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Cervical dysplasia: causes, treatment of 1, 2 and 3 degrees of dysplasia

Often, women undergoing gynecological examination, including taking tests from the vagina, doctors diagnose cervical dysplasia.

The knowledge of most women comes down to the precancerous nature of the detected abnormality. It is not always necessary to associate dysplasia with oncology, but to leave aside such a state is fraught with serious consequences.

Content

Cervical dysplasia: what is it?

Cervical dysplasia, what is it

Cervical dysplasia (neoplasia) is an appearance in the cervical integument consisting of stratified squamous epithelium, atypical cells. Atypical is the change in the shape of the cell, its structure (the appearance of multiple nuclei or an increase in the size of a single nucleus), the loss of the layered structure of the epithelium covering the neck.

Atypical for the structure of this organ, the cells begin to reproduce themselves similar, thereby replacing the healthy epithelium. All these changes occur in cancerous degeneration. However, the only sign distinguishes dysplasia from oncology: the altered cells do not spread deeper than the basal layer of the epithelium.

Pathological mutation of cells occurs at the junction of the cervical mucosa, lined with a cylindrical epithelium, and the vaginal part of the uterine cervix, covered with stratified squamous epithelium. Initially, atypical inclusions form in the basal layer of the epithelium, then capture more and more superficial layers.

At the same time, not only the correct shape of typical cells disappears, but also the boundary between epithelial layers is blurred. Depending on the layer-by-layer localization of mutated cells, there are several stages in the development of the disease.

Dysplasia of the cervix 1 degree (CIN 1)

Mild cervical dysplasia involves the detection of altered epithelium only in the deepest layers. Atypical cells are located in the lower third of the epithelium, the basal layer.

Neoplasia 2 degrees (CIN 2)

Moderate dysplasia is the spread of the process of replacing the normal epithelium with altered cells into the cervical integument. The lesion of the epithelial layer varies in the region of 1/3 - 2/3.

Grade 3 dysplasia (CIN 3)

Severe cervical dysplasia - called non-invasive cancer, captures all epithelial layers, but does not go beyond the boundaries of the basement membrane.

This classification demonstrates the different stages of the formation of atypical lesions on the cervix, which, without proper treatment, eventually leads to oncology. However, the process does not always progress.

Causes of cervical dysplasia

Causes of cervical dysplasia

Cell mutation is far from a spontaneous process. In order for cells to change their structure and begin to randomly divide, it is necessary to break the protective barrier, which is a complex mechanism for controlling the process of cell division and the destruction of abnormal elements.

For such a failure, as a rule, it is necessary to influence several of the factors listed below:

  • infection with the oncogenic type of papillomavirus (HPV) is the most common cause of the appearance of atypical cells in the cervical epithelium, the most dangerous type 16 and 18 have a high risk of carcinogenicity;
  • long-term (more than 5 years) contraception combined hormonal pills;
  • burdened heredity - genital oncology in blood relatives;
  • trauma mucosa - abortion, multiple births;
  • immunodeficiency - stress, malnutrition, chronic infections in the body, long-term treatment with antibiotics and corticosteroids;
  • frequent or untreated infections of the reproductive system;
  • alcohol, active / passive smoking - increase the risk of dysplasia by 4 times.

Women are at risk for precancerous neoplasia:

  • sexual intercourse since the age of 14-15;
  • unscrupulous in choosing partners;
  • having many children;
  • with a large number of abortions in history;
  • leading asocial life;
  • neglecting basic hygiene and condoms.

In post-menopausal women and those who have had their ovaries removed with a replacement with hormonal drugs prescribed by a doctor, the likelihood of dysplastic pathology does not increase.

Symptoms of cervical dysplasia

Symptoms of cervical dysplasia

Cervical dysplasia does not give specific signs. Women often complain of concomitant inflammation:

  • unusual discharge;
  • itching and burning sensation in the perineum;
  • spotting during sexual intercourse;
  • pain, as a rule, is absent and can occur when the tender mucous membrane of the cervix is ​​traumatized during sexual contact.

