Are Atypical Cells Always Cancer?

Atypical squamous cells are a type of cells that are caused by cell mutations caused by inflammation of the cervix. They belong to the atypical cell category. Because they belong to precancerous lesions, they must be closely observed.

Atypical squamous cells (ASC) are cell changes of squamous intraepithelial lesions, but they are not sufficient to make a clear judgment in terms of quality and quantity.

1. Atypical squamouscells of undP.termined significance (ASC-US)

(1) Diagnostic criteria:

with the size of surface and middle squamous cells;

The nucleus is enlarged, and the nucleus area is 2.5 to 3 times larger than that of the normal middle cell nucleus;

N / C increased slightly; The nucleus was deeply stained to varying degrees, and the chromatin distribution and karyotype were irregular.

(2) Note: Including cell morphological changes suggest squamous intraepithelial lesions, but it is not enough to confirm the diagnosis. It also includes too few cells with diagnostic significance. Generally speaking, when it is difficult to classify ASC-H, LSIL, or HSIL as a cytopathic disease, consider ASC-US. According to the statistical analysis of our department in 2009, the detection rate of ASC-US was 3.2% ^[1]

Atypical squamous epithelial cells refer to squamous epithelial cells whose morphological characteristics and pathological abnormalities cannot be confirmed. Such patients should be reviewed. Take care to avoid sexual life and vaginal treatment before review. The presence of malignant lesions can be determined in conjunction with further cervical biopsy ^[1] .

Because it is a precancerous lesion, it must be closely observed. The change from precancerous lesions to invasive cancer is generally very slow, taking about 8-10 years or even 20 years. In the precancerous stage, abnormal cells do not invade the stroma, let alone metastasis. If found at this time and treated accordingly, the chance of cure is very high. However, after cervical cancer has become invasive cancer, it usually develops quickly. Without treatment, patients can die within 2-5 years. Atypical hyperplasia can be divided into mild, moderate and severe. If not treated, about 10-15% of mild and moderate atypical hyperplasia can develop into invasive cancer, and about 75% of severe atypical hyperplasia and carcinoma in situ can develop. For invasive cancer.

If the biopsy is mild atypical hyperplasia, temporarily treat it according to inflammation, follow-up scraping for half a year and biopsy if necessary. Those with persistent lesions can continue to observe.

Patients diagnosed with moderate atypical hyperplasia should apply laser, freezing and electric ironing. For severe atypical hyperplasia, total hysterectomy is generally recommended.

Mild and moderate atypical hyperplasia has the following three outcomes:

1. Regression or reversion; 2. Unchanged; 3. Canceration.

Atypical squamous cell proliferation

Atypical squamous cell proliferation is divided into mild, moderate, and severe, and the mild majority (60%) is reversible. The moderate and severe are precancerous lesions. In fact, the severe can be classified as carcinoma in situ. Atypical squamous cells refer to squamous epithelial cells with morphological abnormalities and morphological abnormalities that are not sure of the nature of the lesion. They are the basis for judging the diagnosis of cytopathology, suggesting that precancerous lesions should be reviewed regularly to confirm. If it is atypical squamous cell proliferation, it means that the cells are heterotypic.