1.What is cervical precancerous lesion? How to diagnose cervical precancerous lesions?
CIN is a collective term for a group of diseases that includes cervical atypical hyperplasia and cervical carcinoma in situ. Precancerous lesions are reversible for a considerable period of time, and the cervix is an easily exposed organ. It can be done by examining the cervix with a cancer smear such as TCT. Then testing for HPV in the cervix. Colposcopy plus biopsy can be done to rule out cervical lesions.
2.What are the risks of cervical precancerous lesions?
Cervical intraepithelial neoplasia includes cervical atypical hyperplasia and cervical carcinoma in situ, which are precancerous lesions of cervical invasive carcinoma, collectively known as ClN. cervical atypical hyperplasia and cervical carcinoma in situ have the same nature of epithelial changes, but the degree is different, with cervical atypical hyperplasia being less severe.
CIN is classified into three grades according to the degree of cellular anomalies.
Grade I: refers to mild atypical hyperplasia of the cervix.
Grade II: refers to moderate atypical hyperplasia of the uterine whiskers.
Grade III: refers to severe atypical hyperplasia and carcinoma in situ of the cervix.
All grades of CIN have the tendency to develop into invasive carcinoma. Generally speaking, the higher the grade, the greater the chance of developing into invasive carcinoma; the lower the grade, the greater the chance of natural regression. Cervical atypical hyperplasia refers to the occurrence of anomalous and atypical differentiation of some or most of the cervical epithelial cells. Cervical atypical hyperplasia can occur in the ectocervix or migratory zone or on the surface of the endocervix. Cervical carcinoma in situ refers to cervical atypical hyperplasia involving the whole layer of squamous epithelium, but not breaking through the basement membrane, not invading the mesenchyme, and the lesion is confined to the squamous epithelial layer.
3.Is cervical precancerous lesion serious?
No, it is not serious. The main cause of cervical cancer is HPV infection, but the process is long, that is to say, it takes a relatively long time to develop from HPV infection to precancerous lesion, that is, CIN, and it also takes a long time to develop from CIN to cancer, which provides me with the opportunity to detect cervical cancer at an early stage, even before it becomes cancerous, and get timely treatment. This is the ideal situation for most patients. As a group, CIN is classified into three levels, CIN I, II and III, according to the extent of the lesion.
First of all, I would like to say that CIN does not necessarily occur if you have HPV infection, but only some of them do, depending on your health condition.
Secondly, the development of CIN does not necessarily lead to cervical cancer in the future.
Therefore, for precancerous lesions, we have plenty of time to treat them. For CINI and II, physical therapy is sufficient, but for CINIII, surgical treatment, specifically at least conization, is necessary. For patients with conization, there are two purposes: one is to clarify the diagnosis and exclude occult cervical cancer, and the other is to treat it. If you have cervical precancerous lesions, it is recommended to go to a regular hospital, have Leep Knife treatment, and have regular screening.
4.Is cervical precancerous lesion cervical cancer and is it hereditary?
It is not cervical cancer. Cervical atypical hyperplasia is a precancerous lesion, which is reversible, that is, part of the lesion can disappear naturally, but it also has progressive nature, that is, the lesion can develop and even become cancerous. Its reversibility and progressiveness are related to the extent and degree of lesions. It is also related to the genetic susceptibility of the family. We have encountered many female patients who had the disease and then brought their sisters for examination and found many precancerous cervical lesions. Therefore, cervical cancer and precancerous lesions are not hereditary, but there is susceptibility. Mild atypical hyperplasia is significantly more likely to disappear spontaneously than moderate or severe hyperplasia. Severe atypical hyperplasia is significantly more likely to develop into cancer than mild or moderate. Some scholars also believe that mild atypical hyperplasia of the cervix is a benign abnormal proliferation that can naturally turn into normal.
5.What are the symptoms of cervical precancerous lesions?
Patients with CIN usually do not show obvious symptoms, or only have symptoms of general cervicitis, such as increased leucorrhea. There are also complaints of blood in leukorrhea or small amount of vaginal bleeding after sexual contact. Gynecological examination reveals a smooth cervix with no obvious inflammation, or a congested or eroded cervix, with varying degrees and ranges of erosion, which sometimes bleeds easily when touched and is not significantly different from general chronic cervicitis.
Therefore, the clinical manifestations of CIN are not specific. The diagnosis cannot be made solely on the basis of its symptoms and signs, but is mainly based on histological examination. Firstly, bleeding after sex, which is a symptom of 70%~80% of cervical cancer patients, or uterine bleeding after gynecological internal examination, are signs of cervical precancerous lesions. Fourthly, mixed blood in the leucorrhoea, except for uterine bleeding caused by IUD, women with mixed blood in the leucorrhoea for a long time should be examined in time.
