第#一章 概述 ····················································································· 1
第#一节 宫颈癌的现状··································································· 1
第二节 宫颈癌的筛查与预防 ························································· 1
第三节 宫颈癌发病的相关因素 ······················································ 2
第二章 宫颈组织病理学 ······································································ 3
第#一节 宫颈解剖学与组织学 ························································· 3
一、宫颈解剖学 ····································································· 3
二、宫颈组织学 ····································································· 4
第二节 人乳头瘤病毒致病机制与宫颈癌疫苗现状 ······························ 7
一、人乳头瘤病毒致病机制 ······················································ 7
二、宫颈癌疫苗现状 ······························································· 9
第三节 宫颈储备细胞及其与宫颈癌发生的关系 ································11
一、宫颈储备细胞的概念 ························································11
二、宫颈储备细胞的起源 ························································12
三、宫颈储备细胞的增生与癌变 ···············································12
第四节 宫颈鳞状上皮癌前病变 ·····················································16
一、鳞状上皮非典型增生 ························································16
二、鳞状细胞原位癌 ······························································17
三、CIN 的分级诊断标准及鉴别诊断 ·········································19
四、点评 ·············································································26
第五节 宫颈上皮化生··································································26
一、化生的定义 ····································································26
二、鳞状上皮化生 ·································································26
三、移行上皮化生 ·································································29
宫颈癌前病变病理诊断要点 vi
四、子宫内膜样上皮化生 ························································29
五、输卵管上皮化生 ······························································29
第六节 宫颈鳞状上皮病变 ···························································29
一、宫颈湿疣 ·······································································29
二、乳头状未成熟性鳞化 ························································32
三、鳞状上皮乳头状瘤 ···························································34
第七节 宫颈鳞状细胞癌 ······························································34
一、病因学与流行病学 ···························································35
二、危险因素 ·······································································35
三、临床特点 ·······································································36
四、浅表浸润性鳞状细胞癌 ·····················································36
五、浸润性鳞状细胞癌 ···························································39
六、少见组织类型 ·································································44
七、点评 ·············································································48
第八节 宫颈腺上皮癌前病变与浸润性腺癌 ······································48
一、宫颈腺癌的病因 ······························································48
二、宫颈高#级别腺上皮内病变 ··················································49
三、原位腺癌 ·······································································52
四、早期浸润性腺癌 ······························································53
五、浸润性腺癌 ····································································55
六、点评 ·············································································64
第九节 其他宫颈恶性肿瘤 ···························································64
一、神经内分泌癌 ·································································64
二、胚胎性横纹肌肉瘤 ···························································66
三、ping滑肌肉瘤 ····································································66
四、髓系肉瘤 ·······································································67
五、恶性淋巴瘤 ····································································67
六、未分化癌 ·······································································67
目 录 vii
第三章 宫颈癌前病变的细胞学诊断 ······················································69
第#一节 细胞学分类及液基细胞学 ··················································69
一、细胞学分类的研究进展 ·····················································69
二、液基细胞学检测 ······························································70
三、宫颈细胞学 TBS 的主要内容（2001 年） ·······························71
第二节 鳞状细胞异常··································································73
一、非典型鳞状细胞 ······························································73
二、鳞状上皮内病变 ······························································75
三、鳞状细胞癌 ····································································79
四、点评 ·············································································81
第三节 腺细胞异常·····································································81
一、非典型腺细胞 ·································································82
二、宫颈管原位腺癌 ······························································84
三、宫颈管腺癌 ····································································85
四、点评 ·············································································85
第四节 良性细胞改变··································································86
一、微生物感染 ····································································86
二、反应性细胞改变 ······························································87
三、表皮细胞萎缩（伴或不伴有炎症） ······································88
四、子宫切除术后腺上皮细胞状况 ············································88
五、正常细胞 ·······································································88
参考文献 ··························································································91
缩略语 ······
张瑜主任医师，教授，第四军医大学（现为空军军医大学）临床医学六年制本科毕业，在部队工作时荣立三等功一次，曾任昆明军区军医学校病理教研室副主任。1987年转业后在西安交通大学附属西北妇女儿童医院工作。2019年4月受聘于西安新长安妇产医院（病理科）。擅长妇产科病理及乳腺科病理诊断，诊断病例达10万例以上。
以第一作者发表论文40余篇，主编专著2部，获省部级科学技术奖2项。2001年9月受邀参加荷兰第25届国际病理学大会，作会议报告《应用扫描电镜技术预测良性与侵袭性葡萄胎》并进行学术交流，该报告发表在英国期刊Histopathology上。2005年3月受邀参加美国第35届国际生理学大会并进行学术交流。
本书系统介绍了宫颈癌前病变的相关概念、病理诊断依据、鉴别诊断、免疫组织化学标记的意义等，并详细说明了避免误诊及混淆的病理诊断要点。同时，对宫颈癌相关内容，如鳞状细胞癌、腺癌等也加以介绍，以期形成较为完整的知识体系。
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