의료인을 위한 유튜브 링크 : https://youtu.be/6TrnNGYFvR4

HSIL.pdf

자궁경부암은 인유두종 바이러스에 의해 생기는 것으로 알러진 여성의 생식기 암이다

자궁 경부암은 증상이 없기 때문에 pap smear, 즉 자궁 경부암 검사를 통해 최근에 조기에 발견되고 있다.

HSIL은 고등급 형성이상을 동반하는 비정상 세포를 의미하는 결과로, 전암병변을 동반하고 있을 가능성이 매우 높고 심지어 추가 검사시 암이 발견될 확률이 2%나 된다.

따라서 HSIL이 검사 결과일시, 자궁 경부를 절제하거나 필요시 검사를 통해 정확한 진단을 받고 그에 따른 치료를 받는 것이 중요하다.

HSIL is the Exam result of pap smear, which has the highest risk of developing into cancer.

1. Definition

HSIL stands for high grade squamous intraepithelial lesion.

2. Significance

As can be expected from its name, it is a precancerous lesion and most of the time, needs immediated treatment.

In patients with HSIL, Five-year cervical cancer risk is 8% in women who is older than 30 years old. 

Up to 2% of women with HSIL results are diagnosed cervical cancer at colposcopy.

2. Management 

So, how should HSIL be managed?

HPV is an identified cause of cervical cancer, and is found in almost all neoplasm. 

In HSIL, HPV negative is uncommon, but even though it is so, the patient still carries a high risk of cervical neoplasm.

For this reason, HPV testing is not recommended.

Rather, Since HSIL carries high risk of cancer, an excisional procedure such as cone biopsy or LEEP or an ablative procedure such as cryotherapy or CO  ₂  laser may be conducted.

HSIL frequently accompanies histology result of CIN2 or 3, which necessitates treatment such as ablation or excision.

* young women 

In case the patient happens to be young, like in early twenties or younger, an option is to follow-up for up to 24 months and treat only if the HSIL persists . This is because treatment may result in adverse outcome in pregnancy and fertility. 

And there actually is evidence that CIN-2 or 3 may regress in six months in young women. 

However, it turns out about half of these women carry HPV-16. 

Therefore, it is important for a doctor to balance the benefit and adverse outcomes in these young women. 

Colposcopic findings and HPV testing may help this decision.

3. Comments

Cervical cancer is not a disease that pops up from nowhere. Rather, it takes a course of developing into a cancer.

Screening with pap smear is to help identify precancerous lesion in the early stage and treat them as early as possible.

This is the end of the video for interpreting cervical neoplasm. I hope this video helped your understanding with pap smear.

See you again witih other series of video!

ASC-H.pdfASC-H.pdf

의료인을 위한 유튜브 링크 : https://youtu.be/88VQA1B_8ak

자궁경부암은 인유두종 바이러스에 의해 생기는 것으로 알러진 여성의 생식기 암이다

자궁 경부암은 증상이 없기 때문에 pap smear, 즉 자궁 경부암 검사를 통해 최근에 조기에 발견되고 있다.

ASC-H는 비정형 세포로, 고등급 형성이상 암을 배제할 수 없는 결과이다. 

다른 결과와 달리, 인유두종 바이러스와 관련이 있을 가능성이 매우 높으며 조직검사에서 전암병변이 많이 발견된다.

이 결과가 나온 모든 환자는 질확대경검사 대상이 되며, 상피내 병변이 발견되는 경우 절제 등의 치료를 필요로한다. 

ASCH is the result of pap smear that sounds rather quizzy. 

1. Definition

Asch stands for atypical squamous cells, cannot exclude high-grade

As is obvious from its name, asch carries higher risk of cervical  neoplasm, but lower than Hsil

2. Significance

As is well known, HPV is the identified cause of cervical neoplasm. 

In other test results, running the HPV test was a recommended step in other results introduced in my other videos.

However, in case of ASCH, HPV testing is deemed inappropriate because HPV detection rate is very high in ASCH.

Even though the HPV test turns out to be negative, 5-year cancer risk amounts to 2%. 

3. Management

Then how should ASCH be managed? 

Regardless of age and risk stratification, colopscopy is recommended. 

Again, HPV testing is not recommended.

Mostly, the histology result will be CIN2-3, which needs treatment.

The patient may be treated with either an excisional procedure such as cone biopsy or LEEP or by an ablative procedure such as cryotherapy or CO  ₂  laser

4. Comments

Cervical neoplasm is mostly asymptomatic. However, with adequate screening and diagnosis, its survival is increasing. 

For further study on this subject, my previous videos are recommended.

Thank you for listening and I'll come back again to finally talk about HSIL. See you