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Vulva
0.7%
Uterine Ovary
Corpus 14.9%
2.7%
Cervical
Cancer
75.5%
in less developed
regions where Latin America
72,000 new cases
there is a lack of 33,000 deaths
effective screening
programmes
Africa
• This demonstrates 79,000 new cases
a clear medical 62,000 deaths
< 3.9 < 7.9 < 14.0 < 23.8 < 55.6
20/04/2019 3
Ferlay J, et al. GLOBOCAN 2002 Cancer Incidence, Mortality and Prevalence Worldwide. Lyon: IARC CancerBase, 2004.
Silinder fibromuskuler ( 3,5 x2,5 cm)
Empat lapisan: epitel, submukosa, muskularis,
serosa
Kanalis endoserviks : ost.int – ost.ext
Bagian serviks yang terlihat: ektoserviks / portio
vaginalis
Ep. kolumner:
upper – mid canal
Ep skuamosa original:
vagina – distal
ektoserviks
Ep.skuamosa
metaplastik:
sentral ektoserviks -
lower canal
How does HPV cause cancer in the
cervix? Shedding of virus-
laden epithelial cells
Cervical canal
Mature
squamous
layer
Viral DNA replication
Squamous (E6 & E7)
layer
Basement membrane
Normal Infected
epithelium epitheliu 20/04/2019 6
Frazer IH. Nat Rev Immunol 2004; 4:46–54.
m
PENYEBAB
100% of cervical cancers are caused
by HPV
20/04/2019 14
HGSIL = high grade squamous
intraepitelial lesion, sama :
Displasia sedang - berat
Neoplasia Intraepitelial Serviks (NIS) II - III
Cervical Intraepitelial neoplasia (CIN) II –
III
Kanker serviks/Invasif :
Perdarahan pervaginam diluar siklus haid
Perdarahan pervaginam pasca coitus
Perdarahan pervaginam pd menopause
Nyeri saat coitus (?)
Gejala Klinis
Pemeriksaan Ginekologi
Inspekulo
VT/ RT
Pemeriksaan Penunjang
Pap Smear/ Pap Test
IVA (inspeksi visual dg asam
asetat) test
Kolposkopi
HPV test
Biopsi Serviks
Pra Kanker serviks/Displasia :
asimptomatik
Keputihan lama (tdk sembuh2)
Kanker serviks/Invasif :
Perdarahan pervaginam diluar siklus haid
Perdarahan pervaginam pasca coitus
Perdarahan pervaginam pd menopause
Nyeri saat coitus (?)
IVA findings
White area
KLASIFIKASI HISTOLOGI :
A. Epitelial
D. Sarcoma,metastatik
Anamnesa lengkap dan pemeriksaan fisik
Penanda tumor utk kanker epitelial (CA
125),germ cell tumors ( CEA,b-HCG,AFP ),
Sex cord stromal tumor ?
Kimia drh,darah lengkap,tes fungsi hati
Foto Toraks
CT-Scan abdomen dan pelvis
Jk simptomatis dpt dilakukan IVP
- Pembedahan penting utk menentukan
diagnostik prabedah, perluasan/stadium,
pengangkatan massa tumor.
Jenis Risiko
hiperplasia Keganasan
Hiperplasia simpleks/ kistik tanpa atipik 1%
Jenis Risiko
hiperplasia Keganasan
Hiperplasia simpleks/ kistik tanpa atipik 1%