Localized low-grade squamous intraepithelial lesion of the cervix

Most women suffer from gynecological diseases. The prevalence of gynecological diseases is very high, and the severity of the disease varies from person to person, ranging from mild to life-threatening. In the past, due to women's lack of attention to the uterus and backward medical technology, many cervical diseases were not effectively treated. Cervical cancer is also divided into low-grade and high-grade. Today, let us learn about local low-grade squamous intraepithelial lesions of the cervix.

The term CIN was first used in the 1970s and

Pathological diagnosis was widely used in the 1980s. However, a large number of studies in the past 20 years have revealed that cervical cancer and precancerous lesions are related to HPV infection. Further studies have found that CIN is not a single continuous lesion of varying degrees, but can be divided into two types of lesions with significantly different clinical pathological processes: low-grade lesions and high-grade lesions.

Understanding Evolution

(a) Carcinoma in situ

situ)

In 1886, John Williams pointed out the presence of non-invasive lesions next to invasive cervical cancer;

In 1900, Cullen recognized that this intraepithelial lesion was histologically similar to invasive carcinoma;

In the 1930s, Schottlander

and Kermauner first introduced the concept of “carcinoma in situ”;

(ii) Dysplasia and carcinoma in situ

In 1956, Reagan introduced the concept of "atypical hyperplasia" to describe the lesions between normal squamous epithelium and carcinoma in situ found in the cervical lesion screening. At the same time, atypical hyperplasia was divided into mild, moderate and severe, and it was believed that the lesions from mild, moderate and severe atypical hyperplasia to carcinoma in situ were a continuous process. At that time, it was believed that it was very important to distinguish between high-grade dysplasia and carcinoma in situ because it was generally believed that the two were lesions of different natures: high-grade dysplasia could recover, but carcinoma in situ could not. In most hospitals, patients diagnosed with atypical hyperplasia are not treated, are only followed up, or receive treatment based on other clinical data, while those diagnosed with carcinoma in situ usually require hysterectomy (different from today's treatment options!).

(III) Cervical intraepithelial neoplasia

intraepithelial neoplasia (CIN)

Research in the 1960s found that there was no difference in the biological properties of cells in atypical hyperplasia and carcinoma in situ lesions. Both were monoclonal hyperplasias with aneuploidy of nuclear DNA. Therefore, Richart introduced the concept of CIN.

CIN still divides cervical squamous epithelial lesions into three grades. CIN I and II correspond to the original mild and moderate atypical hyperplasia, respectively, and CIN III includes severe atypical hyperplasia and carcinoma in situ. CIN classification is considered to be from CIN I to

III is a type of lesion with the same etiology and biological properties but different degrees. It solves the problem of poor repeatability in distinguishing severe atypical hyperplasia from carcinoma in situ. It is believed that anyone diagnosed with CIN has the risk of developing cancer, although there are individual differences. Proper treatment can prevent cancer from occurring.

(IV) Low-grade squamous intraepithelial lesion

squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL)