Pre-cancerous lesions of the cervix are lesions that occur in the area prior to the development of cancer and that lead to cancer. Cervical precancerous lesions are atypical hyperplasia of the cervix. The occurrence and development of cervical cancer has a gradual evolutionary process that can last from several years to decades. It is generally believed that this evolutionary process goes through several stages: hyperplasia, atypical hyperplasia, carcinoma in situ, early infiltration, and infiltrative carcinoma.
Cervical cancer is currently the only gynecological malignancy with a clear etiology associated with persistent infection with high-risk human papillomavirus (HPV), a double-stranded DNA virus with a spherical shell and a diameter of 55 nm that mainly infects the skin mucosal epithelium and causes different lesions. More than 200 HPV viruses have been identified and at least 30 are associated with mucosal infections of the genital tract. 80% of women with HPV can be infected with HPV during their lifetime and are usually cleared spontaneously within 8-10 months, with only a minority (5%) of women being persistently infected.
What are the other high-risk factors associated with cervical cancer?
1. Sexual behavior: early initiation of sexual life and multiple sexual partners.
2.Menstrual and childbirth factors: poor menstrual hygiene, prolonged periods, early marriage, early childbirth, multiple births, etc.
3, Sexually transmitted diseases caused by the inflammation of the cervix on the long-term stimulation of the cervix.
4.Smoking: intake of nicotine reduces the immunity of the body and affects the clearance of HPV infection, leading to increased risk of cervical cancer, especially squamous cancer.
5.Long-term use of oral contraceptives: the risk of cervical cancer, especially adenocarcinoma, increases twofold after taking oral contraceptives for more than 8 years.
Immunodeficiency and suppression: HIV infection leads to immunodeficiency and long-term use of immunosuppressive drugs after organ transplantation leads to increased incidence of cervical cancer.
7.Other viral infections: The association of herpes virus type II (HSV-II) with the etiology of cervical cancer cannot be ruled out.
What are the clinical manifestations of precancerous lesions of the cervix?
1.Bleeding after sex. 70%-80% of cervical cancer patients have this symptom.
2.Cervical erosion. Young women who have cervical erosion for a long time or still have cervical erosion after menopause should pay attention to it.
3.Contact bleeding, bleeding after sexual intercourse or uterine bleeding after gynecological internal examination are all signs of cervical precancerous lesions.
4. Mixed bleeding in the leukorrhea. Except for uterine bleeding caused by IUD, women with long-term mixed bleeding in the leukorrhea should be examined in time.
Can cervical precancerous lesions be cured?
80% of cervical precancerous lesions can be cured through early detection and early treatment.
Patients with cervical precancerous lesions usually do not show obvious symptoms or only have symptoms of general cervicitis, such as increased leucorrhea. There are also complaints of blood in the 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 on the basis of symptoms and signs alone and is mainly based on histological examination.
Cervical atypical hyperplasia is a precancerous lesion, which is reversible, i.e. part of the lesion can disappear naturally, but it is also progressive, i.e. the lesion can develop and even become cancerous. Its reversibility and progressiveness are related to the extent and degree of lesions.
Mild atypical hyperplasia is significantly more likely to disappear spontaneously than moderate or severe. The possibility of severe atypical hyperplasia developing into cancer is significantly greater than that of mild and moderate. Some scholars also believe that mild cervical atypical hyperplasia, which is a benign abnormal proliferation, can naturally turn into normal.
What are the diagnostic methods of cervical precancerous lesions?
1.Cervical cytological examination
(1) Pap smear: It is the traditional cervical cytology examination, and its wide application has successfully reduced the incidence and mortality rate of cervical cancer by about 70% in the past 50 years. However, due to the high rate of false negatives and missed diagnoses, Pap smear no longer meets the needs of today’s medical services and is gradually being replaced by more advanced screening methods.
(2) TCT cervical thin-layer liquid-based cytology: a new cytology technique invented in the late 1990s, which observes cervical cells under a microscope to see if there are abnormalities in cervical cells. It is because cervical cancer starts from the abnormalities of cervical cells at the earliest.
TCT can significantly improve the detection rate of cervical cancer and precancerous lesions, and is the most widely used cervical cytology examination method worldwide.
2.Human papillomavirus HPV test: to detect high-risk incidence group and for further examination.
3.Electronic colposcopy: After TCT thin layer liquid-based cytology test, if abnormal cervical cells are found, colposcopy is required. Under electronic colposcopy with high magnification of 40 times, it is important to observe the subtle changes in the surface layer of cervical precancerous area, which is valuable for early detection and early diagnosis of cervical cancer and precancerous lesions.
4.Cervical iodine test examination.
5.Cervical and cervical canal biopsy: If abnormalities are found in colposcopy, biopsy should be taken under the guidance of special staining. Under the prompt of colposcopy, multi-point biopsy of suspected lesions and separate histopathological examination can confirm the diagnosis of cervical lesions.
6.Cervical conization pathological examination.
7.Vaginal cytology examination.
After the above examinations, cervical lesions can be identified and early stage of cervical cancer can be detected and prevented before it happens.
How to prevent cervical precancerous lesions?
1.Strengthen health education, raise the awareness of prevention, avoid premature sex and eliminate sexual confusion.
