High-grade squamous intraepithelial lesion of the cervix

High-grade squamous intraepithelial lesion of the cervix is ​​a type of cervical cancer lesion and should be further examined. Cervical intraepithelial lesions have many manifestations, such as carcinoma in situ, atypical hyperplasia, etc. Further examination and diagnosis are needed. If it is indeed a pathological condition, it should be treated promptly through surgery or other methods. Recovery should be strengthened after the operation, and follow-up examinations should be carried out regularly.

1. Carcinoma in 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) Atypical hyperplasia 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

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. The CIN classification considers that CIN I to III are a type of lesions with the same etiology and biological properties but different degrees. It solves the problem of poor repeatability in distinguishing severe atypical hyperplasia and carcinoma in situ, and believes 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 (LSIL) and high-grade squamous intraepithelial lesion (HSIL)