Эволюция Пап мазка - к скринингу рака шейки матки сегодня

???????????? ????????????? ????? ???? ?????????? ???????? ???????? ???????????, ???????????? ????????, ??????? ??????? ? ?????? ? ?????? ? ????????? ????????????? ??????? ???????? ???????? ?? ???????? ???????? ???????????? ??????.

? 1926 ???? ?????? ??????????? ???????, ??? ? ??????????? ?????????? ?????? ??? ???? ????? ????? ????? ???? ?????????? ?????????? ??????, ??? ??????? ? ??? ?????????? ??????????? ???? ????? ?? ???????????? ????? ? 1943 ????. ?????? ??????? ?? ????????? ???? ????? ????? ???? ??????? ? ????? ??????????? ? 1945 ????.

??????? 1.1 ?????? ??????????? ????????? ????? ?? ????? ?????

 

????????? ??? ???????????? ???? – ??? ?????

????? ?? ????? ?????, ??? ??? ?????, ??? ?????????? ??? ???????, ???????????? ??????????? ? ?????????????? ????, ??????? ???????????? ?? ???? ???? ? ???????? ????????????? ????? ????? ??? 50 ???. ? ????? ?????? ?????????????? ???????? ??????????? ????? 3 ???. ?????? ?? ????? ?????. ????????? ?????? ????????????? ?????? ? ??????????? ????? ?????, ?????? ????????? ? ??????? ???????, ????? ??? ??????? ?????????? ?????? ????.

? ???????????? ????????? ?????? ????????? ??????????????? ?? ??????? ??? ????? ?? ??????, ? ????? ????????? ? ??????? ????? ????????? ??? ??????. ? ????????? ????? ????? ? ???????? ????????????????? ?????? ??? ????? ???????? ???????????? ????? ?????????? ?????????, ??? ??? ?? ????????? ??????????? ???????? ???? ??????????? ?????????, ? ????? ???????? ????????? ????????  ??? ?????????? ??????. ????? ?? ????? ?? ?????????????, ???????? ????????? ???????? ?????????????? ???????? ? ????? ??????????????? ???????? ??? ????????????????? ????????????.

??????? 1.2. ?????????? ??? ?????? ???????? (?? Arbyn ? ?????. 2007 ????: ??. ????? 8)

 

?????????????? ????????

????????? ??????????? ????????? ???????????? (????????? ????????), ??????? ?????? ???????????? ????????? ?????? ????? ?????? ????? ?????????? ?????? ? ????? ??? ????????? ??. ???????, ?????????? ????????? ?????? ?????????? ???????????? ?????????? ??? ???????????? ????????, ??????? ?????????????? ?????? ? ???????????? ? ???????? ????????????????? ???????? ? ????????????? ??????????? ???????????? ??????????? ??? ??????? ?????????.

???? ??????? ? ???????????? ??????????? ???? ? ??????? ??? ???????? ???? ???????? ?????????? ?????? ????? ??????? ?????????????? ?????????

 

??????? 1.2. ?????????????? ????? ? ?????????????? ?? ? ????? ??????? NHS ???????????? ????????? ????????? ? 1988 ???? ???????? ????? 5)

???????? ????? ???????????? ????? ?? ????? ????? ???????? ?????????????? ???????? ??????????? ???? ????? ????? ?????????? ??????????? ??????????? ????????? - ???????????? ?????????????????? ????????? (??? (CIN)) ? ????? ?????, ???????, ??? ???????, ????????? ???????????? ? ?????????????? ??? ?????????. ?????????????? ??????? ??? ????????? ????????? ??? ????????? ?????????? ???????? ??????????? ??????? ???? ???????? ??????????? ????. ???????? ????????????? ??? ????? ????? ???? ????????? ??? ????????? ?? ???????? ?????????.

???? ???????? ?????? ???????????  ??? ????? ???????? ???????? ???? ???????? ?????? ? ???????? ?? 25 ?? 64 ???, ?? ????? ????? ???? ??????????? ??? ??????????? ??????????? ? ?????? ? ??????????, ??????? ???????? ?? ????????? ?????????. ? ?????? ? ?????????? ??????????? ????? ?????? ???? ????????? ???????????????? ???????????? ? ?????????????? ????????????? ????? ?????, ?????? ??? ??????? ??????????????? ???? ??? ????? ?  ?????? ? ?????????? ???????? ?????????????. ? ?????? ?????? ?????????? ?????????? ???? ????????? ??????????? ??? ????????????? ????????? ??-?? ??????????? ????? ?????????? ????? ? ??????????????? ??????????, ??? ????????????? ???????? ??? ?????????? ????, ???????????? ????????? ?????? ? ?????.

