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Mini-Medical School
Cervical Intraepithelial Neoplasia
子宮頸上皮內贅瘤(英文)

Introduction

Cervical cancer is top malignant tumor for Taiwanese women; and clinically it is discriminated into precancerous lesion ( cervical intraepithelial neoplasia ) and invasive cancer. Researches also indicate that most invasive cervical cancers result from precancerous lesions and there are different degrees to cervical intraepithelial neoplasia and carcinoma in situ.

Etiology

There is evidence indicating that 90% of HPV (Human Papilloma Virus) patients with cervical cancer are associated with early age sexual activities and poor hygiene.

Three degrees of CIN

  • CIN I( mild ) :  With mild dysplasia, abnormal tissues often invade 1/3 of epithelium.
  • CIN II( moderate ) :  Moderate dysplasia takes up 2/3 of the epithelium; cells are well-differentiated but the condition is poorer than CIN I.
  • CIN III( severe ) :  Severe dysplasia with epithelium often reaches almost the entire surface.

Clinical presentation

  • Early stage : There are no specific symptoms and mostly cervical cancer is detected by Pap smear.
  • Late stage : There is increase of vaginal discharge and abnormal bleeding or post-coital bleeding.

Treatment

There are chances for CIN I patients to completely recover, so further treatment is unnecessary; but every 3-6 months Pap smear test is required. CIN II can be treated locally and treatment means includes laser surgery, LEEP ( Loop Electric Excision Procedure ), and therapeutic conization of cervix. Patients with CIN III can be treated with cervical conization; but patients with invasive cancer and other complications, complete hysterectomy is required.

Plans after being discharged from the hospital

  • Return to the hospital if any of the following conditions occurs :

a.  Massive vaginal bleeding

b.  Fever up to 38℃

c. Severe lower abdominal pain

  • It normally takes 3 - 4 weeks for the wound to recover, so patients should rest more for a month and avoid over working. As to sexual life, Return to the clinic to consult your doctor.
  • 2 - 3 weeks after the operation, there is often mild minor odorless vaginal secretion and this is completely normal. 
 
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