→ cin3级我该怎么办？是原位癌吗？
cin3级我该怎么办？是原位癌吗？
来自黑龙江
健康咨询描述：
活检36912点为cin3级上皮细胞无奈乱有异型性
曾经的治疗情况和效果：
想得到怎样的帮助：是要残忍的切除全部的子宫吗？我还年轻还有别的办法吗？如果要切除子宫要化疗吗？是恶性癌症吗？我很疑惑，请帮帮我，谢谢。
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肖雯婷爱心医生
帮助网友：2342称赞：73
&&&&&&病情分析：&&&&&&CIN2及CIN3鳞状细胞癌,如果发现的早,治疗比较及时.&&&&&&指导意见：&&&&&&术后采取有效的化疗手段,杜绝癌细胞的复制和转移.应该是有很大的治愈希望的.
帮助网友：7557称赞：264
&&&&&&病情分析：&&&&&&CIN属于癌前病变，虽然本身不是癌，但是癌变几率很高&&&&&&指导意见：&&&&&&CIN3级是指重度不典型增生或原位癌。如果没有生育要求最好的治疗方法就是全子宫切除，然后做病理检查，这样复发率低。如果术后病理没有发现癌细胞是不用化疗的。除了切除子宫，还可以行宫颈锥切，但是复发率高。
对于一个38岁的女人来说切除子宫会是致命的打击会很快衰老的，术后还有并发症是不是？
15:41医生回答：
如果保留卵巢的话没有您说的那么严重，卵巢也有分泌激素的功能。如果术中冰冻没有发现癌细胞，就可以单独切除子宫，这样的话没有什么严重的并发症；但如果术中冰冻有癌细胞的话，可能就需要按照宫颈癌的术士进行手术，这样的话会有一些术后并发症。
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& &&&& & 正文
患者癌细胞转移到腰椎医生切除腰椎“转”走肿瘤
【字号：&&】【】
　　阅读提示
　　中国江苏网11月5日讯
前段时间，市区的童先生（化名）突然腰痛，还出现了血尿症状，严重时甚至疼得无法入睡。到医院检查后发现，童先生患上了肾癌，且已经到了晚期。随后，童先生做了肿瘤切除手术。谁料想，最近童先生又出现了腿疼的症状。苏北人民医院脊柱外科专家发现，腿疼是因为癌细胞转移到了脊柱。经过考虑，专家组进行了全椎体切除及人工椎体重建术，为童先生切除了第五根腰椎，转移了肿瘤。
　　癌细胞突转移
　　肿瘤组织压迫第五腰椎
　　3个月前，50岁的童先生患上了肾癌，医生为其实施了肿瘤切除术。“我以为肿瘤被切除后，只要不复发，还是能过上一段好日子的。”
　　让童先生没想到的是，10月初，他突然感觉腿疼得厉害，“当时做完手术后，经过2个月的调整已经能在家里慢慢走动，可是最近腿疼起来，坐也不是躺也不是，更别提走路了。”童先生再次来到苏北医院就诊。通过CT、核磁共振等一系列检查，医生在其第五腰椎上发现了癌细胞。
　　“患者之所以感觉到腿疼，是因为癌细胞侵犯了第五腰椎。”苏北医院脊柱外科主任医师杨建东介绍说，腰椎周围有血管、动脉，这些血管和动脉是联通到人的下肢的。“如果不及时清除掉癌细胞，患者的生活将会十分痛苦。”
　　杨建东说，当时患者疼痛十分剧烈，癌细胞出现了转移，整个第五腰椎的骨头内外都有可能有癌细胞，不切除的话后果严重。就这样，在医生和家人的劝说下，童先生同意手术。
　　4小时高难度手术
　　切除癌变椎体置换人工椎体
　　脊柱外科冯新民主任、杨建东主任、陶玉平主任等专家一起讨论患者病情，最终确定可以通过全椎体切除及人工椎体重建术，完整切除第五根腰椎转移肿瘤。
　　整个手术一共持续了4个小时，涉及3个难点，因此耗费的时间比较长。
　　给病人实施全身麻醉后，手术正式开始。杨建东介绍，第五椎体周围神经、血管密集。因为腰椎是立体的，考虑到保护血管、神经的需要，医生必须将椎体分成两个部分予以切除。首先用骨刀将两侧的椎体切断打碎，将后方部分的第五椎体取出。这样一系列操作却只完成了切除术的三分之一。而最为关键的一部分，就是前方椎体的处理。
