What does high-grade squamous cervical lesion mean?

When women are undergoing examinations, they may see test results such as cervical squamous epithelial lesions. When seeing such results, most people do not know what it means. In fact, this lesion is very dangerous. It is a sign of cervical cancer. Everyone knows that cervical cancer is a very serious disease, so it needs timely treatment at this time. The following introduces relevant knowledge about cervical squamous epithelial lesions.

What does high-grade squamous cervical lesion mean?

The term CIN was a pathological diagnosis that was widely used in the 1970s and 1980s. However, a large number of studies in the past 20 years have revealed that cervical cancer and precancerous lesions are related to HPV infection. Further studies have found that CIN is not a single continuous lesion of varying degrees, but can be divided into two types of lesions with significantly different clinical pathological processes: low-grade lesions and high-grade lesions.

It is currently believed that LSIL includes flat and raised warts caused by various HPV infections, papillary immature metaplasia (PIM) in the transition zone, and simple HPV infection; HISL includes the original CINII+CINIII. Among them, flat warts in low-grade lesions can be caused by infection with about 40 different types of HPV. Genital warts are usually caused by infection with HPV types 6 and 11. The HPV virus in low-grade lesions is in the replication stage; while high-grade lesions are often accompanied by infection with a limited number of so-called high-risk HPV types (18, 16, 31, 45, and 56). Low-grade lesions represent lesions of various qualities, with different HPV subtypes, clonality, and DNA ploidy. Most of them can regress spontaneously and rarely continue to progress. High-grade lesions represent homogeneous lesions that are not easy to regress spontaneously and are more likely to develop into invasive cancer. The clinical treatment plans for the two are significantly different.

The distinction between LSIL and HSIL also corresponds well to the TBS system of cervical cytology. From then on, cytopathologists, histopathologists and gynecologists have a common language to communicate. Moreover, through cytological screening, colposcopy and histological diagnosis, plus HPV DNA testing, clinical doctors can decide different treatment plans according to the nature of the lesion.

In summary, as people's understanding of cervical squamous cell lesions deepens, the diagnosis has become simpler: first, severe atypical hyperplasia and carcinoma in situ are combined into CINIII, and then CINIII and CINII are combined into HSIL.

In consideration of the habits of pathologists and clinical doctors, the term CIN will still be used in the following description.

Because precancerous lesions exist for a considerable period of time before invasive cervical cancer occurs, cytological smear detection of abnormally changed cells and timely treatment can effectively prevent the occurrence of invasive cancer and greatly reduce the incidence of cervical cancer. In the United States, cervical cancer was once the leading cause of cancer death among women. However, due to the widespread use of cytological diagnosis, the incidence rate has now dropped to eighth place. However, the country has not done enough in this regard.