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07-SEPTEMBER-2008 03:17:44 - intraepithelial neoplasia Redirected from Cervical dysplasia Main article: dysplasia Cervical intraepithelial neoplasia CIN, also known as cervical dysplasia, is the potentially premalignant transformation and abnormal growth dysplasia of squamous cells on the surface of the cervix. Most cases of CIN remain stable, or are eliminated by the host's immune system without intervention. However a small percentage of cases progress to become cervical cancer, usually cervical squamous cell carcinoma SCC, if left untreated.1 The major cause of CIN is chronic infection of the cervix with the sexually transmitted human papillomavirus HPV, especially the high-risk HPV types 16 or 18. Over 100 types of HPV have been identified. About a dozen of these types appear to cause cervical dysplasia and may lead to the development of cervical cancer. Other types cause warts. The earliest microscopic change corresponding to CIN is dysplasia of the epithelial or surface lining of the cervix, which is essentially undetectable by the woman. Cellular changes associated with HPV infection, such as koilocytes, are also commonly seen in CIN. CIN is usually discovered by a screening test, the Papanicolaou or Pap smear. The purpose of this test is to detect the changes early, while it has not yet progressed to invasive carcinoma, and is easier to cure. An abnormal Pap smear may lead to a recommendation for colposcopy of the cervix, during which the cervix is examined under magnification. A biopsy is taken of any abnormal appearing areas. Cervical dysplasia can be diagnosed by biopsy. Hormonal treatments such as birth control pills have also been linked to higher rates of cervical dysplasia.citation needed Contents 1 Grades 2 Prevalence 3 Progression 4 Treatment 5 References Grades CIN is classified in grades: CIN1 Grade I, the least risky type, represents only mild dysplasia, or abnormal cell growth1 and corresponds to a low grade squamous intraepithelial lesion LGSIL or LSIL.2 It is confined to the basal 1/3 of the epithelium. This corresponds to infection with HPV, and typically will be cleared by immune response in a year or so, though can take several years to clear. CIN2/3 correspond to high grade squamous intraepithelial lesions HSIL.2 Sometimes this is further divided: CIN2 Grade II: Moderate dysplasia confined to the basal 2/3 of the epithelium CIN3 Grade III: Severe dysplasia that spans more than 2/3 of the epithelium, and may involve the full thickness. This lesion may sometimes also be referred to as cervical carcinoma in situ. Normal cervical epithelium HE stain. Grade I CIN. Grade II CIN. Grade III CIN. Prevalence Between 250,000 and 1 million American women are diagnosed with CIN annually. Women can develop CIN at any age, however, women generally develop it between the ages of 25 to 35. If caught early, CIN is usually curable.3 Progression Cases of CIN are thought by some to progress through these stages toward cancer in a linear fashion.145 However most CIN spontaneously regress. About 50% of CIN 2 will regress within 2 years without treatment. Progression to cancer typically takes 15 3 to 40 years. Also, evidence suggests that cancer can occur without first detectably progressing through these stages and that a high grade intraepithelial neoplasia can occur without first existing as a lower grade.16 Treatment In many cases, CIN will regress without treatment. A diet rich in fruits and vegetables, smoking avoidance and condom use increase regression of cervical dysplasia. CIN is curable, although the lifetime recurrence rate is 20%. Methods used to treat CIN require removal or destruction of the surface cells of the cervix. These methods include cryocautery, electrocautery, laser cautery, LEEP, and cervical conization. Therapeutic vaccines are also in development. References ^ a b c d Agorastos T, Miliaras D, Lambropoulos A, Chrisafi S, Kotsis A, Manthos A, Bontis J 2005. Detection and typing of human papillomavirus DNA in uterine cervices with coexistent grade I and grade III intraepithelial neoplasia: biologic progression or independent lesions?. Eur J Obstet Gynecol Reprod Biol 121 1: 99-103. doi:10.1016/j.ejogrb.2004.11.024. PMID 15949888. ^ a b Park J, Sun D, Genest D, Trivijitsilp P, Suh I, Crum C 1998. Coexistence of low and high grade squamous intraepithelial lesions of the cervix: morphologic progression or multiple papillomaviruses?. Gynecol Oncol 70 3: 386-91. doi:10.1006/gyno.1998.5100. PMID 9790792. ^ Cervical Dysplasia: Overview, Risk Factors ^ Hillemanns P, Wang X, Staehle S, Michels W, Dannecker C 2006. Evaluation of different treatment modalities for vulvar intraepithelial neoplasia VIN: CO2 laser vaporization, photodynamic therapy, excision and vulvectomy. Gynecol Oncol 100 2: 271-5. doi:10.1016/j.ygyno.2005.08.012. PMID 16169064. ^ Rapp L, Chen J 1998. The papillomavirus E6 proteins. Biochim Biophys Acta 1378 1: F1-19. PMID 9739758. ^ Monnier-Benoit S, Dalstein V, Riethmuller D, Lalaoui N, Mougin C, Prétet J 2006. Dynamics of HPV16 DNA load reflect the natural history of cervical HPV-associated lesions. J Clin Virol 35 3: 270-7. doi:10.1016/j.jcv.2005.09.001. PMID 16214397. v d e Tumors: urogenital neoplasia - genital neoplasia C51-C63/D25-29, 179-187/218-222 Female Ovaries Surface epithelial-stromal tumor, Luteoma, Meigs syndrome, Krukenberg tumor, Teratoma, Clear cell adenocarcinoma, Endometrioid tumor, Fibroma Fallopian tube Primary fallopian tube cancer, Adenomatoid tumor Uterus Uterus Uterine sarcoma, Leiomyosarcoma Endometrium Endometrioid tumor Cervix SCC, Cervical intraepithelial neoplasia Vagina Vagina SCC, Botryoid rhabdomyosarcoma, Adenocarcinoma/Clear cell adenocarcinoma Vulva Vulva Papillary hidradenoma, Extramammary Paget's disease Male Testicles Seminoma - Endodermal sinus tumor Prostate Prostate - Transitional cell carcinoma - Prostatic intraepithelial neoplasia Penis Penis Extramammary Paget's disease Male/female Sex cord-stromal tumour Sertoli-Leydig cell tumour, Thecoma, Granulosa cell tumour - Germ cell tumor - Gonadoblastoma - Brenner tumour - Embryonal carcinoma See also noncongenital, congenital Retrieved from http://en..org/wiki/Cervical_intraepithelial_neoplasia Categories: Types of cancer | Gynecology | Papillomavirus | Viral diseasesHidden categories: All articles with statements | Articles with statements since September 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages БългарÑ?ки Español SlovenÅ¡Ä?ina Svenska Tiếng Việt This page was last modified on 29 August 2008, at 07:11

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