Cervical intraepithelial neoplasia

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The cervical intraepithelial neoplasia (CIN) is one as a precancerous applicable dysplasia of the uterine cervix is.

Clinical picture

The CIN is divided into three degrees of severity:

  • CIN I: (slight dysplasia) extends from the basal to a maximum of one third of the height of the epithelium ;
  • CIN II: (moderate dysplasia) up to two thirds of the epithelium;
  • CIN III: (severe dysplasia) pervades almost the entire epithelium ( carcinoma in situ ).

  • Normal cervical epithelium.

  • Grade I CIN.

  • Grade II CIN.

  • Grade III CIN.

The CIN III is regarded as a so-called obligatory precancerous condition , which means that a transition to cervical carcinoma is very likely. A protracted HPV infection of the genital type (especially nos. 16 and 18) and a high number of births are considered etiologically significant .

The average age of patients at the onset of one for CIN I and CIN II is 24–27 years. About half of the CIN-1 lesions regress. Around 10% progress to CIN III and 2% become invasive cervical cancer . The mean age of patients when a CIN III lesion was discovered ranged from 35 to 40 years.

The further procedure will be determined depending on the severity of the CIN. In the case of mild dysplasia (CIN I), a spontaneous regression rate of 50 to 70 percent is assumed, so it is mainly a wait-and-see approach and checks at regular intervals to see whether and how the dysplasia is developing. In moderate dysplasias (CIN II) the regression rate is around 30–50 percent. In this case, a decision is made between a wait-and-see approach with regular checks or removal of the affected area on the cervix using conization or laser vaporization. In severe dysplasias (CIN III), the spontaneous regression rate is only 10 percent. A conization should tend to take place here.

Individual evidence

  1. ↑ Stanley Robboy, Maria Merino, George Mother: The Female Reproductive System. In: Raphael Rubin, David Strayer et al .: Rubin's Pathology. 5th edition. Philadelphia 2008, p. 798.