Cervical dysplasia grade 2 - a pathological process, characterized by disruption of the structure of the cervical surface epithelium cells, as well as their architectonic. In this lesion of cervical epithelium is limited to two thirds of its thickness.
GENERAL
Normally, the vaginal part of the cervix is protective. Its surface epithelium consists of three layers, the cells of which are constantly updated. In the development process of dysplastic cells disrupted normal structure with the occurrence of atypia and the correct sequence of layers of the epithelium (arhitektonika).
There are 3 degrees of the disease. If the second degree, which is considered moderate pathological changes in the cellular composition are detected in the surface and intermediate layers of the covering epithelium of the cervix, without affecting the deeply lying layers.
In modern gynecology, this term is not used practically. This corresponds to a pathological condition called "cervical intraepithelial neoplasia - CIN» (cervical intraepithelial neoplasia - CIN). Cervical dysplasia second extent (moderate) corresponds to CIN-2.
The disease most often occurs in women of childbearing age - 25-40 years.
Very often dysplasia develops against the background of existing pathological changes in the cervix - ectopic columnar epithelium, true erosions, scar deformity, and so on..
Why are there dysplasia
The main reasons for 2 degrees of cervical dysplasia are infectious inflammatory processes in the vagina, especially in combination with metabolic and hormonal disorders.
The leading role in the occurrence of pre-cancerous and cancerous processes in the surface of the cervix belongs to the human papilloma virus (HPV), which is detected in almost all women with this disease. Today found that certain serotypes of the virus (tumorigenic, e.g., 8,16, 31, 35 and so on. D.) May provoke the development of cervical epithelial atypia integumentary cells, and consequently lead to the development of dysplasia and cancer authority.
In addition to HPV, cervical change in the structure of skin cells can cause chlamydia, herpes simplex virus, cytomegalovirus, and some other infections.
The presence of various comorbidities on the part of the female reproductive system, some physical illnesses, burdened gynecologic anamnesis, reduced immunoresistance contribute to enhance the properties of an infectious pathogenic exciter.
SIGNS
Signs of the second degree of cervical dysplasia, the majority of women are absent, that is, the disease is usually asymptomatic.
Some patients with cervical dysplasia 2 degrees has increased, vaginal discharge, the occurrence of discomfort in the vulva. It is not uncommon occurrence of contact bleeding - scanty bleeding after sexual intercourse, douching, use of a tampon.
established diagnosis
Given the lack of pathognomonic clinical manifestations, to establish with certainty that it is the degree of dysplasia II, only on the basis of complaints impossible.
In carrying out the usual gynecological examination in most cases revealed any nonspecific changes: redness, change in topography, etc... Sometimes the surface of the cervix can be visually altered. Therefore, verification of the diagnosis is carried out exclusively on the results of additional research methods.
Diagnosis of cervical dysplasia of the second degree:
- Extended colposcopy with biopsy "suspicious" areas of the cervix.
- Cytological examination of pathological material with the surface of the cervix and of the cervical canal.
- Histological analysis of biopsy is the main method of accurate diagnosis of atypical process and its incidence.
- Determination of type of infection the pathogen - bacterioscopy, culture methods, ELISA, PCR, etc..
And possible related hormonal disorders need to be identified, diseases of internal organs.
Therapeutic
Only after further diagnosis, identifying the type of infectious agent gynecologist determine how to treat dysplasia of 2 degrees.
Principles of treatment of moderate dysplasia:
- Second degree of dysplasia treated comprehensively, taking into account all identified etiological and pathogenetic factors.
- Traditionally, the treatment of this disease are two approaches - conservative and surgical.
- At the same destructive surgical treatment should be carried out only after the removal of all causes that can provoke the development of dysplastic process in the cervix.
- It is necessary to carry out the correction of hormonal disorders, treatment of concomitant somatic pathology.
- Main line of conservative treatment - removal of infectious inflammation in the female genital tract to the elimination of a specific pathogen.
- Be sure to conduct a specific treatment and sexual partner.
- In order to enhance the overall and local immune body resistance carried immunomodulatory therapy.
- Conducting surgical local destruction of pathological nidus with CIN-2 is required.
- The choice of method surgical destruction depends on the location and extent of the pathological process to the cervix, as well as its presence concomitant pathologies (ectopic columnar epithelium, deformations and so on. d.).
- The most common methods are local destruction of all types of electrosurgical effects, laser and cryotherapy treatment of radio wave, knife cone biopsy.
- Postoperatively, in some women, particularly in non-compliance with the recommendations of the attending physician, sometimes there are complications - aching pain in the lower abdomen, bleeding from the genital tract and m. p. However, according to reviews, is the treatment of cervical dysplasia grade 2 is still not significantly interferes with their lifestyle.
POSSIBLE COMPLICATIONS
The main danger of this disease is the pathological process transition to the deeper layers of cervical epithelium to form a third degree of dysplasia or preinvasive cancer. In the absence of such treatment probably every five women with mild dysplasia.
Another complication of cervical dysplasia of the second degree is a recurrence of the disease, which is probably due to the insufficiently of the treatment of this pathology.
PREVENTION
In order to prevent the occurrence of dysplastic processes in the cervix every woman of childbearing age, you should regularly (at least once a year) to visit the gynecologist. It is important to make full correction of identified hormonal disorders and treatment of inflammatory diseases of the female reproductive system.
Another area of preventive measures for cervical dysplasia is a health sex life and a healthy lifestyle. As is known, frequent change of sexual partners, and the neglect of the means of barrier contraception significantly increase the risk of contracting sexually transmitted diseases, including HPV.
Carrying out specific HPV vaccination reduces the chances of contracting this type of virus and, therefore, the development of dysplasia.
FORECAST
The prognosis of cervical dysplasia 2 degrees generally favorable.
It is necessary to stress once again the importance of a comprehensive treatment of this disease and the strict implementation of all the recommendations of the attending physician. Such treatment of cervical dysplasia 2 degrees in most cases leads to complete recovery.
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