الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cervical cancer is the second most common cancer and the fifth leading cause of cancer death in women worldwide. Cancer of the uterine cervix is the major cause of death from gynecologic cancer worldwide. Reported incidence rates in developing countries are much higher than those in developed countries.
For squamous cell cervical cancer, squamous cell carcinoma antigen (SCC) is the marker of choice. Serum levels of SCC have been found to correlate with tumor stage, tumor size, and residual tumor after treatment, recurrent or progressive disease, and survival in patients with squamous cell cervical cancer. Carcinoembryonic antigen (CEA) and CA125 in particular have demonstrated possible utility in patients with cervical adenocarcinoma.
Of particular interest are the changes of keratins 8, 10, 13, and 17 that occur from reference cervix to preinvasive and invasive carcinomas. However, both keratins 8 and 17are expressed upon malignant transformation of human cervix, and the presence of these keratins in CIN I, II, and III lesions may indicate progressive potential of the lesion.
The advent of HPV vaccines holds promise of reducing the incidence of cervical cancer as (primary prevention). The current HPV vaccines provide protection against HPV types 16 and 18, which account for about 70% of cervical cancers. Vaccines are most effective when administered in sexually inactive individuals.
The vaccines are indicated for females 9 to 26 years of age for prevention of cervical and other lower genital tract cancers. However, women who have received HPV vaccines must continue to receive Pap smear screening because present vaccines do not provide protection for other high risk HPV subtypes that can cause cervical and other lower genital tract cancers. Recent U.S. Food and Drug Administration (FDA) approval has been obtained for vaccination of males in the similar age group for prevention of anal cancers and other HPV mediated dysplasias.
Patients with Stage IB or IIA disease (early stage disease) have an overall 5 year survival between 66% and 95%. Patients with more advanced stage disease (Stage IIB and higher) have a 5 year survival between 9% and 64%. The presence of lymph node metastases is the most important prognostic factor associated with recurrent disease and poor survival. The five year survival rate of patients with Stage IB or IIA cervical cancer declines dramatically from approximately 80%-95% in patients without lymph node metastases to approximately 50%-65% in patients with positive lymph nodes.
Follow up of patients after primary treatment consists of gynecological investigation. Dependent on clinical symptoms and physical findings, additional cytological or histological investigations, computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound can be performed. The aim of follow up after initial treatment is to detect recurrent disease in an early phase in order to improve prognosis.