Cervical dysplasia

Cervical dysplasia is a pathological process of normal cell degeneration of the cervix epithelium into atypical cells.Most often, dysplasia occurs in the transition zone of the ciliary epithelium of the cervical canal into the multilayered flat epithelium of the cervix.

Dysplasia is a precancerous process. In the absence of treatment, grade III dysplasia necessarily transforms into squamous cell carcinoma, but with timely treatment, complete recovery from this ailment is possible.

Cervical dysplasia: what is it?

Today, dysplasia of the cervix is ​​a fairly common disease. According to experts, every year the number of women who are diagnosed with such an unpleasant diagnosis is steadily growing. Often dysplasia affects women of childbearing age. Most of the patients seeking help from specialists are 25-35 years old.

Why does cervical dysplasia occur, and what is it? The cervix is ​​part of the uterus that is in the vagina. This is a tight muscular ring, in the middle of which there is a cervical canal that connects the uterus cavity and the vagina. Normally, the neck is covered with a cylindrical epithelium - this layer of mucus protects tissues from the harmful effects of the external environment. Dysplasia is a condition in which there is a disruption in the growth and development of cells. With dysplasia of the cervix, the mucosal epithelium begins to degenerate, losing its protective functions. This process captures deeper tissues.

Dysplastic degeneration can go on to the oncological - then squamous cell carcinoma of the cervix develops.

Causes of dysplasia

To date, many causes have been identified that contribute to the emergence of cervical dysplasia. Conditionally they can bedivided into two groups:

1. Infection with human papillomavirus (HPV) of oncogenic type. This cause of cervical dysplasia in 90-95% of all cases of the disease is a priority.
2. In 5-10% of cases of development of dysplasia are inflammations of female genital organs of a protracted nature, background caused by pregnancy, menopause and / or prolonged intake of hormonal contraceptives.

It is known that more than 95% of cases of cervical dysplasia are detected by HPV. But the infection of HPV does not necessarily lead to the development of the disease, this requires certainpredisposing factors:

• pattern of sexual behavior;
• the early age of the first sexual intercourse (up to 16 years);
• a large number of births;
• long (more than 5 years) use of hormonal contraceptives;
• individual genetic predisposition to gynecological malignant processes;
• sexually transmitted infections;
• HIV infection;
• number of sexual partners (more than 3);
• smoking (active and passive);
• long-term use of intrauterine contraceptives;
• deficiency of vitamins A, C and beta-carotene in the diet;
• the history of cytological smears with abnormalities;
• low social level.

The detection of HPV in women with cervical dysplasia is of great prognostic importance and plays a role in addressing the need for treatment and the choice of its methods.

Cervical dysplasia of 1, 2, 3 degrees

Depending on how much the mucosa is damaged, three degrees of cervical dysplasia are distinguished. The deeper and stronger the changes, the heavier the form of the disease.

• 1 degree of cervical dysplasia. Affects individual cells of the epithelium of the mucosa, located, as a rule, in its uppermost layers, has no characteristic features and is difficult to diagnose. Determine the disease at an early stage of its development can be resorted to by screening.
• 2 degree of cervical dysplasia. There are obvious changes in the state of the epithelium, which affect up to 2/3 of the thickness of the epithelium.
• 3 degree of dysplasia of the cervix.It is characterized by the defeat of more than two thirds of the epithelial layer. Morphological changes are very pronounced. For this stage, the appearance of pathological mitosis, as well as the presence of huge hyperchromic nuclei of cells

At any stage, there are enough optimistic predictions with the faster the treatment, the less cancer there is in the cancer.

Symptoms

At all stages of dysplasia of the cervix, the symptoms are almost absent, or are scarce and nonspecific. Only in some cases, usually in severe forms of the disease, there are pulling weakly expressed pains in the lower abdomen, the secretion of the vaginal secretion may increase, sometimes it acquires an unusual unpleasant odor.

Also, vaginal discharge can acquire a rusty color due to the impurity of blood, such a symptom of cervical dysplasia sometimes appears after sexual intercourse. In the vast majority of cases, pathology is detected during the prophylactic examination, before any complaints appear.

A photo

How does dysplasia of the cervix in the photo:

Diagnostics

Due to the fact that dysplasia does not have the characteristic clinical signs, the diagnosis is established on the basis of a physical examination in conjunction with laboratory analyzes and instrumental methods:

1. Gynecological examination using vaginal mirrors. The goal is to detect changes in the mucosa visible to the eye.
2. Colposcopy, which is the next stage in the diagnosis of the disease. It is carried out by women who, as a result of cytological examination of smears, showed abnormalities.
3. A sighting biopsy is performed during colposcopy. A piece of tissue is excised from the suspicious area of ​​the cervix for subsequent histological examination.
4. The histology of the biopsy is a histological examination of the material taken from the biopsy. This is the most informative diagnostic method of dysplasia.
5. Cytology of the Pap smear is a study of the scraping of the mucous membrane of the cervix by a microscope. Promotes the detection of cellular atypia and HPV marker cells.

Biopsy is the main method of diagnosing this disease, as it allows you to study not only the structure of cells, but also the architectonics of epithelial layers.

Treatment of cervical dysplasia of 1, 2, 3 degrees

The tactics of the doctor when choosing a method for treating cervical dysplasia depends on the patient's age, the size of the pathological focus, the presence of concomitant diseases, the degree of dysplasia.

Patients with mild dysplasia (grade 1) are treated conservatively. With moderate (grade 2) and severe dysplasia (grade 3), and also in the absence of effect in the treatment of mild dysplasia, the following can be used:

1. Laser-polarization- The method is based on the action of a low-intensity laser beam on the damaged foci of the cervix, which pathological tissues are destroyed by heating, forming a necrosis zone at the junction with a healthy tissue.
2. Diathermocoagulation- the essence of the technique consists in the destruction (destruction) of the pathological focus by an electric current of high frequency, which is fed to the electrode (loop), which contacts the neck. As a result, necrosis (death) of atypical epithelial cells occurs, and a scab is formed at the burning site.
3. Cryotherapy -destruction of the dysplasia focus with liquid nitrogen with a very low temperature. As a result, atypical cells are destroyed and rejected.
4. Knife conization of the cervix- surgical intervention, during which the conical section of the cervix is ​​removed (as a rule, it is made by a diathermocoagulant loop after anesthesia).
5. Amputation of the cervix.

Contraindicationsto surgical treatment:

• pregnancy;
• adenocarcinoma;
• infection of the cervix and vagina;
• inflammatory diseases of the pelvic organs.

At 1 and 2 degrees of dysplasia, small sizes of the changed zone, the young age of the patient is often chosen expectant management in view of the high probability of independent regression of cervical dysplasia.

How to treat dysplasia of the cervix of the third degree should be determined only by a specialist, and only after a comprehensive examination. Women who are diagnosed with cervical dysplasia of grade 3 treatment, the reviews leave encouraging: the postoperative period proceeds without severe pain, and in the subsequent absence of the cervix or its site does not interfere with normal life at all.

Forecast

Early detection of cervical dysplasia, appropriate diagnosis and treatment, further regular medical monitoring can cure almost any stage of the disease.

After applying surgical techniques, the incidence of cervical dysplasia is 86-95%. The recurrent course of cervical dysplasia is observed in 5-10% of patients who underwent surgery, due to carriage of human papillomavirus or incomplete excision of the pathological site.

In the absence of treatment, 30-50% of the cervical dysplasia degenerates into invasive cancer.

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