Cervical intraepithelial neoplasia(CIN): Diagnosis & Treatments
Diagnosis
As mentioned above, because CIN is a pre-cancerous lesion of cervix cancer, it is important to diagnose it quickly and accurately. A proper screening test can be used to effectively diagnose it.
The most basic test is Pap smear, which is a method of sampling cells of endocervix and exocervix. Specificity is high, but sensitivity is low, which is a disadvantage of this test, so additional testing is needed. Colposcopy is performed in patients with abnormal Pap smears. Biopsy can be performed by looking at the colposcopy. There is a procedure called Conization which can diagnose and treat at the same time.
After these tests are performed to diagnose pre-cancerous lesions, they are classified according to the results. The Pap smear classification includes atypical squamous cell (ASC), low grade squamous intraepithelial lesions (LSIL), and high grade squamous intraepithelial lesions (HSIL). In addition, CIS 1,2,3 and CIS are classified according to biopsy results.
In Pap smear results, ASC-US should be tested regularly every 6 months. For LSIL and ASC-H, colposcopy and biopsy are performed. HSIL, AGUS colposcopy, biopsy and ECC. In the Biopsy results, ECC (-) among CIN 1 and CIN 2 are observed regularly. CIN 2, 3 ECC (+) and microinvasive cancer conization are performed.
Treatments
The first case of CIN was observed on a regular basis. About 80% of them are self-improving. However, ablation or excision can be performed if the lesion continues for more than 2 years. The way to cure CIN 2,3 has ablation or excision, and there is conization mentioned above. This is a procedure that can diagnose and treat at the same time, and can rule out invasive cancer. Patients with HSIL in the Pap smears should be enrolled in the following cases.
→ When all lesions are not visible by coploscopy
→ When SCJ is not visible in Coploscopy
→ when invasive cancer can not be ruled out
→ When CIN 2,3 is output from ECC
→ when the results of cytology, biopsy, colposcopy do not match
As mentioned above, because CIN is a pre-cancerous lesion of cervix cancer, it is important to diagnose it quickly and accurately. A proper screening test can be used to effectively diagnose it.
The most basic test is Pap smear, which is a method of sampling cells of endocervix and exocervix. Specificity is high, but sensitivity is low, which is a disadvantage of this test, so additional testing is needed. Colposcopy is performed in patients with abnormal Pap smears. Biopsy can be performed by looking at the colposcopy. There is a procedure called Conization which can diagnose and treat at the same time.
After these tests are performed to diagnose pre-cancerous lesions, they are classified according to the results. The Pap smear classification includes atypical squamous cell (ASC), low grade squamous intraepithelial lesions (LSIL), and high grade squamous intraepithelial lesions (HSIL). In addition, CIS 1,2,3 and CIS are classified according to biopsy results.
In Pap smear results, ASC-US should be tested regularly every 6 months. For LSIL and ASC-H, colposcopy and biopsy are performed. HSIL, AGUS colposcopy, biopsy and ECC. In the Biopsy results, ECC (-) among CIN 1 and CIN 2 are observed regularly. CIN 2, 3 ECC (+) and microinvasive cancer conization are performed.
Treatments
The first case of CIN was observed on a regular basis. About 80% of them are self-improving. However, ablation or excision can be performed if the lesion continues for more than 2 years. The way to cure CIN 2,3 has ablation or excision, and there is conization mentioned above. This is a procedure that can diagnose and treat at the same time, and can rule out invasive cancer. Patients with HSIL in the Pap smears should be enrolled in the following cases.
→ When all lesions are not visible by coploscopy
→ When SCJ is not visible in Coploscopy
→ when invasive cancer can not be ruled out
→ When CIN 2,3 is output from ECC
→ when the results of cytology, biopsy, colposcopy do not match
