There are 2 main types of tumors of the cervix Intraepithelial lesions of the cervix also called cervical dysplasia. These lesions are precancerous conditions of the cervix. And invasive cervical cancers , when cancer cells have crossed the basal membrane of the cervical epithelium.Cervical dysplasia is usually asymptomatic and discovered on the Pap smear. In this case you must perform a colposcopy and biopsy for pathological examination. These lesions have the potential to evolve into cancer of the cervix thus the importance of screening.
Screening for cervical dysplasia
Cervical dysplasia is usually asymptomatic and discovered on the PAP SMEAR.Intraepithelial lesions are asymptomatic. Their detection is based on the Pap smear. The French policy of routine screening has allowed a reduction in the incidence and mortality of cervical cancer . The rate of Pap smears should be as follows: The first smears performed in the months following first act of intercourse. In the absence of an anomaly, it will be repeated every 2 years until age 65.
How is a cervical smear carried out?
The Pap test is done by your gynecologist' at their practice. It requires no special preparation. You must go outside of your cycle and in the absence of any infection. Your doctor will place a speculum without lubricant.The examination is performed with a cytobrush to collect cells from the ectocervix and endocervix.Your doctor performs a sampling of endo-cervical cells, cervical and exo-cells at the junction of endocervix and ectocervix. The cells collected are sent to the laboratory of pathology for cytological analysis. The results will be communicated promptly by your gynecologist.
Cervical smear results
Results are ranked among the following types: :-Uninterpretable smear, your gynecologist should perform a cervical smear again.- Normal smears: no cells suggests the possibility of an intra-epithelial dysplasia.-Abnormal smear: abnormal cells suggestive of intraepithelial lesion high grade or low grade.[(ANY ABNORMAL PAP TEST NEEDS A COLPOSCOPY )]
Colposcopy procedure::
If your PAP SMEAR is abnormal your gynecologist will prescribe a colposcopy. This examination will be conducted at their practise.The colposcopy should be performed between J8 and J14 of your cycle. Your doctor will observe your cervix with a colposcope (a type of binocular microscope), first without preparation and with preparation. The preparation requires coating the cervix with two successive dyes, acetic acid and then Lugol. This painting will allow your doctor to identify the junction zone between ectocervix endocervix and-dysplastic lesions. If they find suspicious areas (dysplasia), they will perform a biopsy and a pathological analysis will be performedOnly the pathologic analysis of these biopsies can diagnose intraepithelial lesions.
Possible results of biopsies: :
We can find either intraepithelial lesions of low grade, also called CIN 1 (cervical intraepithelial neoplasia type 1) or mild dysplasia, abnormal cells that are localized in the lower third of the different layers constituting your cervical epithelium. These lesions heal in 2 out of 3 cases. Or we find intraepithelial lesions of high grade. These are divided into several categories.CIN 2 and CIN 3The CIN 2 are moderate dysplasia, abnormal cells reach the 2 / 3 of your deep cervical epitheliumThe CIN 3 are severe dysplasia, abnormal cells are found throughout the height of your cervical epithelium, but do not exceed its basement membrane. These are dysplasia carcinoma in situ. This classification will guide the therapeutic action of your gynecologist
TREATMENT
Intraepithelial lesions of high grade :
We know that in 60% of cases, these lesions heal and disappear.The attitude is to recheck these lesions 6 to 9 months later and to realize the destruction in case of persistenceThe destructive treatment, when considered is performed by the laser vaporization method. It is performed in your gynecologist's practice, without anesthesia, it is in most cases painless. This technique allows the destruction of these lesions. The risk of these lesions is that they move towards high-grade lesions where the indication for destructive treatment is called for in the case of persistence of this dysplasia.
Intraepithelial lesions of high grade
The treatment of these lesions is surgical. It is performed under anesthesia. Your gynecologist will perform a cone biopsy. It can be carried out by different means: the snare, or cold knife. The choice depends on the surgeon and the characteristics of the lesion.
Les informations fournies sur ce site sont destinées à améliorer, non à remplacer, la relation qui existe entre le patient (ou visiteur du site) et son médecin.
Victor Hugo