Cervical Intraepithelial Neoplasia (CIN)

I’ve been diagnosed of having Cervical Intraepithelial Neoplasia (CIN) or Cervical dysplasia. I was lucky to discover this at early stages. Because CIN can be further associated to Cervical cancer at later stages. It started when i went to Klinik to check my episiotomy (whereby i had to undergone 2nd time stitch coz the granulation tissue has grow outside at the opening of episiotomy), ni case ganas sgt during my confinement, asyik berjalan je. Mane taknya, Azri was admitted to Paed NICU, Hospital Kajang for three days when his 5 days old sebab jaundice. So, at the klinik, i opted to do pap smear skali, kebetulan aku ternampak package ‘Pap Smear & Ultrasound Pelvic for RM50 only.Before this, aku dah pernah buat Pap smear test dekat hospital serdang, end of 2006 dulu and the result was normal.

After Pap, aku kena tunggu result dari lab for three days. On third day, Dr Aziani call and wanted to see me. Aku dah budget, ni mesti ada yang tak best ni. Masa jumpa Dr.Aziani, she explained how to read a pap smear report. Basically macam ni (from my understandinglah), dalam pap smear report ni ada 4 category which class 1,2,3 & 4. If class 1 & 2, basically the result is okay, just repeat pap smear untuk next2 year. But if class 3&4, result shows that there was an abnormalities in Pap smear test. In this class, Dr. advise to do a copolcospic biopsy dekat hospital. In my case, i was in class 4!.So Dr. Aziani tulis referal letter to do the biopsy and again aku pilih HUKM jugak sebab dah banyak history aku kat situ.

On 17 December 2008, aku buat colposcopic biopsy tu, caranya lebih kurang mcm ni lah, dia masukkan wayar mcm camera tu untuk tengok tisu2 kat pangkal rahim tu,so kita pun bleh tengok skali kat skrin tv tu. Then die spray liquid yg macam cuka (kita akan rasa pedih la time tu) dekat cervix area tu, klu permukaan/tisu2 kat cervix tu turns into white, meaning that memang ada unhealthy tisu kat situ. And dr. need to remove those infected area by doing a minor surgery called LEEP (Loop Electrosurgical Excision Procedure),ni haku explain di lain tajuk. Masa buat biopsy tu, dr ambik sket tisu/daging di permukaan cervix tu untuk dihantar ke lab. After 2 weeks, the result shows that aku CIN II . Sebab Cervival Intraepithelial neoplasia ni ada 3 categories; CIN I, II, III. Kat bawah ni aku excerpt artike dari ‘MedlinePlus Medical encyclopedia’ pasal Cervical Dyslplasia.

Cervical dysplasia

Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix

Definition Return to top

Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition.

Cervical dysplasia is grouped into three categories:

  • CIN I — mild dysplasia (a few cells are abnormal)
  • CIN II — moderate to marked dysplasia
  • CIN III — severe dysplasia to carcinoma-in-situ (precancerous cells only in the top layer of the cervix)

Causes Return to top

Most cases of cervical dysplasia occur in women aged 25 to 35.

The cause is unknown. However, the following may increase your risk:

  • Multiple sexual partners
  • Becoming sexually active before age 18
  • Giving birth before age 16
  • If your mother took a drug called diethylstilbestrol (DES) during pregnancy
  • Sexually transmitted infections, especially HIV or HPV (genital warts)

Symptoms Return to top

There are usually no symptoms.

Exams and Tests Return to top

A pelvic examination is usually normal.

A Pap smear shows abnormal cells. A colposcopy-directed biopsy is done to confirm the condition and determine its severity.

Other tests may be done to find out if the abnormal cells have spread outside the cervix:

Treatment Return to top

Treatment depends on the degree of dysplasia. Mild dysplasia may go away on its own . You may only need careful observation by your doctor with repeat Pap smears every 3 to 6 months.

Treatment for moderate to severe dysplasia or dysplasia that does not go away may include:

Women with dysplasia need consistent follow-up, usually every 3 to 6 months or as recommended by their provider.

Outlook (Prognosis) Return to top

Early diagnosis and prompt treatment cures nearly all cases of cervical dysplasia.

Without treatment, 30-50% of cases of severe cervical dysplasia may lead to invasive cancer. The risk of cancer is lower for mild dysplasia.

Possible Complications Return to top

The condition may return.

When to Contact a Medical Professional Return to top

Call for an appointment with your health care provider if you are a woman who is sexually active or aged 20 or older and you have never had a pelvic examination and Pap smear.

See: Physical exam frequency

Prevention Return to top

To reduce the chance of developing cervical dysplasia:

  • Wait until you are 18 or older before becoming sexually active
  • Practice monogamy and use condoms during intercourse

References Return to top

Noller KL. Intraepithelial Neoplasia of the Lower Genital Tract (Cervix, Vulva) : Etiology, Screening, Diagnostic Techniques, Management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 28.

Wright TC Jr, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ; ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002 Apr 24;287(16):2120-9. Review.

Hoffman MS, Martino MA. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol. 2004 Sep;191(3):1049

Update Date: 5/26/2008

(Source :http://www.nlm.nih.gov/medlineplus/ency/article/001491.htm)

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