It promotes the transformation of the human body tissue from benign to malignant.Early testing for HPV allows us to estimate the likelihood of developing cervical cancer.
It is very important, because according to statistics, about 90% of the world's population are infected with the virus.
beginning of the degeneration of the tissue is the presence of dysplasia, which is the preliminary stages of oncological process.
Its essence lies in the pathological changes of the epithelial cells and the relationships between them.The term "dysplasia" is replaced by "cervical intraepithelial neoplasia" In modern medicine.
cervical dysplasia dysplasia in most cases develops due to HPV infection.The latter takes on a more aggressive course, when combined with the presence of the herpes virus in the body (especially the second type).He performs a contributory factor that triggers carcinogenesis process
Papillomavirus has a lot of variations in the structure on which strains of the virus is isolated (in present they are about 70).While some may cause these or other clinical manifestations, and others - and can not cause.The virus is characterized by a tropism to the epithelial cells of the skin and mucous membranes.
degree oncogenic risk will depend on the strain that caused the infection.Therefore distinguish strains with low-risk, medium and high oncogenic risk.
Cervical Dysplasia 1, 2, 3 degrees
There are three main types of cervical dysplasia of the epithelium, which determine the risk of malignant transformation.
first degree of dysplasia, dysplasia or light, characterized in that the cells that do not have defined differentiation in the area of 1/3 of the total thickness of the epithelial layer from the surface to the basement membrane.If this moderate dysplasia, they are found at the site of 2/3 of the entire thickness of the epithelium.In severe dysplasia they penetrate more than 2/3 of thickness of epithelial layer.
In the same category is included and preinvasive cancer.To differentiate between them is not possible.But due to the same high risk for women tactics of treatment should be the same.
Symptoms of cervical dysplasia
cervical intraepithelial neoplasia, or dysplasia, can be combined with warts and papillomas.They can be localized in the genitals, soles, mucous membranes of the respiratory tract, etc.
This combination of symptoms and the doctor should touch up on the idea of finding precancerous process.
In general, cervical dysplasia are asymptomatic.During the inspection in the mirror may show areas of erosion or keratinization.In this case, be sure to conduct more targeted diagnostic search.
diagnosis of dysplasia
Depending on the severity of the changes in the epithelium of cervical dysplasia is classified into three grades:
- colposcopy with a detailed study of the diseased portion
- cytology smears
- histological examination, which puts an end to the establishment of the correct diagnosis.
addition koylotsitov can also be found:
- dead skin cells and keratinizing epithelial
- cells with two nuclei
Thus, 30% of false negative results can be obtained, that is, if it is not diagnosed dysplasia.Therefore, the detection of pathological changes in the cytological smear is shown holding a histological study that evaluates the degree of dysplasia.
It includes biopsy of pathologically altered areas of the neck and / or the separate diagnostic curettage of the cervical canal.The main histological features of dysplasia is considered to be the following:
- cell nucleus becomes larger
- its shape becomes irregular
- more intense staining
- nucleus various options for the structure of the nuclei in one material
- large number of mitotically dividing
- abnormal mitosis
- broken or missing cell maturation.
- 1) Polymerase chain reaction, allowing to estimate the specific strain and its degree of carcinogenic risk.
- 2) serology, which determines the antibodies to these viruses.
Treatment of cervical dysplasia
mainly use surgical and destructive treatment of cervical dysplasia.Let us examine in more detail what method is best to use.
- 1) destructive, in which destroyed the pathological cervical epithelium (the use of laser, cryotherapy, diathermocoagulation)
- 2) Surgical, implying the removal of the tissue.This includes all types of excisions.
efficiency of this method ranges from 70 to 97% in the treatment of epithelial dysplasia ektotservikalnogo.A significant disadvantage of this treatment is the inability to control the depth of the tissue.In addition, quite often may develop complications:
- scarring, including deforming the cervical canal (this may further affect the process of opening the cervix during labor, so nulliparous diathermocoagulation not recommended)
- constant pain during the healing period
- the possibility of relapse
- violation of ovarian-menstrual cycle
- exacerbation of chronic inflammatory processes of genitals.
- 1) Poor penetration ability in tissue
- 2) The need for a repetition of freezing
- 3) lymphorrhea - sustained release watery discharge from the genital tract
- 4) The possibility of recurrence.
Laser vaporization is a modern destructive treatment for cervical dysplasia epithelium based on application of laser energy.Its main advantage - it is the complete removal of a diseased site, as well as monitoring the impact of depth.It does not cause the development of scars, so used in the treatment of nulliparous women.The effectiveness of it reaches almost 100%, but sometimes can be and 70%.
Excision is the removal of the altered portion of the epithelium.It is produced when the pathological process involves endocervical as well as when there is a severe dysplasia.In the case of severe scar cervical strain without this procedure also can not do.
Prediction and prevention
The outcomes of cervical dysplasia can be:
- spontaneous regression
- regression as a result of the treatment
- rebirth in squamous cell carcinoma (cervical cancer).
- 1) Early detection of infection with papilloma viruses, and treatment
- 2) Exclusion of casual sex
- 3) The use of condoms during sexual intercourse with an unvisitedpartner
- 4) Conduct specific prevention through vaccination.Currently, there are two major vaccine "Cervarix" and "Gardasil" in the pharmaceutical market, which are able to initiate an immune response against HPV.The optimal time for their introduction is the age before the sexual activity began.However, the upper age limit is 26-30 years.
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