　　“前方的椎体之所以取下来有困难，主要是这里神经紧贴，主动脉离椎体前方很近，而且周围的静脉也很多。”杨建东表示，如果一个不小心割到了主动脉，就会导致患者大出血而死亡。
　　为防意外发生，医生慢慢打碎椎体，用手术工具一点点拿出。杨建东告诉记者，取出椎体时，他们的手不能有抖动，动作要快、稳、准。椎体成功取出后，医生将事先准备好的人工椎体用钉子固定、安装，再通过骨水泥的注入，将这段脊柱固定住。
　　陶玉平医生告诉记者，他们用枪一样的设备，将骨水泥从人体腰部的后方推入椎体里面。据了解，骨水泥是半固体状的物质，被注入椎体后一段时间，骨水泥会自然凝固。骨水泥可以对人造脊椎部位起到固定和支撑的作用。
　　避免术中大出血
　　专家用“球囊”阻断止血
　　因为患者第五脊柱被切断，再加上患有肾癌，很容易大出血。据专家介绍，椎体转移肿瘤手术复杂，出血量非常大，还面临神经损伤瘫痪的风险。为控制术中出血，脊柱外科联合介入科及血管科制定详细的手术计划，首次在手术中使用了球囊。
　　“球囊就好比是个阀门。”杨建东表示，球囊导管必须完全放置在肾动脉远端的腹主动脉内，若球囊位置偏高会栓塞肾动脉和卵巢(睾丸)动脉，造成肾功能衰竭和生殖功能异常。手术时，医生使用定位仪对球囊进行定位，球囊正好位于腹主动脉的最末端。术中将球囊充气，就可以阻挡住出血。杨建东说，这项新技术是他们第一次应用，止血效果很好，手术结束后放松主动脉球囊。医生检查发现，患者在手术过程中出血仅为1800毫升。
　　如今，术后的童先生已能走路，完全可以正常生活。
患者癌细胞转移到腰椎医生切除腰椎“转”走肿瘤
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From VOA Learning English, this is the Health and Lifestyle Report.
这里是美国之音健康报道。
Not many people consider a bacterium that makes millions of people sick ... a friend. But scientist Roy Curtiss does.
许多人都不会把让数百万人生病的细菌当做朋友，但是科学家Roy Curtiss确实这样。
&Yeah, I'm always looking for new uses for a bug that most people think is an enemy -- it's my friend. And I would like to make it your friend too.&
是这样的，我经常寻找大家经常认为是敌人的细菌的一些新用途，它们是我的朋友。我也希望大家能和它做朋友。
Roy Curtiss is a microbiologist at the Biodesign Institute at Arizona State University in Tempe, Arizona. He uses the word &bug,' a common expression for a germ or virus, when talking about Salmonella bacteria.
Roy Curtiss是亚利桑那州一家生物设计研究所的微生物学家。在我们讨论沙门氏菌的时候他用&虫子&这个常见的字眼来代表细菌和病毒。
Mr. Curtiss studies Salmonella and thinks it &gets a bad rap.& In other words, many people only have bad thoughts when they hear the word, &Salmonella.&
Curtiss专门研究沙门氏菌，并认为人们给它扣了一个&坏名声&。换句话说，大多数人当听到沙门氏菌的时候想到的只是不好的想法。
What is Salmonella?
