Cervical cone biopsy at 3 degrees of dysplasia

Cervical dysplasia is a precancerous pathology, which is characterized by the growth of abnormal cells in the epithelium. Dysplasia refers to one of the most frequently diagnosed disease in women of reproductive age. In another pathology called preinvasive oncology or cancer in situ.

The cervix is ​​part of the reproductive system, which connects the uterine body and vagina cervical canal. Cervical canal helps prevent infection of the vagina into the uterus, which is sterile. This is achieved thanks to the narrowness of the anatomical canal and the presence of special glands producing protective mucus. channel cylindrical surface lined with single layer cells.

A significant part of the cervix is ​​not available for inspection. Gynecological examination can visualize only its vaginal portion, which cover the flat multilayer cellular elements.

cervical epithelium consists of several layers:

• basal;
• intermediate;
• surface.

The deepest layer called the basal contains immature round cells with a large nucleus. As they mature, they rise, undergoing flattening. When dysplasia this natural process is disrupted. Cells acquire the attributes of atypia.

Atypical or atypical cells are intermediate between malignant and healthy. Unlike normal, atypical cells may be of any shape and may include more than one core.

When dysplasia structural changes occur in the cervical epithelium. Normal division into layers is also lost.

In the development of dysplasia grade 3 was isolated.

1. The pathological process involved no more than one third the thickness of the epithelium.
2. Defeat more than a third of the cervical epithelium.
3. The spread of abnormal cells more than half the thickness of the epithelium.

Dysplasia is considered to be 3 degrees preinvasive cancer and different from cancer lack of germination of malignant cells in the stroma. At 3 degrees clinicians resorting to surgical treatment, e.g., cervical conization.

Causes of

In modern gynecology proved a direct link between the appearance of dysplasia, particularly of 3 degrees, and HPV. This virus, flagging the cell, causing cell mutation. Often, however, for the development of the pathological process must be the effects of some negative factors:

• burdened family history;
• chronic inflammatory and infectious processes in the pelvis;
• disorders of the immune system;
• smoking;
• hormonal imbalance;
• onset of sexual activity at a young age;
• cervical injury;
• disorderly sex life.

The clinical picture in dysplasia in most cases, is absent. Characteristic signs usually occur with the progression of disease in 3 degrees and after joining infection.

Among the symptoms in the development of dysplasia grade 3 can be identified:

• nagging pelvic pain;
• discomfort of the genital organs;
• abnormal discharge, which may be accompanied by an unpleasant odor;
• contact isolation during intercourse and pelvic exam.

The lack of symptoms in dysplasia necessitates regular checkups and surveys. Timely diagnosis and surgical treatment, which is at grade 3 dysplasia typically includes electroconization provide complete recovery women

Diagnosis and treatment

To identify pathology following techniques:

• gynecological examination;
• smear on onkotsitologiyu;
• PCR study;
• extended colposcopy;
• biopsy;

• blood tests for tumor markers, syphilis and HIV;
• bakposev and general smear;
• Hormone diagnostics;
• Pelvic ultrasound.

The main research method is a cytological diagnosis, which is a sampling of material from the different areas of the cervix to detect abnormal cells and inflammation.

Upon detection of atypical cells the patient is assigned to extended colposcopy using special reagents, and in oncological alertness - cervical biopsy.

dysplasia treatment mainly surgical grade 3 which most often is conization. At the initial stage, or when pregnancy is possible to use observational tactics. The patient visits the doctor regularly and is undergoing tests.

Progression of disease is an indication for the use of surgical techniques.

• Cone biopsy. This intervention refers to the organ-tactics. The operation involves the removal of cervical region including atypical tissue, in the form of a cone. Amputated tissues contain fragments of the cervix and cervical canal. Manipulation is carried out both for diagnostic and therapeutic purposes.

cervical cone biopsy can be performed in different ways.

1. Knife. The operation is performed with a scalpel. In this modern gynecology cone biopsy is used infrequently due to high trauma. In addition, there are more efficient and sparing technique.

