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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!