevention, and the HPV vaccine, which currently includes bivalent, quadrivalent and ninth valent HPV vaccines, is approved for marketing in China. Among them, the bivalent coverage is type 16 and 18, the applicable range is 9 to 45 years old; the quadrivalent coverage is 16, 18, 6 and 11, the applicable range is 20 to 45 years old; the nine-valent coverage is 16, 18, 31, 33, 45, 52, 58, 6 and 11, the applicable age is 16 to 26 years old, and related studies have also shown that the promotion and use of prophylactic HPV vaccine for cervical cancer precancerous lesions and persistent infection of HPV have shown a highly effective protective effect, so if they meet the conditions, Economic conditions allow me to recommend vaccination for prevention.
●So for some women over 50 years old, with menopause or menopause women's hormone levels and the body's immunity decreasing, how to deal with the increase in HPV (human papillomavirus) infection rate due to the decrease in the ability to clear the virus? My suggestion is regular physical examination, in fact, it is also very convenient, do a TCT (liquid-based thin layer cell detection) for screening, the price is not expensive, not troublesome, so that even if there is a problem, you can also get early diagnosis and treatment in time, better than waiting until the late stage of multiple transfers and cutting the uterus, cutting the vagina, doing chemotherapy lucky. Moreover, when the woman is over 65 years old, if the screening results are negative for 10 consecutive years and there is no history of cervical intraepithelial tumor, the screening can be terminated.
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