Neoplasia does not provoke sterility and does not adversely affect the developing fetus. In addition, hormonal changes during pregnancy cause a physiological change in the cervix, which is often mistaken for dysplastic processes.

The cylindrical epithelium moving from the cervical canal emerges from the external pharynx of the cervix in the form of a red corolla (ectropion or pseudo-erosion).

Diagnostics

Pathological changes are found in the following studies:

  • gynecological examination of the uterine cervix in the mirrors - whitish plaques that practically do not change color when stained with Lugol solution (Schiller testing);
  • colposcopy - pale color of the dysplastic focus, increased blood circulation;
  • Cytology (PAP-test) - detection of atypical cells (sensitivity increases with severe neoplasia) and HPV markers
    targeted biopsy and histology of the material taken;
  • PCR analysis is an immunological study that detects HPV infection.

Methods and means of treating cervical dysplasia are selected depending on the results of diagnostic examination.

Treatment of cervical dysplasia 1 degree

Treatment of cervical dysplasia 1 degree

Since in most cases the slight degeneration of the epithelial layer and the papillomavirus that caused it self-eliminated within 1–2 years, in the treatment of grade 1 cervical dysplasia:

  • regular observation by a gynecologist, including annual cytology and colposcopy;
  • full treatment of vaginal inflammation;
  • replacement of combined oral contraceptives with alternatives;
  • elimination of endocrine disorders and strengthening the immune system;
  • lifestyle correction - good nutrition, refusal from cigarettes, adequate hygiene.

With the ineffectiveness of these recommendations and the fixation of grade 1 dysplasia, after 2 years it is possible to process the changed focus with chemical agents - Vagotid, Solkogin.

Treatment of cervical dysplasia 2 and 3 degrees

Developing neoplasia requires a more radical approach, correction of lifestyle and removal of inflammation in the treatment of cervical dysplasia 2 and 3 degrees is not enough, surgery is required.

  • Electrocoagulation is the removal of atypical cells by burning with electric current. Available financial method does not allow you to adjust the depth of impact. In the stage of healing, it often forms coarse scars that prevent the opening of the cervix in subsequent births.
  • Cryodestruction - freezing of the modified area with liquid nitrogen. Does not leave scars (indicated for the treatment of nulliparous patients), is fraught with long-term (up to 1 month and more) fluid flow.
  • Laser coagulation - evaporation of the altered epithelium by means of a laser. To avoid damage to healthy cells, a woman should not move / flinch during the procedure. High efficiency due to the ability to adjust the depth of exposure.
  • Radio wave treatment - removal of cervical dysplasia 2, 3 degrees due to heating by high-frequency radio waves. Rapid recovery, lack of scars and high precision of processing determine the absence of relapses and complications. It is used in non-women. Quite an expensive method of treatment.
  • Conization of the cervix with dysplasia - surgical excision of the pathological formation. The most traumatic intervention is not recommended for women of childbearing age. In the presence of special equipment in the clinic, the removal of a neoplasia with a scalpel is replaced with a laser excision. This reduces the likelihood of postoperative bleeding and infection, and healing is faster.

Minimally traumatic operations for cervical dysplasia 2 degrees are performed on an outpatient basis, immediately after the end of menstrual bleeding and in most cases do not require general anesthesia.

In any case of surgical treatment, it is necessary to abandon sexual intercourse, taking a bath and visiting a sauna / pool, visiting beaches and a solarium. At the end of the menstrual period after surgery, a gynecological examination is necessary.

Forecast

The prognosis for cervical dysplasia is clearly dependent on the degree of pathology:

  • When diagnosing light neoplasia, only in 1% of cases there is a transition to moderate and severe degree.
  • In patients with identified CIN 2, the severe precancerous form develops only in 16% of cases in 2 years and in 25% of cases in 5 years.
  • Severe form of neoplasia (grade 3) becomes invasive cancer (spread of altered cells beyond the basement membrane) in only 12–32% of patients.

These figures indicate the need for timely detection (preventive examinations) and treatment of the identified pathology. Only a complete lack of attention from the woman herself threatens her with serious consequences.

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