Precancerous Lesions Or Precursors Of Cancer Of The Cervix
The cancer of the cervix not develops suddenly, their development for years, starting generally at the level of the lining scaly, these normal cells, in some patients probably by deficits in their defenses or local immunity, together with other co-factors (tobacco, hormonal factors, infections and herpesvirus virus such, etc. ) to the aggression of a factor carcinogenic already tested as is the infection by the virus HPV (human papilloma virus) Contracted through sexual intercourse, with a higher incidence among the 20 and 40 years, virus for which there to the date more than a hundred varieties or subtypes, remain predominantly the category of “high risk” (HPV 16, 18, 45, 56) which have been found in a high percentage in precancerous lesions, squamous cell carcinoma in situ, squamous cell carcinoma, infiltrating adenocarcinoma of the cervix and their propagation outside the body (metastasis).
Before these stimuli chronic not controlled or treaties (agent carcinogenic and co-factors) normal cell begins to suffer modifications kernel-cytoplasmic and architectural, known as precancerous lesions or precursors of invasive cancer of the cervix, this being the last that kills the patient.
Some women with precancerous lesions develop cancer with a recurrences that ranges from 20 % 60 % , process that often takes years, but sometimes can occur in a short time, especially in patients with weakened immune systems, such as those who suffer an organ transplants since the immunosuppressive treatment to which are subject to lessen the rejection, the makes prone at the same, the carriers of neoplasia, e.g.: Lymphomas, which still regimes of chemotherapy or patients with infection by HIV (human immunodeficiency Human – AIDS).
However, most of these lesions, once detected early, disappeared after a regular monitoring and control cytology (Pap) and a proper medical treatment-gynecological.
Only a minority of them, as the precancerous lesions or squamous intraepithelial high degree (CIN 2 – CIN 3), that by not responding to medical treatment or be very extensive, needed to cure the removal quirurgica complete of the same in the form of a cone, hence the name of surgical procedure quotation, for which can be used numerous methods, being the most common thermocoagulation, cryosurgery, laser and loop. The material or piece of conizacion is placed in a liquid fixative (formalin) for the conservation and sent to the pathologist for the study of microscopic himself and the definitive diagnosis.
A Pap Smear or exfoliative cytology cervical must be made on a regular basis in any woman who began their sexual activity or after the 18 to 20 years, on an annual, (as doctor), which permits to detect and diagnose time precancerous lesions, with a medical treatment appropriate gynecological achieves the prevention of the most cancers of the cervix.
The literature medica was using to over the years different terms to call the precancerous lesions, the first and universally accepted was DYSPLASIA, introduced in cytology in 1949 by Dr. George Papanicolaou, of which bears his name the technique of exfoliative cytology cervical commonly known as Pap Smear, which allows us to detect clearly such precancerous lesions or dysplasias, in order to stop its evolution achieving reduce the incidence of cervical cancer and save many lives.
The cell dysplasia or precancerous to be observed under a microscope, evidence alterations kernel-cytoplasmic and architectural, with greater size of the kernels (cariomegalia), which is progressive action as it aggravates or evolves over time the dysplasia, as well as in the intensity in the color of the same (hipercromasia), increase in the divisions cellular, some abnormal (mitosis atypical) among other alterations, due to changes in the content of DNA in cells displásicas .
The same are graded according to the level they occupy in the squamous epithelium concerned:
- Mild Dysplasia or CIN 1 (if they affect a lower third of the epithelium).
- Dysplasia Moderate or CIN 2 (if they affect the two-thirds of basal epithelium).
- Severe Dysplasia-Carcinoma In Situ-CIN 3 (if they affect all the thickness of the epithelium).
It is estimated that a CIN high-grade progresses to a invasive carcinoma in a variable period of 10 to 12 years.
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