Abnormal Cervical Cells: Do You Need Surgery for CIN2? - Obstetrics and Gynecology

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Cervical cell abnormalities


Hello, doctor.
In October, I had my first Pap smear, which indicated abnormal cells.
I was referred to a private hospital and underwent a hysteroscopy in November, where biopsies were taken from three locations.
Yesterday, I received the report stating that one of the locations showed CIN2.
The area was treated with a solution but remained white, so the recommendation is to undergo a loop electrosurgical excision procedure (LEEP).
Since I am young, the doctor mentioned that this could affect my fertility and increase the risk of preterm birth.
Is it necessary to have the surgery to achieve a cure?

Ms. N, 20~29 year old female. Ask Date: 2015/11/25

Dr. Xu Junrui reply Obstetrics and Gynecology


Yes, the full name of the condition you have is Stage II cervical intraepithelial neoplasia.
The standard treatment is indeed surgical intervention for definitive management.
If surgery is not performed, there is a risk of progression to Stage III precancerous lesions or even cancer.

Reply Date: 2015/11/25

More Info


When it comes to abnormal cervical cells, particularly in the case of CIN2 (Cervical Intraepithelial Neoplasia grade 2), the question of whether surgery is necessary for treatment is a significant one. CIN2 is classified as a moderate level of dysplasia, which indicates that there are abnormal cells on the surface of the cervix that have the potential to progress to cervical cancer if left untreated.
The standard treatment for CIN2 typically involves surgical intervention, specifically a procedure known as a cone biopsy or cervical conization. This procedure involves removing a cone-shaped section of the cervix that contains the abnormal cells. The rationale behind this approach is to ensure that all potentially cancerous cells are removed and to prevent the progression of the disease to more severe stages, such as CIN3 or invasive cervical cancer.

In your case, the recommendation for a loop electrosurgical excision procedure (LEEP) is common for CIN2. While it is understandable to have concerns about the impact of surgery on future pregnancies, it is important to weigh the risks of not undergoing surgery. If CIN2 is not treated, there is a risk that it could progress to CIN3, which is a high-grade lesion that has a higher likelihood of developing into cervical cancer. The progression from CIN2 to CIN3 can occur over a few years, and the longer the abnormal cells remain untreated, the greater the risk of cancer development.

Regarding your concerns about fertility and the possibility of preterm birth, it is true that surgical procedures on the cervix can have implications for future pregnancies. However, many women who have undergone conization go on to have successful pregnancies. The key is to have careful monitoring during pregnancy, as there may be a slightly increased risk of complications such as preterm labor. It is essential to discuss these concerns with your healthcare provider, who can provide personalized advice based on your medical history and future family planning.

As for the question of whether it is possible to rely solely on enhancing your immune system to resolve CIN2, the consensus in the medical community is that while the immune system plays a role in controlling HPV (the virus often associated with cervical dysplasia), it is not a reliable method for treating established CIN2 lesions. The immune system may clear HPV infections in some cases, but once dysplasia has developed, surgical intervention is typically necessary to ensure that the abnormal cells are removed.

In summary, while the decision to undergo surgery can be daunting, it is crucial to consider the potential risks of not treating CIN2. Surgical intervention is the most effective way to prevent the progression of cervical dysplasia and to safeguard your long-term health. It is advisable to have an open discussion with your healthcare provider about your concerns, the implications of surgery, and the best course of action for your specific situation. Regular follow-ups and monitoring are also essential after treatment to ensure that any future changes in cervical health are promptly addressed.

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