“子宫颈糜烂”的发生机制及近现代观

一百多年前,子宫颈糜烂被描述为因炎症导致宫颈表层上皮脱失的一种宫颈形态。近现代观为:子宫颈糜烂是指位于宫颈外口的原始柱状上皮或早-中期的化生上皮,因雌激素影响,宫颈管内柱状上皮延伸至宫颈管外口,形成临床所见宫颈异位或外翻的典型外观。子宫颈糜烂曾被视作宫颈浸润癌的高危因素。现公认高致癌型人乳头瘤病毒(human papilloma virus,HPV)感染是发生宫颈浸润癌的核心因素。子宫颈糜烂与子宫颈癌的发生无关,对其治疗属过度医疗行为,应予以制止。

The modern view and occurrence mechanism of the cervical erosion

One hundred years ago,the cervical erosion was described as the tissue representing a form of erosion associated with a loss of surface epithelium due to an accompanying inflammation. The modem view of the cervical erosion was defined as the eetocervix having evidence of original columnar and early or mid - metaplastic epithelium. As a result of estrogen stimulation, endocervical columnar epithelium extends to the ectocervix obviously, producing the classical appearance of what was clinically referred to as an ectopy or ectropion. The cervical erosion once was deemed as the high risk factor of invasive cervical cancer （ ICC ）. It has been now well established that infection with high oncogenie risk human papilloma virus （HPV） types is the central causal factor in ICC. The cervical erosion has nothing to do with the occurrence of cervical cancer. Treating the cervical erosion belongs to excessive medical behavior and should be prevented.