6.How to treat cervical precancerous lesions?
If your cervical biopsy report has different degrees of CIN, you should follow up and treat according to the requirements of professional doctors. There is no need to panic too much or even despair because most CIN lesions are limited and the one-time cure rate of conservative treatment is as high as 97%, and CIN III has no metastasis so the survival rate is 100%.
(1) CIN I: test HPV, if HPV(-), you can follow up or anti-inflammatory treatment. If HPV(+), especially high-risk type(+), physical therapy (freezing, laser, microwave) or cervical LEEP treatment can be chosen.
(2) CIN II: preferably, LEEP treatment can be excluded at the same time as the presence of more advanced lesions. Or choose physical therapy (freezing, laser, microwave), etc.
(3) CIN III: It is better to choose cervical conization (LEEP) first to exclude cervical cancer, and hysterectomy can be done if there is no fertility requirement and no condition for follow-up.
7.Can pre-cancerous lesions in uterus be cured?
The so-called precancerous lesion refers to the lesion of the body tissue, but it is not diagnosed as cancer. If not treated, after a period of time, some patients may develop cancerous lesions. Therefore, with active treatment, mainly through surgery, the lesioned tissue can be completely cured after removal.
8.Can I get pregnant with precancerous cervical lesions?
CINI can choose to be treated first and then have children or choose to have children first and then be treated. If you are already pregnant because of cervical precancerous lesions detected during maternity checkups, you can rest assured that you can get pregnant. It will not worsen during pregnancy. You can wait until after delivery before treating precancerous cervical lesions. Do not induce labor or abortion. Otherwise, it is likely to be infertile and regret in the future.
9.Can cervical cancer be cured?
Cervical cancer is the most common malignant tumor in women and ranks first among female malignant tumors. It is mostly seen in women aged 40-50 years old, and rare in those under 20 years old. The exact cause of cervical cancer is caused by human papilloma infection, probably the following behaviors would be more considered as early marriage, early childbirth, multiple births and disordered sexual life, which may be important causative factors.
Clinical manifestations of cervical cancer are
(1) Vaginal bleeding. A small amount of contact bleeding or intermittent bleeding after menopause, increased leucorrhea in the early stage and increased bleeding in the late stage. Generally cauliflower type is easy to bleed, and infiltrative type bleeds later. Occasionally, large blood vessels are eroded, causing to life-threatening hemorrhage.
(2) Vaginal discharge. Initially, it is not much and odorless. As the cancerous tissues break down, the discharge increases and is watery. In late stage, due to necrosis of cancerous tissues and infection, large amount of rice-soup-like or purulent foul-smelling leucorrhea may appear.
(3) Pain. In late stage, due to infiltration of parametrial tissue and involvement of nerves, persistent pain may appear in thigh and lumbosacral area. In addition, if the tumor invades the bladder and rectum, abnormal urination and defecation may occur, and even fistula may be formed.
(4) When going to hospital for gynecological examination, pay attention to the lesions of the cervix, such as the texture of the cervix and whether there is contact bleeding. The cure rate of early cervical cancer is also very high.
10.How to follow up after cervical precancer treatment?
HPV and cancer smear and colposcopy will be reviewed three months after the operation. As long as all the tests are normal, you will be examined again after six months. Six times in total every six months. If they are still normal, they can be rechecked once a year. The total number of check-ups will be 20 years. If there is no problem, you can rest assured. It is most important that there is no recurrence in the first two years.
11.Do I need male contraception all the time after cervical precancer treatment?
If you have fertility requirements after cervical precancer treatment, you can have normal intercourse and do not need male contraception. If there is no fertility requirement, male contraception can be used for a period of time to achieve complete negative virus in the body.
12.Will cervical precancerous lesions recur after treatment?
It is necessary to go to the hospital for three months after LEEP for cervical precancerous lesions to check the viral smear and colposcopy in order to understand the effect of cervical lesion treatment. To find out if there are any residual lesions after the cervical wound has healed.
If there are still lesions, it is important to see if the lesions are low or high grade.
If the lesion is a low grade lesion i.e. CINI it can be treated with laser.
If the lesion is still CINII or higher, a repeat LEEP procedure is needed.
Some people with a small cervix may also need to be hospitalized and have the bladder and rectum pushed out and then have the LEEP procedure done again. Otherwise, there is a risk of injury to the bladder and rectum if done directly.