Acta Medica Medianae (Jan 2005)
DIRECTIONS IN THE EVOLUTION OF CERVICAL L-SIL LESIONS
Abstract
Molecular activities in the basic cytopathological substratum of the lesions on utherus cervicus, in case of HPV infection in form of squamous intraepithelial lesions of the low (L - SIL) and high (H - SIL) level, are defined by bathesda therminological system. More frequent, L - SIL changes include CIN I, coil atypia and condilomata lata and can be recognized by cellular abnormalities in the basal and parabasal layer with minor cellular structural changes , nuclei hyperhromasia with hromatin condensation, acantosis, paraceratosis with well differentiated cells and faster exfoliation. Women more prone to develop L-SIL are those older than 41, with III degree of vaginal secretion, with the colposcopic finding of aceto-white epithelium and Papa-Nicholaus test of III group. The control cervical, colposcopically controlled biopsy was resumed after four control medical check-ups done every three months after the L-SIL diagnosis. The results showed that lesions remained at the same stage (41,67%), whereas regression appeared in every third examinee (33,33%), slight progression in every eight examinee (12,50%), and significant progression in every twelfth examinee (8,33%).Our conclusion was that L-SIL lesions do not require the ablativ therapy a priory, and what is needed is a regular colpocytological check-up every three months and cervical biopsy, if necessary. Diagnosis of HPV infection certainly changes one’s attitude and requires loop diameter because of the additional diagnostic indications and final therapy.
