What is cervical cancer in situ

Cervical carcinoma in situ refers to early cancer in which cancer cells are limited to the cervical epithelial layer and have not broken through the basement membrane. It is the highest level of cervical intraepithelial neoplasia. Cervical carcinoma in situ is mainly diagnosed through cervical biopsy, and timely intervention is required to prevent progression to invasive cancer.

1. Pathological characteristics

Cervical carcinoma in situ shows that the entire thickness of cervical squamous epithelium is replaced by atypical cells, with deeply stained nuclei and disordered polarity, but the basement membrane is intact without stromal infiltration. Pathologically, it is a CIN grade 3 lesion, which is closely related to persistent high-risk HPV infection. Common viral subtypes include HPV16 and HPV18.

2. Clinical manifestations

Most patients have no obvious symptoms, and some may experience contact vaginal bleeding or abnormal discharge. Cervical erosion-like changes or acetic acid white epithelium can be seen in gynecological examination, and the diagnosis needs to be confirmed through cervical cytology, HPV testing and colposcopy biopsy.

3. Diagnostic methods

Adopt a three-step diagnostic process: when cervical TCT examination reveals ASC-H or HSIL results, it needs to be combined with HPV typing testing； Colposcopy to locate suspicious lesions ； The final diagnosis was pathologically confirmed by cervical conization biopsy. Immunohistochemical detection of P16 protein can assist in the identification of high-grade lesions.

4. Treatment measures

Standard treatment is cervical conization, including cold knife conization and LEEP electrical conization. For patients who do not want to have children, total hysterectomy is an option. After treatment, follow-up TCT and HPV testing are required every 3-6 months. If there is no recurrence for 2 years, routine screening can be switched.

5. Prognosis management

The cure rate after standard treatment is over 95%, but there is still a risk of progression to invasive cancer. After surgery, patients should stop smoking, have a regular schedule, keep the perineum clean, and avoid resuming sexual life prematurely. HPV vaccination can prevent other types of infection, but you need to continue to receive cervical cancer screening.

After being diagnosed with cervical cancer in situ, strenuous exercise should be avoided, the intake of fresh vegetables and fruits should be increased, and folic acid and vitamin C should be supplemented in an appropriate amount. It is recommended to choose pure cotton underwear and change them every day, and wash them separately from other clothing. Bathing and swimming are prohibited within 3 months after treatment. If abnormal vaginal bleeding or fever occurs, timely follow-up is required. Maintaining a positive attitude and regular follow-up visits are key to preventing recurrence.