Cervical Dysplasia (cont.)
How is cervical dysplasia classified?
Cytologic analysis (screening tests)
Pap smear analysis and reports are all based on a medical
terminology system called The Bethesda System that was developed at the National
Institutes of Health (NIH) in Bethesda, Maryland in 1988 and modified in 2001. The major
categories for abnormal Pap smears reported in the Bethesda Systems are as
follows:
- ASC-US: This abbreviation stands for atypical squamous cells of undetermined
significance. The word "squamous" describes the thin, flat cells that lie on the
surface of the cervix. One of two choices are added at the end of ASC: ASC-US,
which means undetermined significance, or ASC-H, which means cannot exclude HSIL (see below).
- LSIL: This abbreviation stands for low-grade squamous
intraepithelial lesion.
This means changes characteristic of mild dysplasia are observed in the cervical
cells.
- HSIL: This abbreviation stands for high-grade squamous intraepithelial
lesion. And refers to the fact that cells with a severe degree of dysplasia are
seen.
Histologic analysis (cervical biopsies)
When precancerous changes are seen in tissue biopsies of
the cervix, the term cervical intraepithelial neoplasia (CIN) is used. "Intraepithelial" refers to
the fact that the abnormal cells are present within the lining, or epithelial,
tissue of the cervix. "Neoplasia" refers to the abnormal growth of cells.
CIN is classified according to the extent to which the abnormal, or
dysplastic, cells are seen in the cervical lining tissue:
- CIN 1 refers to the presence of dysplasia confined to the basal third of the
cervical lining, or epithelium (formerly called mild dysplasia). This is
considered to be a low-grade lesion.
- CIN 2 is considered to be a high-grade lesion. It refers to dysplastic
cellular changes confined to the basal two-thirds of the lining tissue (formerly
called moderate dysplasia).
- CIN 3 is also a high grade lesion. It refers to precancerous changes in the
cells encompassing greater than two-thirds of the cervical lining thickness,
including full-thickness lesions that were formerly referred to as severe
dysplasia and carcinoma in situ.
Next: What are the treatments for cervical dysplasia? »
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