Cervical leukoplakia

Cervical leukoplakia
[Summary]



Cervical leukoplakia (Leucoplasia of the cervix), means the Department of the cervix vagina a gray opaque patchy lesion. Most scholars believe that clinical leukoplakia only said that the naked eye can see there are different degrees of epithelial hyperplasia. As the precancerous lesions and early cervical cancer and colposcopy in-depth study of the extensive application of the disease has been increasingly drawing attention.



[Diagnosis]




(A) As local consultation: Through careful observation of cervical local, regional plaque can be found in white, but could not identify the naked eye Insufficiency keratosis lesions.

(B) povidone-iodine test: epithelial keratosis due to the lack or insufficiency keratosis glycogen storage capacity of local non-iodine Tu coloring to the scope of diseases can be found. However, iodine test non-specific, such as cervical erosion, valgus or precancerous lesions, and so it also positive.

(C) colposcopy: colposcopy enlarge to observe cervical lesions than the naked eye observation of cervical leukoplakia found to be much easier. Shanghai Second Medical University, has been the subject of colposcopy 1,000 cases and found 79 cases of cervical leukoplakia, or 7.9 percent.

According to local consultation as iodine testing and colposcopy, in general it is not difficult to make the diagnosis. But more important is that after further examination leukoplakia, and leukoplakia avoid missing the coexistence of early cervical cancer. It was reported in the literature, the various colposcopy leukoplakia, early cervical cancer is an important performance. For people in 105 cases of carcinoma in situ colposcopy see abnormal changes in the 60 cases, all types of leukoplakia to the majority (36 cases). Leukoplakia of the cervix, it should be biopsy to rule out the existence of early cancer.


[Treatment]




As leukoplakia benign cervical lesions, they generally exclude cervical malignant lesions, can be used for cervical treatment, ironing or frozen. Associated with the severe cervical erosion, the Palace may consider resection of cervical shape, and pathological consecutive biopsy to determine whether early cervical cancer, in order to take timely further treatment. On asymptomatic patients can be closely observed, regular follow-up.


[Etiology:




The cause of cervical leukoplakia not yet clear, and may be related to the following factors:

(1) endocrine disorders: in estrogen levels increased, resulting abnormal cervical epithelial surface keratosis.

(B) local irritation: cervix such as chronic inflammation, Trichomonas vaginalis and so on. Zhongshan Medical University, in 700 cases of cervical erosion biopsy clinical analysis, we found 37 cases of cervical leukoplakia, or 5.2%, we can see that in Manxingzi cervicitis cases, the incidence has increased significantly.

(C) other factors: According to the literature, even leukoplakia and cervical dysplasia, carcinoma in situ or invasive early coexist. That the occurrence of cervical leukoplakia, and cervical cancer may be carcinogenic factor.

[Pathological changes:




General observation, we can see that the surface of cervical opaque white spot Flake region, size, shape different lesions generally smaller, not more than 1 cm in diameter. Single or multiple emergence of individual cases of cervical leukoplakia than the vaginal fornix. Surface than the surrounding grey or only slightly shiny pink mucosa, some neat edge, clear boundaries, while others vary with leukoplakia Mianqian easy to wipe the surface, the bottom point was bleeding.

Endoscopic findings have the following characteristics: ① leukoplakia hyperkeratosis the surface appear incomplete or keratosis; ② epithelial cell proliferation, hypertrophy, with spine cell layer thickness; ③ granule cell layer thickness, epithelial legs extended, widened; ④ epithelium under a circular mesenchymal cells and lymphocyte infiltration. Some morphological characteristics in accordance with the organization, will be divided into two cervical leukoplakia, cervical epithelial surface layer only 2 to 3 keratosis or incomplete keratosis, the spine cells under basal cell layer and to maintain a normal or benign, as leukoplakia Ⅰ level; diagonalization of the epithelial cell proliferation is not typical, as leukoplakia Ⅱ.

[Clinical]




Leukoplakia asymptomatic cervical more simple, and might have dissipated naturally; if the merger cervical erosion endometrial or cervical ectropion, then Leucorrhea increase, or sometimes bloody vaginal secretions and contact bleeding. Local checks seen as above.