Stenderisaspender

At a doctor’s appointment, women are often confronted with incomprehensible terms: “erosion”, “ectopia”, “colposcopy” and others. Sometimes in the analyzes you can see words such as “dysplasia”, “CIN”, “LSIL”, “HSIL”. Let’s see what these and some other terms mean.

Quite often, especially in young women, gynecologists detect ectopia of the cervix (the outdated term “erosion”). Ectopia of the cervix is ​​the appearance of a columnar epithelium lining the cervical canal on the vaginal part of the cervix, that is, outside its usual location. Ectopia is asymptomatic and does not require treatment. In case of an uncomplicated course, it is necessary to regularly undergo an examination by a gynecologist, at least once a year to do a cytological examination (oncocytology) and colposcopy for the timely detection of pathological processes (including papillomavirus infection associated with cervical oncology)

Oncocytology is an absolutely painless removal of a scraping from the cervix using a special brush. Worldwide, this study is considered the only one capable of preventing the development of cervical cancer. Oncocytology can give different results:

Normal, or NILM – absent atypical cells.
CIN I, or mild dysplasia, or LSIL, is an abnormality in cells associated with the Human Papilloma Virus (HPV). Consultation of a gynecologist is required for further examination and treatment.
CIN II, or moderate dysplasia, or HSIL are more pronounced pathological changes. Urgent doctor’s consultation for examination, including HPV, treatment and removal of the altered area.
CIN III, or severe dysplasia, or HSIL is a severe lesion of the epithelium of the cervix and cervical canal, which does not exclude the occurrence of cancer, therefore, treatment is recommended to be carried out in oncological dispensaries at the place of residence. It should be noted that according to the new classification, the term HSIL combines CIN II and CIN III.

The most common examination for cervical pathology is colposcopy or video colposcopy. This is an examination of the cervix and the walls of the vagina with a special colposcope device. This device illuminates the area to be inspected and magnifies it many times, which allows you to examine in detail the cervix and vagina, the perianal area. In this case, a test is carried out with 3% acetic acid and a test with Lugol’s solution (the doctor lubricates the cervix with cotton swabs dipped in these solutions). This procedure is absolutely painless and allows you to identify inflammation, processes associated with the human papilloma virus (HPV), precancerous changes. With the help of a colposcope, you can examine the vulva area, then this study is called a vulvoscopy. The doctor may order a test for the presence of sexually transmitted infections (STIs). Inflammation caused by STIs can significantly worsen the picture of cervical pathology. In some cases, after anti-inflammatory treatment, the indicators return to normal. Screening for STIs is also very important when planning a pregnancy.

It is important to screen for the presence of HPV https://en.wikipedia.org/wiki/Human_papillomavirus_infection and determine its type. They are designated by different numbers, and have varying degrees of oncogenicity (the ability to lead to cervical cancer). Using the real-time PCR method, it is possible to carry out not only genotyping (type determination), but also to determine the amount of the virus (DNA typing of HPV (27 types) with determination of the total viral load (RT-PCR), or DNA typing of HPV (16 , 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 types) with individual viral load (RT-PCR)), as well as to determine the presence of specific E6 / E7 proteins, the presence of which indicates activity HPV and a high risk of cervical cancer.

In some cases, the doctor may recommend a genetic examination to determine the genes associated with the risks of cervical cancer (GP9 Cervical cancer – 5 genes). The result helps to determine further treatment tactics, to give the patient recommendations in terms of further monitoring and optimization of her lifestyle. The purpose of genetic tests is to reduce the risks of developing the disease.

Sometimes a biopsy of the cervix may be required, that is, the collection of small tissue particles from the most pathologically altered areas of the cervix. Curettage of the cervical canal (collection of cells directly from the canal) also allows you to clarify the diagnosis. In the future, the materials obtained are sent for histological examination, that is, a thorough examination of the samples under a microscope.

As a result of all diagnostic measures, the gynecologist may come to the conclusion that radical treatment is needed. There are a number of techniques for removing the pathological area. The radio wave method is considered one of the most effective. It allows you to make a histological examination of a remote area. It is used to treat various pathologies (CIN, or dysplasia, warts, papillomas, cicatricial deformity of the cervix, etc.). However, the risk of complications such as bleeding and scarring is extremely low.