Management of patients with abnormal screening results and precancerous conditions of the cervix according to national standards 2024 (clinical case)
DOI:
https://doi.org/10.15574/HW.2024.6(175).8388Keywords:
squamous intraepithelial lesion, atypical glandular cells, sorting additional examination, risk of CIN 3 , targeted biopsyAbstract
Аim - to solve the problem of early diagnosis and treatment of pathological conditions of the cervix in accordance with the national standard of medical care (order of the Ministry of Health of Ukraine No. 1057) using the example of a clinical case analysis.
Clinical case. Patient B., born in 1986, complained of periodic pain in the lower abdomen and the inability to get pregnant for 7 years. Additional examination was performed: the conclusion of liquid cytology ASC-US, HPV genotyping revealed 16, 18, 31 HPV genotypes. Full diagnosis as: Primary infertility. ASC-US (atypical squamous epithelial cells of unclear genesis). Immediate risk of CIN 3+ 4.4%. Clinical form of HPV (16, 18, 33 genotypes). Ectopia of the cervix. Transformation zone type 1. Chronic cervicitis. Anti-inflammatory therapy was performed. Diagnosis after treatment: HSIL, AGUS. Immediate risk of CIN 3+ 32%. Clinical form of HPV (16). Ectopia of the cervix. Transformation zone type 1. Chronic cervicitis. Was targeted radio wave excision of the cervix was performed. The results of the pathohistological examination indicated low-grade squamous intraepithelial lesion LSIL, atypical glandular cells were not detected. Diagnosis: LSIL. Immediate risk of CIN 3+ 2.9%. Clinical form of HPV (16). Ectopia of the cervix. Transformation zone type 1. Taking into account the recommendations of the standard, after receiving the appropriate histological conclusion, we can subsequently observe the woman for 1 year.
Conclusions. The analysis of a clinical case indicates that for the timely diagnosis of intraepithelial lesions of the cervix, it is necessary to conduct cervical screening, sorting additional examination and determining the risk of CIN 3+. If cervical screening is already standardized in gynecological practice, sorting additional examination and determining the risk of CIN 3+ are new concepts that are generally not used.
The study was performed in accordance with the principles of the Declaration of Helsinki. The woman's informed consent was obtained for the study.
The author declares that there is no conflict of interest.
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