Cervical dysplasia is a pathological process of degeneration of the normal cervical epithelial cells 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 turn into an 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. Conventionally, they can be divided into two groups :
- 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.
- In 5-10% of cases of development of dysplasia are inflammations of female genital organs of a protracted nature, hormonal disturbances 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 certain predisposing factors:
- pattern of sexual behavior;
- early age of first sexual intercourse( up to 16 years);
- a large number of deliveries;
- a long( more than 5 years) use of hormonal contraceptives;
- individual genetic predisposition to gynecological malignant processes;
- infections that are sexually transmitted;
- is an 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;
- 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 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 dysplasia of the cervix .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 dysplasia of the cervix .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. Characterized by the lesion of more than two thirds of the epithelial layer. Morphological changes are very pronounced. At this stage, the appearance of pathological mitosis, as well as the presence of huge hyperchromic nuclei of
cells. At any stage, there are optimistic enough predictions, the faster the treatment is started, the less possibilities for cancer to begin to develop its turbulent activity.
Symptoms of
Symptoms of cervical dysplasia are virtually absent in all stages of cervical dysplasia, or are scarce and nonspecific. Only in some cases, usually in severe forms of the disease, pulling low-grade pains appear in the lower abdomen, vaginal secretion may increase, sometimes it acquires an unusual unpleasant odor.
Also, vaginal discharge can acquire a rusty color due to 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.
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How does dysplasia of the cervix in the photo:
Diagnosis
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 tests and instrumental methods:
- Gynecologic examination using vaginal mirrors. The goal is to detect changes in the mucosa visible to the eye.
- 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.
- A guided biopsy is performed during colposcopy. A piece of tissue is excised from the suspicious area of the cervix for subsequent histological examination.
- Biopsy histology is a histological examination of a biopsy specimen. This is the most informative diagnostic method of dysplasia.
- Cytology of the Pap smear - a study of the microscope scraping from the mucous membrane of the cervix. Promotes the detection of cellular atypia and HPV marker cells.
Biopsy is the main method of diagnosis of 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 1, 2, 3 degrees
The tactics of a 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) undergo conservative treatment. At 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:
- Laser diodes - the method is based on the action of a low-intensity laser beam on the damaged foci of the cervix, as a result of which pathological tissues are destroyed by heating, forming a necrosis zone at the junction with a healthy tissue.
- 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.
- Cryotherapy - destruction of the dysplasia focus with liquid nitrogen with very low temperature. As a result, atypical cells are destroyed and rejected.
- Knife conization of the cervix is a surgical procedure during which the conical section of the cervix is removed( as a rule, it is made by a diathermocoagulant loop after anesthesia).
- Amputation of the cervix.
Contraindications to surgical treatment:
- pregnancy;
- adenocarcinoma;
- infection of the cervix and vagina;
- inflammatory diseases of the pelvic organs.
At 1 and 2 degrees of dysplasia, small size of the altered zone, the patient's young age often chooses expectant management because 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 pronounced 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 the application of 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.