Salmonella is the most common bacteria to harm, or contaminate, food. It is found in undercooked meats, eggs and milk. Salmonella can cause a higher than normal body temperature and pain in the abdomen. The person may feel sick, throwing up whatever is in the stomach.
沙门氏菌是对食物来讲最常见的细菌或者污染物，存在于一些未煮熟的肉类，鸡蛋和牛奶中。沙门氏菌可以引起身体发热和腹部疼痛。患者可能会感到恶心，出现呕吐。
One form of Salmonella is also responsible for the disease typhoid.
沙门氏菌其中的一种菌种还会造成伤寒病。
So, it is only natural that a bacterium that makes people sick is given a bad rap. The question is, &When does a food-borne bacterium become your friend?& The answer: when it helps to kill cancer cells.
所以人们才会很自然的认为这种细菌能够给人类带来疾病，从而背上了不好的名声。那么问题来了：什么时候食源性细菌才能成为你的朋友?答案：当这种细菌可以帮助人类杀死癌细胞的时候。
&The enemy of my enemy is my friend.&
Millions of people are sickened each year by Salmonella. But a genetically-engineered version of the bacteria may someday be used as a weapon against cancer. As the old saying goes, &The enemy of my enemy is my friend.&
每年有数百万人因沙门氏菌生病，但是经过基因转换工程后的沙门氏菌在未来的某一天可以被用来作为消灭癌症的武器。就像一句古话说的那样：我敌人的敌人，就是我的朋友。Researchers in the United States and Germany have turned Salmonella into a weapon against cancerous tumors. Roy Curtiss says the bacteria can make the cancer cells disappear.
美国和德国的研究人员已经把沙门氏菌转化称了对抗肿瘤癌症的武器。Roy Curtiss称这种细菌可以使癌细胞消失。
The experiment
And here is the experiment. First, the researchers changed the genes of the Salmonella to die in healthy tissues but kill cancer cells. They put human cancer cells into mice. Then, he says, they put the genetically-modified Salmonella bacteria into the animals.
这是一个实验。首先，研究人员改变了沙门氏菌的内部基因转而去杀死癌细胞。研究人员向小老鼠体内注射了人类癌细胞。然后他说，他们将转换过基因的沙门氏菌注射到动物体内。
&We genetically modify the Salmonella so that it is unable to survive in healthy tissues, but has a preferential homing (attraction) to tumors, which [are] a very nutrient-rich environment where they grow like crazy and, in so doing, kill the cancer cells within the tumor.&
我们对沙门氏菌进行了基因修饰使其无法在健康组织中正常生存，但是肿瘤对于这些基因来讲是一个很好的生存条件，这是一个营养丰富的环境他们可以疯狂的生长，然后就可以发挥修改过基因的沙门氏菌的作用来杀死癌细胞。
A report describing the work was published in the medical journal mBio.
记者称这一研究发表在了医学杂志mBio上。
Roy Curtiss says it will be a while before the genetically-modified version of Salmonella is tested on human beings. He wants to make more changes to the bacteria to increase their cancer-killing power.
Roy Curtiss说在人类身上进行修改过的沙门氏菌基因实验还需要等一段时间。他希望能够对细菌进行更多修饰来增加其抗癌的作用。
Salmonella would not be a stand-alone treatment for fighting cancer. Instead, Mr. Curtiss hopes the genetically-modified bacteria will be used in addition to more traditional therapies, such as chemotherapy and radiation.
沙门氏菌不会是对抗癌症的唯一治疗标准。相反，Curtiss希望修改细菌基因研究将会更广泛应用到传统治疗方法当中，例如化疗和放射疗法。
I'm Anna Matteo.
VOA science reporter Jessica Berman wrote this report from Washington, D.C.. Anna Matteo adapted it for Learning English. George Grow was the editor.
