Treatment of cervical precancerous lesions

When cervical precancerous lesions occur, the most important thing is active treatment.

If it is confirmed that it is cervicitis, and it is only mild erosive inflammation, if the area is small, it can be controlled with drugs for 3 months to observe the effect. For those with moderate or severe erosion and no fertility requirements for the time being, physical therapy (including laser, freezing, electrocoagulation, microwave therapy, etc.) can be performed. Various treatment methods are similar. But it is worth mentioning that for those with cervical hypertrophy and cervical glandular cysts, cervical LEEP knife circumcision (i.e. cervical electrothermal loop circumcision) can be performed.

Once cervical precancerous lesions are diagnosed, it is important to pay more attention to them. But at the same time, we must also be careful not to be too nervous. We must "strategically despise it and tactically pay attention to it". Immediate diagnosis and treatment, follow-up examinations and prevention can control it well. In clinical practice, we often see patients holding pathological reports of precancerous lesions, who are worried and unable to sleep at night, thinking that they have cancer. In fact, there are three outcomes for cervical precancerous lesions, namely natural regression (or reversal), persistence (or stable lesions), and progression (or canceration). The risks of progression of cervical precancerous lesions grades I, II, and III are 15%, 30%, and 45%, respectively. The risks of cervical precancerous lesions grades I, II, and III progressing to cervical cancer are 4 times, 14.5 times, and 46.5 times the normal, respectively.

Therefore, attention should be paid to grade II and above, and among the factors related to prognosis, high-risk HPV infection is the main factor for cervical cancer. The risk of cervical lesions progression in patients with persistent high-risk HPV infection is 6.46 times that of low-risk. The relative risk of cervical cancer is 250 times that of normal women. Patients with cervical precancerous lesions I and negative HPV infection have a 1% lower chance of canceration, and 2/3 of cases can regress naturally.

It has been observed that the natural evolution of cervical precancer to cancer generally takes about 10 years. It does not necessarily progress in sequence and the time may be shortened. However, with age, the reversal rate of cervical precancer gradually decreases, especially for HPV-positive patients, so it should be checked and treated immediately. At present, patients with cervical precancer I and negative HPV infection can be observed for 6 to 12 months and re-examined with TCT (membrane liquid-based ultra-thin cytology test), or physical therapy can be performed; patients with HPV-positive cervical precancer I and cervical precancer II can undergo LEEP knife circumcision; patients with cervical precancer III are hospitalized for cone biopsy, and the cone biopsy specimen is sent to pathology, and the next step of treatment is performed based on the pathological diagnosis.