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What is this?
What is CIN?
What is it associated with?
- It is Cervical Intraepithelial Neoplasia
- HIGHLY associated with HPV 16,18 (for high grade) and HPV 6,11 (for low grade)
In the cervix, what is SCC associated with?
What is Adenocarcinoma associated with?
How is CIN graded?what is it associated with?
- -HPV 16 and MICROINVASION
- -HPV 18
-graded on how far it moves up in the epithelium. CIN III all the way through. Associated with either HPV6,11 or 16,18 depending on the grade.
What are some risk factors for CIN? (OIMESS)
- Multiple sexual partners
- Early age at first intercourse
- Oral contraceptive use
What is the natural history of:
HSIL? How many of these develope de novo?
60% regress, 30% persist, 10% progress to HSIL
- 30% regress, 60% persist, 10% progress to carcinoma
- 20% de nuvo
- See its progression
- from low grade (lft--> to high grade)
For Cervical SCC
What is the Mean age?
What % of all cervical cancers are SCC?
Mean age is 45
80% of cervical cancers are SCC
What percent of cervical cancers are Adenocarcinomas?
What is its precursor lesion?
Is it more or less aggressive then SCC?
makes up 15% of all cervical cancers
Adenocarcinoma in situ (AIS) is its precursor
it is MORE AGGRESSIVE
See the thickened gland on the Right
How do you treat CIN I, II, III?
- CIN I
- -Follow-up, Ablative therapy
- CIN II/III
- -LEEP (loopelectrosurgical excision procedure) AND “Cold Knife” Conization
- Cervical Cancer
- Radiation/chemotherapy AND Surgical
what are the ages for the HPV vaccine?
do we test for low risk HPV? Why?
- Recommendations (ACIP)
- -Young as 9 years old
- -Females 11-12 years old
- -Catch up 13-26 years old
We do not because they do not cause cancer