_____________________________________________________________
Words in This Story
bad rap & idiomatic expression a negative and often undeserved reputation &often used with bum or bad (Example: He got a bad (or bum) rap by the press.)
borne & adj. carried by : spread by & used in combination as in &waterborne& and &airborne&
genetically-modified - adjective containing genetic material that has been artificially altered so as to produce a desired effect
tumor & n. a mass of tissue found in or on the body that is made up of abnormal cells
contaminate & v. to make (something) dangerous, dirty, or impure by adding something harmful
chemotherapy & n. medical the use of chemicals to treat or control a disease (such as cancer)
radiation & n. medical the use of controlled amounts of radiation for the treatment of diseases (such as cancer)
From VOA Learning English, this is the Health and Lifestyle Report.
Not many people consider a bacterium that makes millions of people sick ... a friend. But scientist Roy Curtiss does.
&Yeah, I'm always looking for new uses for a bug that most people think is an enemy -- it's my friend. And I would like to make it your friend too.&
Roy Curtiss is a microbiologist at the Biodesign Institute at Arizona State University in Tempe, Arizona. He uses the word &bug,' a common expression for a germ or virus, when talking about Salmonella bacteria.
Mr. Curtiss studies Salmonella and thinks it &gets a bad rap.& In other words, many people only have bad thoughts when they hear the word, &Salmonella.&
What is Salmonella?
Salmonella is the most common bacteria to harm, or contaminate, food. It is found in undercooked meats, eggs and milk. Salmonella can cause a higher than normal body temperature and pain in the abdomen. The person may feel sick, throwing up whatever is in the stomach.
One form of Salmonella is also responsible for the disease typhoid.
So, it is only natural that a bacterium that makes people sick is given a bad rap. The question is, &When does a food-borne bacterium become your friend?& The answer: when it helps to kill cancer cells.
&The enemy of my enemy is my friend.&
Millions of people are sickened each year by Salmonella. But a genetically-engineered version of the bacteria may someday be used as a weapon against cancer. As the old saying goes, &The enemy of my enemy is my friend.&
Researchers in the United States and Germany have turned Salmonella into a weapon against cancerous tumors. Roy Curtiss says the bacteria can make the cancer cells disappear.
The experiment
And here is the experiment. First, the researchers changed the genes of the Salmonella to die in healthy tissues but kill cancer cells. They put human cancer cells into mice. Then, he says, they put the genetically-modified Salmonella bacteria into the animals.
&We genetically modify the Salmonella so that it is unable to survive in healthy tissues, but has a preferential homing (attraction) to tumors, which [are] a very nutrient-rich environment where they grow like crazy and, in so doing, kill the cancer cells within the tumor.&
A report describing the work was published in the medical journal mBio.
Roy Curtiss says it will be a while before the genetically-modified version of Salmonella is tested on human beings. He wants to make more changes to the bacteria to increase their cancer-killing power.
Salmonella would not be a stand-alone treatment for fighting cancer. Instead, Mr. Curtiss hopes the genetically-modified bacteria will be used in addition to more traditional therapies, such as chemotherapy and radiation.
I'm Anna Matteo.
VOA science reporter Jessica Berman wrote this report from Washington, D.C.. Anna Matteo adapted it for Learning English. George Grow was the editor.
_____________________________________________________________
Words in This Story
bad rap & idiomatic expression a negative and often undeserved reputation &often used with bum or bad (Example: He got a bad (or bum) rap by the press.)
borne & adj. carried by : spread by & used in combination as in &waterborne& and &airborne&
genetically-modified - adjective containing genetic material that has been artificially altered so as to produce a desired effect
tumor & n. a mass of tissue found in or on the body that is made up of abnormal cells
contaminate & v. to make (something) dangerous, dirty, or impure by adding something harmful
chemotherapy & n. medical the use of chemicals to treat or control a disease (such as cancer)
radiation & n. medical the use of controlled amounts of radiation for the treatment of diseases (such as cancer)
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