According to statistics, cervical neoplasia (CIN), that is, cancer, occupies a leading place in the structure of oncological diseases. Most often, the degeneration of normal tissue into tumor tissue is observed on the cervix. This is due to the characteristics of the epithelium. Due to the fact that squamous cell carcinoma of the cervix belongs to common forms of cancer, its early diagnosis is carried out. With the advent of special screening programs, one can learn not only about the initial stages of the tumor, but also about the conditions preceding atypia. Early diagnosis and treatment of cervical cancer can save many women. Therefore, the prognosis of pathology today is less deplorable.
Squamous cell carcinoma of the cervix - what is it?
Cervical cancer is considered an urgent topic not only for doctors, but also for every woman. Since the active prevention of this disease and its diagnosis began, it became known about the enormous scale of this pathology. Most often, squamous cervical cancer is found. This type of tumor is known for the fact that atypical elements emerge from an immature stratified epithelium that lines the ectocervix. In other words, this type of cancer is located in the place where the cervix passes into the vagina.
In the modern world, this disease is one of the most common oncological pathologies. The frequency of ectocervix cancer is 15 people per 100 thousand of the population. Despite the annual increase in mortality from this pathology, the prognosis of the disease tends to improve. Previously, squamous cervical cancer was diagnosed only in the last stages, but now treatment is started from the moment predisposing factors are discovered.
Like all gynecological oncological diseases, cervical neoplasia for a long time has no clinical manifestations. Therefore, it is important to pay attention to the slightest changes that occur in the body, as well as periodically visit a gynecologist.
Causes of Cervical Cancer
The appearance of squamous neoplasia is associated with various etiological factors. First of all, this concerns violations of the endocrine system. It is believed that between oncogynecological pathologies and the hormonal state of the female body there is a direct relationship. Often, when detecting cervical cancer, there is an increase in estrogen levels. These hormones form in the ovaries. An increase or decrease in their level is controlled by the hypothalamus. Given the relationship of the disease with endocrine disorders, the following causes of cervical cancer of the poppies are known:
- Long-term use of contraceptives. Most contraceptives incorporate estrogens. Therefore, when using COCs, it is necessary to consult a doctor from time to time to determine the level of hormones.
- Treatment with Tamoxifen and its analogues. This medicine is used in the treatment of breast cancer. Nevertheless, the drug should be used with extreme caution, since it is also hormonal.
- Obesity and thyroid disease (hypothyroidism). These conditions also contribute to an increase in estrogen levels and the development of cervical cancer.
In addition, there are other predisposing factors. Among them: chronic genital infections, abortions, a large number of pregnancies and childbirth, as well as their complete absence. Squamous cell carcinoma of the cervix uteri also mainly arises against the background of pathologies such as polyp, erosion, leuko and erythroplakia, and dysplasia. Recently, the disease has been associated with papillomavirus types 16 and 18. Scientists have come to this conclusion, since this pathogen is found in almost all patients suffering from cervical neoplasia.
Squamous cell carcinoma
Given the nature of the epithelial cells that undergo atypia, several types of cervical neoplasia are distinguished:
- Adenocarcinoma. This type is less common than the rest.
- Squamous keratinizing cervical cancer. It is characterized by the formation of keratin granules on the surface of the epithelium. A diagnostic sign of such a disease is considered to be the "pearl of cancer." In the smear, cells with a different appearance and size are found with uneven edges.
- Low grade tumor. It is impossible to establish which cellular elements underwent atypia. This option is the most unfavorable.
- Squamous non-keratinized cervical cancer. It is characterized by the absence of keratin. Large oval bodies containing an eosinophilic cytoplasm are visible in the smear.
Degrees of cervical neoplasia
If neoplasia (CIN) is detected, it is necessary to conduct an examination and find out the extent of its spread. Given the development of atypical cells, 4 stages of the disease are distinguished. Dividing by degrees allows you to choose an adequate treatment and determine the prognosis. Stage 0 denotes non-invasive cancer, that is, atypical cells are present on the surface of the epithelium, but did not penetrate the thickness of the cervical tissue. The first degree - the tumor has grown in depth by several mm. This implies that an invasive squamous cell carcinoma of the cervix has developed that extends beyond the organ. In the second stage, neoplasia spreads to the parametrium or upper part of the vagina. The third degree is characterized by the appearance of cancerous elements on the walls of the pelvis. Also affected is the lower part of the vagina, regional lymph nodes. In stage 4, the tumor passes to the bladder or intestines. Distant metastases appear.
The clinical picture of cervical cancer
It is difficult to suspect CIN, since it has practically no characteristic signs. At first, the cancer does not appear or has symptoms such as menstrual irregularities, pain in the lower abdomen and lower back, and clear discharge from the vagina. Contact bleeding, that is, appearing during intercourse, is considered a characteristic sign. Swelling of the lower extremities, low-grade fever are considered a later symptom. At the last stage, weight loss, weakness, decreased appetite and an increase in lymph nodes in the groin are noted.
Diagnosis of squamous cervical cancer
Detection of squamous cell carcinoma is carried out both when complaints appear, and as a screening. It consists in a special analysis, in which a swab is taken from the vagina and cervix (PAP test). Thanks to this method, it is possible to determine not only cancer, but also dysplasia - small changes in the cellular composition. In case of doubtful results, colposcopy is performed using acetic acid and iodine (to determine suspicious areas of the epithelium). If cancer remains suspected, a cervical biopsy is necessary. Another study is HPV testing.
Cervical cancer treatment
Treatment for squamous cervical cancer includes surgical removal of the tumor, chemo and radiation therapy. The volume of surgery depends on the stage, as well as the age of the patient. With non-invasive neoplasia or grade 1, the uterus is extirpated, leaving the ovaries. This operation is indicated for patients capable of conception. If the patient is in the menopause, then a hysterectomy, removal of the appendages and the greater omentum is performed. This amount of surgery is needed because there is a risk of metastasis or tumor recurrence. Also, patients are shown hormone therapy. At the last stage, only symptomatic treatment is carried out .
Squamous cell carcinoma of the cervix uteri: prognosis of the disease
Despite the high mortality rate, a cure is possible. This applies to patients with neoplasia identified in the initial stages. Five-year survival after treatment averages around 55%. The indicator changes in connection with the stage of the tumor process (at 1 degree is 78%, at 4 - 7.8%).
Cancer Prevention
The main preventive measure is to visit a gynecologist at least 1 time per year. It is also important to treat genital infections on time, not to use combined oral contraceptives for more than 5 years, periodically determine the level of hormones. In the presence of predisposing factors (cervical erosion, polyp, leukoplakia), colposcopy is necessary. In the future, the doctor will decide on the treatment of background diseases. In recent years, specific prevention of cervical cancer has been developed - vaccination aimed at HPV types 16 and 18. It is carried out in adolescence. Before vaccination it is necessary to consult a doctor.