Etiopathogenesis, pathology and treatment of cervical cancer

Iako karcinom vrata maternice nije više vodeći uzrok smrti žena među malignomima, prvenstveno zahvaljujući preventivi cijepljenjem protiv HPV-a i PAPA testu, broj slučajeva je daleko od zanemarivog broja, pogotovo u nerazvijenim zemljama. Zbog toga je i dalje važno usavršavati dijagnostiku i liječenje. Cilj je otkriti bolest u što ranijoj fazi kada je izlječiv u skoro 93% slučajeva. Nažalost prognoza uznapredovale bolesti je i danas loša pogotovo kod nekih podvrsta adenokarcinoma vrata maternice. Gotovo svi karcinomi pločastog epitela i 75% adenokarcinoma vrata maternice su posljedica infekcije HPV virusima visokog rizika. U liječenju je vrlo važno odrediti klinički stadij bolesti kako bi multidisciplinarni tim odredio individualno optimalnu terapiju na temelju kliničkog pregleda, nalaza dobivenih pomoću suvremenih dijagnostičkih uređaja (ultrazvuk, CT, PET-CT, MR), rezultata biokemijskih pretraga i patohistološkog nalaza. Pored kirurškog liječenja, radioterapije zračenjem, kemoterapije citostaticima ili kombinacijama tih metoda u novije vrijeme sve više se radi studija o učinkovitosti bioloških terapija. To je novi pristup liječenju u kojem se cilja na biološke procese koji su često ključni za razvoj tumora. Takvo liječenje može uključivati humana monoklonska protutijela, cjepiva i genske terapije. Provedene studije polučile su obećavajuće rezultate.Although cervical cancer is no longer the leading cause of death among women among malignancies, primarily thanks to prevention by HPV vaccination and the PAPA test, the number of cases is far from negligible, especially in underdeveloped countries. That is why it is still important to improve diagnostics and treatment. The goal is to detect the disease as early as possible because it is curable in almost 93% of cases. Unfortunately, the prognosis of advanced disease is still poor, especially in some subtypes of adenocarcinoma of the cervix. Almost all squamous epithelial carcinomas of cervix and 75% of adenocarcinomas of the endocervix are the result of infection with high risk HPV viruses. In treatment, it is very important to determine clinical stage of the disease so that multidisciplinary team can determine individually optimal therapy based on clinical examination, findings obtained using modern diagnostic devices (ultrasound, CT, PET-CT, MR), biochemical test results and histopathological findings. In addition to surgical treatment, radiotherapy, chemotherapy with cytostatic or combinations of these methods, more and more studies are being done on the effectiveness of biological therapies. It is a new approach to treatment in which it targets biological processes that are often crucial for tumor development. Such treatment may include human monoclonal antibodies, vaccines, and gene therapies. The studies conducted have yielded promising results