Does bloody vaginal discharge mean cervical cancer? What are the pathological characteristics of cervical cancer?

The lesions of the female internal reproductive organ cervix are not easy to be discovered by the patient themselves. Even if the doctor examines, he needs to use a special instrument, the speculum, to open the vaginal wall for diagnosis. What is more easily overlooked is the early stage of female cancer cervical cancer. Because there is no pain, it does not attract the attention of patients. Squamous cell carcinoma accounts for 90%-95%, and adenocarcinoma accounts for only 5%-10%. However, there is no special difference in appearance between the two cancers, and both occur in the cervix, vagina or endocervical canal.

Is leucorrhea blood a sign of cervical cancer?

Leucorrhea is a mixture of vaginal mucosal exudate and secretions from the cervical glands and endometrium. Normal leucorrhea is white and pasty to the naked eye, generally without odor, and varies in quantity, which is related to estrogen levels and congestion of the reproductive organs. If the amount of leucorrhea increases slightly and becomes thinner in the first half of the menstrual period, the amount of leucorrhea will decrease and become thicker in the second half of the menstrual period.

In daily life, the only early symptom that patients can perceive is a small amount of vaginal bleeding after sexual intercourse or double diagnosis, that is, blood mixed in the leucorrhea. The blood comes from the diseased cervix. Generally speaking, a normal cervix will not bleed, and it will only bleed when the cervix becomes cancerous. Cervical precancerous lesions (CIN) In women who have sexual life, most cervical diseases can be detected by liquid-based cytology testing (TCT) to be discovered and treated at the precancerous stage. Blood and leucorrhea flow out of the vagina, which is what is called leucorrhea blood in this article. In addition, there is vaginal discharge, which is mainly caused by ulceration, destruction or infection of cancerous tissue. The early discharge is small and has no odor. In the late infection, a large amount of smelly leucorrhea such as purulent rice soup is discharged.

Is cervical cancer cancer?

Cervical intraepithelial neoplasia is not cancer, but it is closely related to cervical cancer. CIN is usually divided into three levels, CIN 1, 2, and 3. Strictly speaking, CIN1 is not a precancerous lesion. About 60% to 85% of CIN will disappear naturally, while CIN2.3 has a much greater chance of developing into cervical cancer, so it is also called a precancerous lesion. "Cervical cancer is the only gynecological tumor that can be detected and prevented early through physical examinations. As long as you pay attention to regular cervical screening, most of them can be detected and treated in the precancerous lesion (CIN) stage. Treatment of precancerous lesions does not require removal of the uterus and has little effect on future fertility.

Pathological characteristics of cervical cancer

General manifestations

Before developing into invasive cancer, there is no special abnormality in naked eye observation, or it is similar to general cervical erosion. The cervix can show the following four types:

Ulcerative type: Whether it is exogenous or endogenous, the cancerous tissue necroses and falls off, forming an ulcer, and even the entire cervix is ​​replaced by a large cavity. Due to secondary infection, foul-smelling secretions are discharged.

Endophytic type: also known as the invasive type, the cancer tissue infiltrates into the deep tissues of the cervix, the cervix becomes enlarged and hard, but the surface is still smooth or there are only superficial ulcers.

Exophytic type: Also known as hyperplastic or cauliflower type, there are polyps or nipple-like protrusions, which then develop into cauliflower-like growths of varying sizes in the vagina, which are fragile and prone to bleeding. Cervical cancer, especially adenocarcinoma, can also grow in the endocervical canal, causing the cervix to enlarge in a barrel shape, which is also an endophytic type.

Erosive type: There are rough granular erosion areas around the external cervical os, or the ulcerated surface is irregular and prone to bleeding.

Carcinoma in situ:

Carcinoma in situ (CIS) is also known as intraepithelial carcinoma. The polarity of the entire epithelium disappears, the cells are obviously heteromorphic, the nuclei are large and darkly stained, the chromatin is unevenly distributed, and there is a nuclear division stage. However, the lesion is still confined to the epithelial layer, does not penetrate the basement membrane, and has no stroma infiltration. The heteromorphic cells can also enter the cervical glands in the mobile area along the opening of the cervical gland cavity, causing the original columnar cells of the glands to be replaced by multiple layers of heteromorphic squamous cells, but the basement membrane of the glands is still intact, which is called cervical carcinoma in situ involving the glands.

Atypical hyperplasia

Atypical hyperplasia is characterized by proliferation of underlying cells, disordered cell arrangement, enlarged and darkly stained nuclei, and uneven chromatin distribution. Atypical hyperplasia can be divided into mild, moderate, and severe.

Mild atypical hyperplasia (anaplastic grade 1): Epithelial cells are slightly disordered, with mild cell atypia in the lower third of the epithelium.

Moderate atypical hyperplasia (anaplasia) II has disordered arrangement of epithelial cells with obvious atypia, and the atypical epithelium occupies two-thirds of the subepithelium.

Severe atypical hyperplasia (anaplasia) grade III): Almost all epithelial polarity is disordered or lost, the cells are obviously atypia, and it is difficult to distinguish from carcinoma in situ.

If women have leucorrhea and vaginal discharge, they should go to the hospital immediately for early detection, diagnosis and treatment of cervical cancer. Otherwise, it will delay treatment and affect the prognosis.