71. Precancerous lesions of the cervix. Screening methods for cervical pre-cancer and cancer.Primary and secondary prophylactic. Flashcards
what is a precancerous lesion of the cervix called ?
cervical intraepithelial neoplasia or also known as cervical dysplasia
where does CIN usually occur ?
in the squamocolumnar junction
CIN is graded into what ?
CIN 1 - mild dysplasia
Epithelial architecture mostly intact
CIN 2 - moderat dysplasia
Loss of epithelial architecture into as far as the middle third of the epithelium
Koilocytes may be present.
CIN 3 - severe dysplasia - undifferentiated neoplastic cells - known as carcinoma insitu
Loss of organized epithelial architecture
Irregular nuclei and mitotic figures can be found throughout all epithelial layers.
Basal membrane is still intact.
Koilocytes may be present
CIN is graded as I, II, or III. It refers to dysplastic cells with a defect in their nuclear/ cytoplasmic ratio and chromatin abnormalities of the nucleus
what are the signs and symptoms of CIN ?
no specific symptoms of CIN alone
abnormal or post menopausal bleeding
HPV infection of the vulva and vagina can cause genital warts or be asymptomatic
what is the cause of CIN
chronic infection of the cervix with HPV
they are increased risk in people contracting HPV which is : smoking multiple sex partners multipara women early sexual life
how is CIN diagnosed
Pap smear screening
and HPV test ; PCR: detection of HPV DNA
Histology: presence of koilocytes
conisation
Procedure: excision of a cone of cervical tissue that contains parts of both the ectocervix and endocervix
May be performed using a cold knife, electrosurgical loop (LEEP), or a laser
what is the primary prevention ?
HPV vaccine - females 9-26
and the number of doses is 3
what is secondary prevention of CIN ?
21 years and above pap smear and and HPV testing
Treatment for CIN 1?
70% of CIN 1 will regress within one yea
Therefore, it is instead followed for later testing rather than treated
treatment for CIN 2
About 50% of CIN 2 will regress within 2 years without treatment
closely monitoring CIN 2 lesions also appears reasonable
Excisional (also provides diagnostic value; e.g., LEEP, laser, and cold-knife conization) or ablative (purely therapeutic) procedures (e.g., cryotherapy or laser ablation)
