The term dys means abnormal, while plasia means growth. Cervical dysplasia means abnormal growth of cervical cells. Cervical dysplasia is also called cervical intraepithelial neoplasia, or CIN. Dysplasia is not cancer, but it can develop into cancer of the cervix. Cervical dysplasia is classified as either Mild (CIN I), Moderate (CIN II), or Severe (CIN II or Carcinoma-in-situ). Linked to a sexually transmitted disease caused by some strains of a wart virus, called the human papillomavirus (HPV), it is more common in women who have many sex partners or who began to have intercourse before age 18. Cervical dysplasia has also been associated with cigarette smoking and too little folic acid in the diet. It rarely has any symptoms and the first clues of it's presence is when a Pap Smear result is abnormal. The definitive diagnosis is made by biopsies (small pieces of tissue taken from the body and looked at under a microscope). The biopsies are done during a procedure called a Colposcopy (Please see the Colposcopy Page for more information about the procedure). Most often found in women between 25 and 35 years of age, it can occur in younger and older women. The outside of the cervix and the vagina are covered by a layer of flat cells called squamous or skin-like cells. There are many of these cell layers before the first flattened layer of cells with a nuclei or center. Normally at the bottom of the cell layers are the round, younger cells. As the cells mature, they rise to the surface and become flat. The skin-like covering is separated from the underlying structures by a basement membrane. This is an extremely important concept to remember as well as the Transition Zone area discussed on the Pap Smear Page.In mild dysplasia (CIN I) only a few cells are abnormal. Mild cervical dysplasia sometimes goes away without treatment. However many doctors will treat it at this early stage to prevent it from progressingIn moderate dysplasia (CIN II) the abnormal cells involve about one-half of the thickness of the surface lining of the cervix. In severe dysplasia (CIN III), also called carcinoma-in-situ, the entire thickness of cells is abnormal, but the abnormal cells have not yet spread below the surface or basement membrane. Carcinoma-in-situ literally means "cancer in place". This severity of dysplasia MUST BE TREATED because it will most often develop into invasive cancer. In all grades of dysplasia and carcinoma-in-situ all of the abnormalities are confined to the cells ABOVE the basement membrane of the cervix. |
With invasive cancer, the cells are not only abnormal throughout the entire thickness from the top to the basement membrane, but they invade the basement membrane. Invasive cancer is treated entirely differently than dysplasia and usually involves extensive surgery. The depth of invasion past the basement membrane is an important piece of information that will help make the decision on the proper treatment needed. Micro - invasive cancer, invasion less than 3 mm, may be treated differently and more conservatively than invasive cancer that goes deeper. |
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