2. Laser. Cone biopsy using a laser beam is considered to be the most expensive.

3. Electroconization. In another way, this intervention is called loop conization. This is the most common kind of conization.

• High amputation. With such tactics occurs radical cervical ablation, which is recommended for grade 3 dysplasia and oncological alertness. high amputation method allows you to stop the progression of the malignant process.

Before the cone biopsy and other surgical procedures woman performs the necessary tests:

• general and biochemical blood test;
• diagnosis of syphilis and hepatitis;
• general urine analysis;
• Smear on the flora;
• swab by PCR;
• colposcopy;
• a biopsy.

cervical cone biopsy can have negative consequences.

• When changes conization cervical anatomy. As a result, the cervical canal remains extended, which may lead to chronic infections.
• There is a risk of relapse in the case of the technical complexity of the conization, which is caused by certain anatomical features of the cervix.
• Once formed ability cervical conization transformed into the birth canal is lost, which causes the need for surgical delivery.
• Cone biopsy does not affect the reproductive capacity of women, however, it increases the risk of miscarriage and premature birth.
• When the surgeon conization difficult to calculate the depth of the impact, the result can be captured too vast tracts of healthy tissue. Sometimes in nulliparous patients doctor amputate a minor amount of the affected epithelium, leading to a recurrence of dysplasia.

In order to prevent the development of inflammation, the patient is carried out antibacterial treatment. When expressed pain syndrome is shown receiving analgesics.

Within a month after conization woman it is not recommended to use the sauna or swimming pool, lift weights and use tampons. Sex life is also prohibited due to the risk of infection and excessive attachment traumatic cervical damaged. Re colposcopy held not earlier than four months after conization.

electroconization

Electroconization is a surgical approach, in which the cone-shaped excision of the affected cervical fragment special electrodes. Medical tactic widely used in grade 3 dysplasia. After electroconization histologically studied tissue sample that allows pinpoint cervical pathology and subsequently assign the appropriate therapy.

Overall electroconization performed if there are to be:

• dysplasia grade 2 and 3;
• questionable results colposcopy;
• pathological processes of the cervical canal;
• opposite results of cytology and histology;
• grade 3 dysplasia, cervical combined with deformation;
• ineffectiveness of other treatments.

Electroconization contraindicated in inflammatory and infectious processes, and when diagnosed with cervical cancer.

Cone biopsy, in particular, electroconization, held at the beginning of the cycle. electroconization procedure is performed using a special apparatus which includes different electrodes and electric generator. The duration of the manipulation of no more than twenty minutes. The patient gives consent to the procedure that is performed under general anesthesia.

During the electroconization used plastic speculum and a colposcope. Applied to the cervix of Lugol's solution, which helps determine the absence of staining pathological sites. Then passed through a set elektropetlyu current and to a depth of several millimeters amputated selected cervical portion. The resulting, thus sending a tissue sample for histological examination.

Within a few days after electroconization observed allocation of bloody nature and pelvic pain.

The disadvantages electroconization include:

• amputiruemyh inability to control the depth of tissue;
• the possibility of bleeding and infection merger;
• scar formation;
• narrowing and fusion of the cervical canal;
• recurrence of dysplasia;
• menstrual disorders;
• the risk of abortion and preterm delivery in subsequent pregnancies.

If after electroconization conducted by a woman increased bleeding, there was an unpleasant smell and intense pain, worse overall health, you should immediately contact a medical facility.

Conization represents one of the fundamental treatments for cervical dysplasia 3 degrees. If untreated, grade 3 dysplasia following complications may arise:

• proliferation of atypical epithelial sites;
• the gradual weakening of the immune system due to tumor growth;
• malignant degeneration of tumors;
• development of metastasis;
• signs of intoxication.

Dysplasia at 3 degrees is a serious disease which refers to precancerous pathologies. And even after conization conducted by the risk of relapse.