What is high-grade esophageal intraepithelial neoplasia

When I see the word "tumor", I always feel an inexplicable sense of fear. However, tumors can be divided into benign and malignant, but most tumors are malignant. Esophageal intraepithelial neoplasia is definitely a malignant tumor, not to mention high-grade esophageal intraepithelial neoplasia, which is definitely worse than that. However, some people do not understand this type of disease, so they don’t know what to do. So what is esophageal high-grade intraepithelial neoplasia?

Intraepithelial neoplasia, also known as intraepithelial neoplasia (IN), is a commonly used diagnostic term in clinical pathology. It covers atypical hyperplasia or dysplastic lesions of epithelial tissues in multiple organs, including the cervix, prostate, endometrium, and esophagus, gastrointestinal tract and other organs of the digestive system. IN is a special stage before the occurrence of epithelial malignant tumors. IN has obvious changes in cell morphology and cell arrangement compared with normal tissues. There are also gene clonal changes in its genetics and it has certain invasiveness in biological behavior.

Grading

There are two types of intraepithelial neoplasia grading: grade 2 and grade 3. The 2-grade method divides intraepithelial neoplasia into low-grade and high-grade, where low-grade is equivalent to mild to moderate atypical hyperplasia and high-grade is equivalent to severe atypical hyperplasia or dysplasia or carcinoma in situ. The 2-level method is widely used in prostatic intraepithelial neoplasia. The 3-grade method divides intraepithelial neoplasia into grade 1, grade 2, and grade 3. Grade 1 is equivalent to mild atypical hyperplasia, grade 2 is equivalent to moderate atypical hyperplasia, and grade 3 is equivalent to severe atypical hyperplasia or dysplasia or carcinoma in situ. The 3-level method has been widely used in the diagnosis of cervical epithelial lesions.

Several common types

1. Cervical intraepithelial neoplasia

Cervical cancer is the most common gynecological malignancy. It is an infectious cancer that is preventable and curable. The concept of cervical intraepithelial neoplasia was proposed in 1967, which includes atypical cell hyperplasia and carcinoma in situ. The risk of CIN developing into carcinoma in situ and invasive cancer is 20 times and 7 times the normal level, respectively. ACOG (American College of Obstetricians and Gynecologists) recommends that all sexually active women over the age of 18 should undergo a cervical cytology test every year. When three or more consecutive examinations are satisfactory and the results are normal, the number of examinations may be reduced as appropriate.

2. Vulvar intraepithelial neoplasia

Vulvar intraepithelial neoplasia is a precancerous lesion that occurs in the squamous epithelium of the vulva. VIN includes what were formerly known as vulvar atypical hyperplasia, carcinoma in situ, Bowen's disease, and erythema proliferative, but does not include non-squamous intraepithelial lesions such as melanoma in situ. In 1987, ISSVD (International Society for the Study of Vulvovaginal Diseases) and the International Society of Gynecologic Pathology decided to name and classify common vulvar precancerous lesions. Vulvar carcinoma in situ is a vulvar intraepithelial carcinoma or preinvasive cancer. The lesions can affect the entire layer of the epithelium but not the dermis. It grows slowly and has a variety of appearance manifestations, such as reddish-brown papules, scaly plaque-like lesions, granulomas, white patches or mottled lesions slightly above the skin surface.

3. Pancreatic ductal intraepithelial neoplasia

Hyperplasia and atypical hyperplasia of the pancreatic duct epithelium are often seen around pancreatic ductal carcinoma. The concept of pancreatic ductal intraepithelial neoplasia (Pan IN) introduced in recent years includes all kinds of proliferative changes of pancreatic duct epithelium. Pan IN 1A is the mildest type and includes some proliferative states of the ductal epithelium that were previously called mucous cell metaplasia or mucous cell hyperplasia and simple hyperplasia. Pan IN is actually very common and can be seen in many cases, but when Pan IN 2 and Pan IN 3 lesions are seen in pancreatic specimens, they should be noted.

4. Penile intraepithelial neoplasia

Penile intraepithelial neoplasia (PIN) is a histological spectrum of precancerous lesions corresponding to the lesions of the same name in the vulva and cervix of the female reproductive tract, characterized by impaired epithelial maturation, abnormal cell polarity, and nuclear atypia. In the past, it was named mild, moderate, severe dysplasia, and carcinoma in situ. Currently, penile intraepithelial neoplasia I, II, and III are used, and penile squamous intraepithelial lesions are also used. High- and low-grade erythema or Bowen's disease is equivalent to high-grade squamous intraepithelial lesions or squamous cell carcinoma in situ. Erythema is commonly used clinically for the glans penis and foreskin, while Bowen's disease is commonly used for the penis body. WHO considers giant genital warts as precancerous lesions of the penis.

5. Conjunctival intraepithelial neoplasia

Conjunctival intraepithelial neoplasia (CIN) refers to localized tumor proliferative lesions within the conjunctival epithelium. Such lesions are precancerous lesions and include conjunctival epithelial atypical hyperplasia and carcinoma in situ diagnosed in the past. This disease is a relatively common epithelial tumor of the conjunctiva. Because a small number of lesions will develop into invasive squamous cell carcinoma, it is considered a precancerous lesion.

6. Colorectal intraepithelial neoplasia

Colorectal adenoma is the most common type of polyp clinically, also known as intraepithelial neoplasia, which has histological and cytological atypia. In other words, if there is no histological and cytological atypia, it cannot be diagnosed as an adenoma. Colorectal adenoma is closely related to colorectal cancer. According to statistics, about 80% of colorectal cancers originate from malignant transformation of adenoma.

After reading the above introduction to what high-grade esophageal intraepithelial neoplasia is, I think everyone should have some understanding of it. The tumor of this disease is indeed a malignant tumor. Patients should identify the cause and take measures as soon as possible for targeted treatment. Never seek medical treatment blindly, otherwise it will cause immeasurable consequences. It's too late to regret in the end.