When your biopsy is analysed in the laboratory, the histologist will be looking for different changes in the cells.
The changes they review are:
- The cell nucleus – irregular size, shape and colour of the cell nucleus is the first indication of an abnormality.
- The maturity of the cells – a normal
cell will grow from an immature to mature cell. Cells that are abnormal
can often still grow into mature cervical cells which still function in a
similar way to normal cells. If the abnormal cells still mature this
indicates a low grade abnormality (e.g. CIN 1). New cells that grow with
increased abnormalities may no longer be able to function normally and
may remain as immature abnormal cells. The more immature the abnormal
cells there are the higher the grade of abnormality (e,g, CIN2 & 3).
Immature abnormal cells have the potential to develop more readily into
cancerous cells than mature abnormal cells. - The thickness of abnormal cells in the
lining of the cervix – The grading for CIN cells comes from the
thickness of immature abnormal cells within the ectocervix.
If your biopsy comes back positive it is
because you have abnormal cells or Cervical Intraepithelial Neoplasia
(CIN), you will have both abnormal mature cells and variable quantities
of immature abnormal cells. Immature abnormal cells are more likely to
develop into cancer so the quantity of these cells within the ectocervix
is important. The grading of CIN is established according to the
thickness of immature cells within the sample taken.
That means that:
- If you have CIN 1 the lining of the
cervix has fully mature abnormal cells at the surface and the lower 1/3
has immature abnormal cells. - CIN 2: the lining of the cervix has fully mature abnormal cells at the surface and the lower 2/3 has immature abnormal cells.
- CIN 3: the lining of the cervix has immature abnormal cells through it's entire thickness
All the results listed show that
you have cervical abnormalities. This does not mean that you have or
will get cancer. It just means that the laboratory has detected some
changes to your cells that are abnormal and, if they are not treated,
they may develop into cervical cancer.
Abnormal cervical cells: CIN and CGIN
The cervix is covered with a layer of skin-like cells on its outer
surface, called the ectocervix. There are also glandular cells lining
the inside of the cervix called the endocervix. These cells produce
mucus. The skin-like cells of the ectocervix can become cancerous,
leading to a squamous cell cervical cancer. The glandular cells of the
endocervix can also become cancerous, leading to an adenocarcinoma of
the cervix. Pre-cancerous changes to these different cells are also
categorised differently: Cervical Intraepithelial Neoplasia (CIN) are
cellular changes to the ectocervix and Glandular Cervical
Intraepithelial Neoplasia (CGIN) represent abnormal changes to the
endocervix.
Treatment for CIN depends on the degree of abnormality of the cells.
CGIN is not as common as CIN, but it is treated exactly the same. There
is no good evidence that CGIN is “more aggressive” than CIN. CGIN is
harder to pick up during screening and since that cellular changes are
inside the cervical canal they can be marginally more difficult to
treat.
If your cervical screening result shows
abnormal cells you will be asked to attend a colposcopy appointment.
Remember testing positive for CIN or CGIN means that you have abnormal
cervical cells that may, if untreated lead to cancer but CIN and CGIN
are not cancerous cells. Treatment for abnormal cellular changes is
usually very successful.