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Severe cervical dysplasia
Last reviewed: 05.07.2025
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As a result of a histological examination of pathologically altered cervical epithelium, severe cervical dysplasia can be diagnosed, which, according to the international classification, is called cervical intraepithelial dysplasia of the third degree (out of the existing four).
The disease is considered a precancerous condition of the tissues of the cervix and has not one code according to ICD 10, but two: class XIV (diseases of the genitourinary system), N87 - Dysplasia of cervix uteri, and class II (neoplasms), D06 - Carcinoma in situ of cervix uteri.
[ Causes of severe cervical dysplasia
In oncology, precancerous is the term used to describe changes in the cervix that make it more sensitive to the human papillomavirus (HPV). This may be somewhat at odds with the definition of carcinoma as a cancer of epithelial tissues.
Today, according to numerous epidemiological studies, the causes of severe cervical dysplasia in 62% of diagnosed cases are caused by this persistent viral infection. Although most genital HPV infections do not cause cancer.
Pathological changes in the form of atypical cells of the cervical epithelium are observed in the so-called transformation zone - where one type of mucous membrane, consisting of glandular and cylindrical cells, constantly (in connection with the menstrual cycle) changes into another type of squamous epithelium.
The pathogenesis of any, including severe, cervical dysplasia is associated with the fact that HPV damages the cells that line the cervix (an increase and chromatosis of the nuclei, a change in the shape of the cells, etc. are noted). Sometimes the virus damages the gene of healthy cells (introsomal type of damage), which causes not only abnormalities in the morphology of cells of almost the entire layer of squamous epithelium, but also their intensive proliferation.
Gynecologists note that factors that increase the risk of developing severe dysplasia include unprotected sexual intercourse; decreased immune reactivity of the body (including due to a deficiency of immune-supporting vitamins - ascorbic acid and retinol); disruption of homeostasis (in particular, increased acidity of the internal environment of the body, which is largely facilitated by smoking); multiple pregnancies in the anamnesis; a hereditary tendency to the development of gynecological malignancies, as well as long-term contraception with the help of hormone-containing pills taken orally.
Symptoms of severe cervical dysplasia
Precancerous changes in the cervix often occur without obvious manifestations. And the first signs of the disease are an abnormal result of a cervical smear (pap test, pap test or Papanicolaou smear).
Obvious symptoms of severe cervical dysplasia may include:
- discomfort and painful sensations during coitus;
- bloody vaginal discharge or bleeding after coitus;
- pruritis (itching) in the genital area;
- the appearance of other atypical vaginal discharge;
- aching and pulling pain in the lower abdomen and pelvic area.
Cervical neoplasia of the third degree (CIN III) or severe dysplasia of the cervix affects only the flat epithelium and has complications in the presence of concomitant infections (chlamydia, vaginosis, vulvitis, colpitis). The consequences of severe dysplasia are its further development with all the signs of oncology. Or spontaneous disappearance (50 to 50), however, it is extremely difficult to predict the "behavior" of the disease.
Diagnosis of severe cervical dysplasia
A standard scheme has been developed for diagnosing severe cervical dysplasia.
After examining the cervix on the chair, the doctor prescribes tests:
- cytological smear of the cervical mucosa (Pap test according to the Papanicolaou method);
- smear for the presence/absence of human papillomavirus (HPV) with determination of its serotype;
- taking a sample of cervical tissue (by scraping) for papillomavirus DNA.
Instrumental diagnostics are also used: colposcopy (vaginal endoscopy), which allows visualization of the tissues of the cervix under multiple magnification using a special endoscopic device (colcoscope).
Differential diagnosis of severe cervical dysplasia (from ectopia, cervicitis, retention cyst, etc.) is carried out on the basis of a biopsy, which is often performed during colposcopy, and a histological examination of the resulting sample of altered tissue.
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Treatment of severe cervical dysplasia
Currently, medications are not used in the treatment of this pathology (by chemically destroying atypical cells): their ineffectiveness is recognized by everyone.
Therefore, surgical treatment of severe cervical dysplasia using excisional methods such as:
- diathermy or loop electrical excision procedure – LEEP (Loop Electrosurgical Excision Procedure);
- cryocoagulation (freezing with liquid nitrogen);
- laser ablation (used on clearly localized pathological areas of cervical tissue or when an entire layer of tissue on its surface is affected);
- resection of the pathological area using a scalpel;
- cervical ectomy or removal of the entire cervix (used when abnormal cells are found in the cervical canal).
To restore healthy cells, vitamin therapy (vitamins A, C, group B), zinc and selenium supplements are used.
Folk treatment with turmeric, pineapple juice, and green tea is designed to stimulate the body's defenses against HPV. Herbal treatment uses decoctions of plants with an immunostimulating effect taken orally - Echinacea pupa and especially astragalus, which activates the synthesis of interleukin-2, which is capable of destroying the papilloma virus and mutant cells.
Homeopathy uses aloe juice and thuja occidentalis extract in its preparations to combat HPV, as well as a topical remedy based on the essential oil of Melaleuca alternifolia – tea tree.
Prevention and prognosis
Prevention of this pathology is possible if all women after reaching the age of 18 will annually take a smear test and undergo screening pap testing. If a negative result is detected twice within 6-12 months, then it is enough to be examined every three years.
In the absence of treatment, doctors give a prognosis for this pathology based on statistics: according to some data, in 20-30% of cases, according to others in 30-50%, according to others -12%, severe cervical dysplasia progresses to squamous cell carcinoma.