Cervical squamous intraepithelial neoplasia 2

Cervical Squamous Intraepithelial Neoplasia 2

Cervical Squamous Intraepithelial Neoplasia 2 (CIN 2) is a medical condition characterized by moderate dysplasia of the cervical epithelial cells. It is considered a precancerous lesion that can potentially progress to cervical cancer if left untreated. CIN 2 is part of a spectrum of cervical intraepithelial neoplasia, which is classified into three grades: CIN 1 (mild dysplasia), CIN 2 (moderate dysplasia), and CIN 3 (severe dysplasia to carcinoma in situ).

Pathophysiology

CIN 2 is caused by persistent infection with high-risk types of Human Papillomavirus (HPV), particularly HPV types 16 and 18. These viruses integrate into the host cell DNA, leading to the disruption of normal cell cycle regulation. The E6 and E7 oncoproteins of HPV interfere with tumor suppressor proteins such as p53 and retinoblastoma protein (pRb), promoting uncontrolled cell proliferation and the development of dysplastic lesions.

Diagnosis

The diagnosis of CIN 2 is typically made through a combination of Pap smear screening, colposcopy, and histological examination of cervical biopsy specimens. During a Pap smear, abnormal squamous cells may be detected, prompting further investigation. Colposcopy allows for visual examination of the cervix and targeted biopsies of suspicious areas.

Management

The management of CIN 2 depends on several factors, including the patient's age, reproductive plans, and the presence of other medical conditions. Options include:

• Observation:In young women, especially those under 25, CIN 2 may regress spontaneously. Close follow-up with repeat Pap smears and colposcopy is often recommended.
• Excisional procedures:Techniques such as Loop Electrosurgical Excision Procedure (LEEP) or cold knife conization are used to remove the affected tissue.
• Ablative therapies:Cryotherapy or laser ablation may be used to destroy the dysplastic cells.

Prognosis

The prognosis for CIN 2 is generally favorable, especially with appropriate management. Many cases of CIN 2 regress spontaneously, particularly in younger women. However, without treatment, there is a risk of progression to CIN 3 and eventually to invasive cervical cancer.

Prevention

Primary prevention of CIN 2 involves vaccination against HPV. The HPV vaccine is effective in preventing infection with the most common high-risk HPV types. Secondary prevention includes regular cervical screening to detect and treat precancerous lesions before they progress.

Also see

• Cervical cancer
• Human Papillomavirus
• Pap smear
• Colposcopy
• HPV vaccine