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전암 병변을 가진 부인과 환자의 처치

Management of gynecologic patients with precancerous disease

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참고문헌

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주제분류산부인과학

초록

부인암 중 자궁경부암은 예방이 가능한 암으로 알려져 있는데, 전암 병변에서 장기간에 걸쳐 서서히 침윤성 암으로 진행하게 되므로 선별검사를 통한 조기 진단 및 치료가 효과적이기 때문이다. 전암 병변을 제대로 치료하지 못하면 침윤암의 위험을 증가시키고, 반대로 불필요할 정도로 과도하게 치료하면 합병증을 증가시킬 수 있기 때문에, 전암 병변을 적절하게 치료하는 것이 중요하다. 환자 개개인별로 치료방법을 선택할 때에는 환자의 나이, 출산경력, 나중에 아이를 갖고자 하는 열망, 선호도, 이전 세포검사 결과와 치료병력, 추적검사 중에 문제가 있었는지 여부, 수술자의 경험, 변형층 (transformation zone)이 보이지 않는 경우 등과 같은 사항을 고려한다.

Abstract

Cervical cancer of gynecologic cancer is considered a preventable disease because it has a long preventive state, cervical cytology screening programs are currently available, and treatment of precancerous lesions is effective. Proper management of precancerous disease is important because improper management of precancerous disease can increase risk of invasive cancer on the one hand and can result in complications from overtreatment on the other. The decision as to which therapeutic option to use in an individual patient depends on considerations such as patient age, parity, desire for future childbearing, preferences, prior cytology and treatment history, and history of default from follow-up, operator experience, and nonvisualization of the transformation zone.

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