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 is one of the most 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 saves many women. Therefore, the prognosis of pathology today is less deplorable.
Squamous cell cervical cancer - what is it?
Cervical cancer is considered a hot topic not only for doctors, but for every woman. Since the active prevention of this disease and its diagnosis began, it has become known about the huge scale of this pathology. The most common squamous cell carcinoma of the cervix. This type of tumor is known for having atypical elementsarise from the immature stratified epithelium that lines the ectocervix. In other words, this type of cancer is located where the cervix meets the vagina.
In the modern world, this disease is one of the most common oncological pathologies. The incidence of ectocervix cancer is 15 people per 100,000 population. Despite the annual increase in mortality from this pathology, the prognosis of the disease tends to improve. If earlier squamous cell carcinoma of the cervix was diagnosed only in the last stages, now treatment begins from the moment predisposing factors are discovered.
Like all oncogynecological diseases, cervical neoplasia has no clinical manifestations for a long time. Therefore, it is important to pay attention to the slightest changes occurring in the body, as well as periodically visit a gynecologist.
Causes of cervical cancer
The appearance of squamous cell neoplasia is associated with various etiological factors. First of all, this concerns disorders of the endocrine system. It is believed that there is a direct relationship between oncogynecological pathologies and the hormonal state of the female body. Often, when cervical cancer is detected, there is an increase in estrogen levels. These hormones are produced in the ovaries. The 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 are known:
- Long-term use of contraceptives. Most contraceptives contain 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 drug is used in the treatment of breast cancer. However, the drug should be used with extreme caution, as it is also hormonal.
- Obesity and thyroid disease (hypothyroidism). These conditions also contribute to increased estrogen levels and the development of cervical cancer.
In addition, there are other predisposing factors. Among them: chronic sexual infections, abortions, a large number of pregnancies and childbirth, as well as their complete absence. Also, squamous cell carcinoma of the cervix mainly occurs against the background of such pathologies as a polyp, erosion, leuko- and erythroplakia, 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.
Types of squamous cell carcinoma
Given the nature of the epithelial cells that undergo atypia, there are several types of cervical neoplasia:
- Adenocarcinoma. This type is less common than the others.
- Squamous keratinizing cervical cancer. It is characterized by the formation of keratin granules on the surface of the epithelium. diagnostic signsuch diseases are considered "pearls of cancer". In the smear, cells of various appearance and size with jagged edges are found.
- Poorly differentiated tumor. It is impossible to establish which cellular elements have undergone atypia. This option is the most unfavorable.
- Squamous cell nonkeratinizing cervical cancer. It is characterized by the absence of keratin. The smear shows large oval bodies containing eosinophilic cytoplasm.
Degrees of cervical neoplasia
When 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. The division into degrees allows you to choose an adequate treatment and determine the prognosis. Stage 0 means non-invasive cancer, that is, atypical cells are present on the surface of the epithelium, but have not penetrated into the thickness of the cervical tissue. Grade 1 - The tumor has grown a few mm deep. By this is meant that invasive squamous cell carcinoma of the cervix has developed, extending beyond the organ. In the second stage, the neoplasia extends 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 small pelvis. The lower part of the vagina, regional lymph nodes are also affected. In stage 4, the tumor moves to the bladder or intestines. Distant metastases appear.
Cervical cancer clinical picture
Suspicion of CIN is difficult, becauseas it has almost no characteristic features. At first, the cancer does not appear or has symptoms such as menstrual irregularities, pain in the lower abdomen and lower back, and clear vaginal discharge. Contact bleeding, that is, appearing during sexual intercourse, is considered a characteristic sign. A later symptom is swelling of the lower extremities, subfebrile temperature. In the last stage, there is weight loss, weakness, decreased appetite, and swollen lymph nodes in the groin.
Diagnosis of squamous cell 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. With a doubtful result, colposcopy is performed using acetic acid and iodine (to identify suspicious areas of the epithelium). If cancer is still suspected, a biopsy of the cervix is needed. Another study is an analysis for the determination of HPV.
Cervical cancer treatment
Treatment for cervical squamous cell carcinoma includes surgical removal of the tumor, chemotherapy and radiotherapy. The volume of surgical intervention depends on the stage, as well as the age of the patient. For non-invasive neoplasia or grade 1, hysterectomy is performed, leavingovaries. This operation is indicated for patients capable of conception. If the patient is in the menopause, then a hysterectomy is performed, the removal of the appendages and the greater omentum. Such a volume of surgery is needed due to the fact that there is a risk of metastasis or tumor recurrence. Also, patients are treated with hormonal drugs. At the last stage, only symptomatic treatment is carried out.
Squamous cell cervical cancer: disease prognosis
Despite the high mortality, a cure is possible. This applies to patients with neoplasia detected in the initial stages. Five-year survival after treatment averages about 55%. The indicator changes in connection with the stage of the tumor process (at grade 1 it is 78%, at grade 4 - 7.8%).
Preventive measures to avoid cancer
The main preventive measure is to visit a gynecologist at least once a year. It is also important to treat sexual infections in time, not to use combined oral contraceptives for more than 5 years, and periodically determine the level of hormones. In the presence of predisposing factors (cervical erosion, polyp, leukoplakia), it is necessary to undergo colposcopy. In the future, the doctor will decide on the treatment of background diseases. In recent years, a specific prevention of cervical cancer has been developed - vaccination aimed at HPV types 16 and 18. It is carried out in adolescence. Please consult your doctor before getting vaccinated.
