1. “Celiac disease”: an inappropriate term In outpatient work, patients often ask: “Doctor, do I have celiac disease? Doctor, I was found to have celiac disease in another hospital, can you please help me get checked again? Does celiac disease affect pregnancy?” And so on and so forth with similar questions. So what exactly is celiac disease and does it need to be treated? ”Cervical erosion” is one of the most common diagnostic terms used in gynecological practice and has been considered the most common pathology of chronic cervicitis, a medical term translated from “cervical erosion”. Cervical erosion has been widely treated over the past few decades because it was previously thought to be a form of chronic cervicitis that caused symptoms such as increased leucorrhea and could become cancerous if it progressed. In recent years, with the increasing understanding of the mechanism of cervical erosion, the development of colposcopy technology, and the further clarification of the mechanism of cervical cancer, the obstetrics and gynecology community has come to realize that the clinical term “cervical erosion” is no longer appropriate and that it is neither synonymous with chronic cervicitis nor with cervical cancer. It is neither synonymous with chronic cervicitis nor a direct risk factor for cervical cancer, but actually “cervical erosion” is a clinical phenomenon. 2. “Cervical columnar epithelial ectasia”: a new term to replace “cervical erosion” The cervical epithelium consists of two parts, one is the cervical columnar epithelium (which looks erosive to the naked eye) and the other is the cervical squamous epithelium (which looks smooth to the naked eye). The junction between the squamous and columnar epithelium is called the “squamocolumnar junction”. Before puberty, the exposed part of the cervical surface is covered by squamous epithelium and appears smooth. After puberty, under the influence of estrogen secreted by the ovaries, the cervix gradually enlarges, causing the squamous-columnar junction to move outward and the columnar epithelium to become erosion-like, which used to be called “cervical erosion”, but now this concept has been updated to “cervical columnar epithelial ectasia”. When estrogen fluctuates in the body, such as during pregnancy and oral contraceptives, the squamocolumnar junction can migrate outward; after menopause, as estrogen levels decline, the squamocolumnar junction returns to the cervical canal and the cervix becomes smooth again. In other words, the intersection of the squamous column can move with the change of estrogen. 3.Whether “cervical erosion – cervical columnar epithelial ectopic” needs treatment The cervical erosion found during gynecological examination is only a clinical sign, to clarify whether treatment is needed, we must first clarify whether the cervical erosion is physiological columnar epithelial ectopic, or pathological cervical infection, cervical intraepithelial neoplasia, and early cervical cancer. The squamous epithelium of the cervix is smooth, resistant to disease and not easily infected by viruses and bacteria, while the columnar epithelium is thin and susceptible to infection. If it is physiological columnar epithelial ectopic, no treatment is needed; if it is other pathological conditions, appropriate treatment should be chosen according to the actual situation. So, how to distinguish between physiological or pathological “celiac disease”? The first step is to perform a cervical cytology screening, including traditional Pap staining and modern cervical fluid-based cytology (TCT). It is well established that HPV infection is the direct cause of cervical disease developing into cervical cancer, and HPV testing can be performed at the same time if available. The decision to perform colposcopy and biopsy to rule out cervical intraepithelial neoplasia and cervical cancer is based on the screening results. Physiological cervical columnar epithelial ectoplasia does not require treatment in general; for patients with infection, cervical intraepithelial neoplasia and cervical cancer, treatment is individualized according to the patient’s specific conditions (e.g. age, need for fertility, etc.). It is important to note that a smooth cervix is not the same as a normal cervix. Because the columnar epithelium of a smooth cervix is hidden in the cervical canal, the symptoms of infection and malignant lesions may appear later and are often not easily detected at an early stage. Therefore, women with a smooth cervix should also be screened for cervical disease every year after marriage.