Diagnostic criteria for cervical precancerous lesions

I believe everyone has heard of cervical precancerous lesions in daily life. We also know that this is a very serious disease. Many patients with cervical precancerous lesions have almost no obvious symptoms in the early stages of the disease. Only when they are diagnosed, they realize that they have cervical precancerous lesions. Faced with such a blow, most patients will be at a loss. So how to diagnose cervical precancerous lesions?

(I) Cervical smear cytology diagnosis

It is the main method to find the early lesions and early cervical precancerous lesions of cervical cancer. However, attention should be paid to the correct sampling site and careful microscopic examination, as there may be a 5% to 10% false negative rate. Therefore, it should be combined with clinical conditions and diagnosed regularly to screen with this method.

(II) Iodine test

Normal cervical or vaginal squamous epithelium contains abundant glycogen, which can be dyed brown by iodine solution, while endocervical columnar epithelium, cervical erosion and abnormal squamous epithelial areas (including squamous metaplasia, atypical hyperplasia, carcinoma in situ and invasive carcinoma areas) do not have glycogen, so they are not colored. In clinical practice, after exposing the cervix with a vaginal speculum, the surface mucus is wiped off, and the cervix and fornix are smeared with iodine solution. If an abnormal iodine-negative area is found, a biopsy can be taken from this area for pathological diagnosis.

3. Cervical and endocervical biopsy

When the cervical smear cytology diagnosis is grade III to IV or above, but the cervical biopsy is negative, four-point biopsies should be taken at 6, 9, 12 and 3 o'clock at the junction of the cervical squamous and columnar parts, or multiple tissues should be taken from the unstained area of ​​the iodine test and the suspected cancerous site, and a section diagnosis should be performed, or a small curette should be used to scrape the endocervical canal and the scrapings should be sent for pathological diagnosis.

(IV) Colposcopy diagnosis

Colposcopy cannot directly diagnose cancer, but it can help select the biopsy site for cervical biopsy. According to statistics, if a biopsy can be taken with the help of colposcopy, the diagnostic accuracy of early cervical precancerous lesions can reach about 98%. However, colposcopy cannot replace scraping cytology diagnosis and biopsy, and cannot detect lesions in the cervical canal.

(V) Cervical Conization

When the biopsy is uncertain about the presence of invasive cancer, cervical cone excision can be performed. However, diagnostic cervical cone excision is rarely used nowadays. When the cervical precancerous lesions are confirmed, lung radiography, lymph node angiography, cystoscopy, and colonoscopy can be performed according to the specific situation to determine the clinical stage of cervical precancerous lesions.

It seems that there are many methods for diagnosing cervical precancerous lesions. However, since the basic conditions of each patient are different, it is recommended that you consult a doctor when diagnosing to see which diagnostic method to choose to prevent misdiagnosis.