Treatment is now not recommended as an option in women with CIN 1 who have previously had ASC-US, ASC-H, or LGSIL. Now, follow-up with cytology every six to 12 months or HPV testing at 12 months is recommended.
When it comes to considering alternative treatments, we can consider our topical and systemic options for helping to clear the virus and the abnormal cells changes, especially for ASC-US and LGSIL. Even those with histologic changes of CIN 2,3 can be candidates for more aggressive natural treatment protocols involving supplementation, topical suppositories, and the use of an herbal escharotic treatment.
Clinical Acronyms Atypical glandular cells AGC Atypical glandular cells not otherwise specified AGC-NOS Adenocarcinoma in situ AIS Atypical squamous cells ASC Atypical squamous cells: cannot exclude high-grade ASC-H Atypical squamous cells of undetermined significance ASC-US Cervical intraepithelial neoplasia CIN High-grade squamous epithelial neoplasia HGSIL Human papillomavirus HPV Low-grade squamous intraepithelial lesion LGSIL
Rates of regression among patients with HGSILs and LGSILs
were statistically significant.
The descriptor LGSIL encompasses both mild dysplasia and condyloma acuminatum (Figures 5 and 6).
Patients with these lesions may have had LGSIL that has progressed, or may not have had regular Pap smears, resulting in late detection of the lesion.
LGSIL, which denotes low-grade squamous intraepithelial lesion, equates to cellular changes associated with mild dysplasia, cervical intraepithelial neoplasia I (CIN 1) or human papillomapirus (HPV); HGSIL, high-grade squamous intraepitbclial Icsion, equates to moderate dysplasia (CIN2) or severe dysplasia (CIN 3 or carcinoma in situ).
"See and Treat" Colposcopic Impression ELECTZ Histology LGSIL, n HGSIL, n Other, n Negative(*) 13 2 1 LGSIL 7 1 2 HGSIL 4 16 0 Total 24 19 3
There are no definite guidelines on how long to continue to follow patients with LGSIL. Recent guidelines issued by the National Cancer Institute recommend observation for 2 years through cytologic testing alone, as an alternative to immediate colposcopy.(21) Consideration should be given to treating LGSIL that persists for over 1 year.(22)
Lesion Characteristic Ablative Excisional Size <2 quadrants >2 quadrants Grade LGSIL, focal HGSIL All grades SIL >5 mm in os No Yes LGSIL denotes low-grade squamous intraepithelial lesion; HGSIL, high-grade squamous intraepithelial lesion.