 

???? ?????? ????????? ???????? (???)

???????? ???, ??? ????????? ??????????????? ??????? ???????? ???? ????? ????? ? ??? ???????????????? ???????? ?? ???????????? ???????? ? ???? ????????? ? ???????? ?????????.

??????? 1.4 ????????????? ??????????? ?????? ????????? ???????? (?? ????? 4)

 

? ????????? ????? ??? ???????????? ????????????? ??? ?????????? ?????? ? ?????????? / ???????????? ???????????? ?????????. ??????????? ??? ????? ??????????? ????????? ? ?????????? ??? ?????????? ? ???????? ??????? ??? (???? ???????????????? ???????). ???? ?????????????? ???????????? ???????? ????? ?????????????? ??????? ????????? ?????????, ???????, ??????? ???? ????????? ?? ?????????? ??? ????????? ? ?????? ??????????? ????? ???????? ????. ? ?????? ?????? ??? ??????????? ???????? ??? ???????????? ????? ?????????????, ??? ?????????????? ????????????.

?? ?????? ??????? ?????????? ????????? ??? ????????, ?.?. ???? ????????, ??? ?? ????? ????????????, ??? ????????? ??? ??????????? ?????????? ???. ??? ? ????? ?????? ???? ????????? ?? ????????????? ????? ?? ??????????????? ????. ??? ?? ?????, ??? ?? ?????? ???????? ??????????????? ???????????? ????? ????? ??? ???????? ??????? ?????? ???????? ????????.

 

??????? ??????????? ?????????

????? ??????? ?????????????? ?????????? in situ, ??????? ?????? ???????? ???????????? ?????????????????? ?????????? 3 ??????? (???3). ??????? ????????? ? ????????????? ???? ????????????? ???????? ???????.

? 1990-? ????? ???? ??????????? ??????? ??? ???????? ??? ? ???? ????????????? ? ???????? ????? ???????????????, ?? ?????? ???????????? ?????? ???????: ???????? ???????? ???????? ???? ????????????? (large loop excision of the transformation zone (LLETZ). LLETZ ? ????????? ????? ???????? ??????? ??????, ???? ??????? ?????, ???????????? ? ???? ????????????? ????? ?????????????? ??? ???????????????? ??????????, ?????????? ????????? ? ???????????????? ?????????? ????.

 

?????????? ?????? ???

?????????? ? ????????? ??????? ?????? ???, ??????? ???? ?????????? ? ???????? ??????? ? 2005 ????, ????? ?????????????? ?????????? ????????? ???????????? ????????? ????? ?????, ???????????? ? ??????? ??????????? ????????? ????? ?????. ? ??????????????? ??????, ??? ????????? ???????? ? ??????????????? ?????????? ??????? ? ????? ???????, ??? ?????????, ?????????? ????????? ?????? ???????? ?????????????????? ??????????? ????????? ? ???.

? ?????????? ???????? ?????????????????? ??? ? ???? ???????? ???????????????? ??????????????? ????????? ? PPV ????? ???? ?????????????, ??? ???????? ????? ?? ?????? ????????? ?????????? ??? ???????????? ?? ?????? ???????. ???????? ?? ???, ?????? ????????????? ??? ???????????? ??????? ????????????? ??????????????? ???????????? ? ???????? ???????????????? ????? ?????????? - ??????? ????? ???????? ???????? ?????? ???????? ??????????? ????????? ? ???????? ???????? ???????????? ? ???????.

??????? 1.5. ?????????? ?? ??? ???????? ????? (?? ????? 7)

 

Learning points from Chapter 1

  1. The cervical smear or Pap test has been used worldwide as a screening test for more than 50 years and has saved countless lives.
  2. Pre-cancerous lesions are found by regular screening of women without symptoms or clinically evident lesions.
  3. Cytological screening may also identify early occult invasive cancers before symptoms develop.
  4. Cytological screening may be unreliable in women with symptomatic clinical cancer.
  5. Persistence of high-risk types of human papillomavirus (HPV) is the underlying cause of cervical carcinoma and its precursors.
  6. HPV vaccination of teenage girls will substantially reduce the incidence of cervical carcinoma and its precursors.

 

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