2.Gynecological examination should be done regularly. Married women are recommended to have cervical cytology examination at least once every two years, and further pathological examination should be done if problems are found.
3. For cervical lesions and reproductive system infections that have been detected, especially HPV infection, corresponding treatment measures should be actively taken to prevent the occurrence and development of cervical cancer.
What are the early symptoms of cervical cancer?
1. Vaginal bleeding. Irregular vaginal bleeding is the main symptom of cervical cancer patients, especially postmenopausal vaginal bleeding should be noticed. The amount of vaginal bleeding can be large or small, and vaginal bleeding is often caused by the rupture of tumor blood vessels, especially vegetable type tumor, which shows bleeding symptoms earlier and in larger amount.
2.Increased vaginal discharge. This is the main symptom of cervical cancer patients. It mostly occurs before vaginal bleeding. Initially, the vaginal discharge may not have any smell, but with the growth of cancer tumor, the secondary infection and necrosis of cancer tumor, the discharge will increase, such as rice water-like or mixed with blood, and with foul smell. When the tumor spreads upward and involves the endometrium, the secretion is blocked by the cancerous tissue of cervical canal and cannot be discharged, which can form fluid or pus in the uterine cavity, and the patient can have symptoms such as lower abdominal discomfort, abdominal pain, back pain and fever.
3.Urinary frequency, urinary urgency and pain. When the cancer spreads to the front, it can invade the bladder, and the patient may experience drop and urinary frequency, urgency, painful urination and hematuria, which are often misdiagnosed as urinary tract infection and delay the diagnosis. In serious cases, vesicovaginal fistula can be formed.
4.The cancer can spread backward and invade the rectum, and there are symptoms such as falling, difficulty in defecation, urgency, blood in stool, etc. Further development can lead to vaginal-rectal fistula.
What are the symptoms of late stage cervical cancer?
1.Distant metastasis may appear in the late stage of the disease. The metastasis site is different and so are the symptoms. The more common one is supraclavicular lymph node metastasis, in which nodes or lumps appear. Cancer infiltration can spread to distant organs through blood vessels or lymphatic system and metastases can appear in the corresponding parts, with corresponding symptoms.
2. Pain. This is a symptom of advanced cervical cancer. The cancer tumor extends along the parietal tissue, invades the pelvic wall and presses the peripheral nerve, which is clinically manifested as persistent pain in the sciatic nerve or one side of sacrum and iliac region. The tumor compresses or encroaches on the ureter, and the narrowing and obstruction of the duct leads to hydronephrosis, which is manifested as back pain on one side or even severe pain, and further develops into renal failure, resulting in uremia. The invasion of lymphatic system leads to blockage of lymphatic vessels and obstruction of reflux, resulting in swelling and pain of lower limbs and other symptoms.
What do we need to pay attention to in the dietary management of cervical cancer?
1. Early stage of cervical cancer generally has less impact on the function of digestive tract, so it should mainly enhance the patient’s ability to resist disease and improve immune function, and should supplement nutrients as much as possible, and protein, sugar, fat and vitamins can be reasonably consumed.
(1) When the patient has a lot of vaginal bleeding, he should take some blood-supplementing, hemostatic and anti-cancer foods, such as lotus root, coix seed, hawthorn, black fungus, umeboshi, etc.
(2) When the patient’s leucorrhea is watery, it is appropriate to nourish, such as turtle, pigeon egg, chicken, etc. When the patient’s belt is sticky and smelly, it is advisable to eat light and damp products, such as coix seeds, adzuki beans, white fungus root, etc.
2, after surgery: dietary regimen to nourish the blood, the essence of the meal, such as yam, cinnamon, mulberry, wolfberry, pig liver, snapper, sesame, donkey skin gum, etc..
3, radiotherapy: diet nourishes blood and nourishes yin, such as beef, pig liver, lotus root, fungus, spinach, celery, pomegranate, rhizome, etc. If radiotherapy causes radioactive cystitis and radioactive proctitis, meals that clear heat and dampness and nourish yin and detoxify should be given, such as watermelon, coix seed, adzuki bean, water chestnut, lotus root, spinach, etc.
4.When chemotherapy: dietary regimen to strengthen the spleen and nourish the kidneys, available yam powder, coix rice porridge, animal liver, placenta, aconite, turtle, fungus, wolfberry, lotus root, banana, etc. In case of gastrointestinal reactions, nausea, vomiting and loss of appetite, meals to strengthen the spleen and stomach should be used, such as sugar cane juice, ginger juice, umeboshi, banana, kumquat, etc.
5.Late stage of cervical cancer: foods with high protein and high calorie should be chosen, such as milk, egg, beef, snapper, adzuki bean, mung bean, fresh lotus root, spinach, winter melon, apple, etc.
What are the dietary contraindications of cervical cancer?
1.Cervical cancer is caused by stagnation of qi and blood, coagulation of phlegm and dampness, and accumulation of poison and heat. Diet should avoid fatty, sweet and alcoholic, spicy and fragrant, fried, baked and fried foods that produce moisture, phlegm and heat, which are easy to cause bleeding.
2, the patient leucorrhea more watery, avoid eating cold, melons and fruits, cold food and hard indigestible food; with more sticky, smelly, avoid eating nourishing and greasy products.