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Cervival, vaginal and vulvar precancerous lesions – basics of new terminology

Kamila Trepka, Piotr Bodzek, Anita Olejek

Affiliacja i adres do korespondencji
Curr Gynecol Oncol 2018, 16 (2), p. 109–112
DOI: 10.15557/CGO.2018.0014
Streszczenie

Uniform medical nomenclature enables proper communication both in scientific and clinical settings. The aim of this analysis is to present the latest nomenclature of vulvar, vaginal and cervical precancerous conditions compared with the previous terminology. In 2012, the College of American Pathologists and American Society for Colposcopy and Cervical Pathology replaced the three-grade classification of precancerous lesions of the vulva, vagina and cervix, i.e. IN (intraepithelial neoplasia), with a two-grade system, i.e. SIL (squamous intraepithelial lesion): LSIL and HSIL. This terminology concerns HPV-induced non-neoplastic lesions of all the mentioned areas. The mandatory diagnostic workup now also includes p16 immunostaining. At present, precancerous vulvar lesions are divided into: 1) LSIL, including condyloma and HPV effect, 2) HSIL, previously called uVIN, occurring in younger women and associated with HPV infection, and 3) dVIN, developing in older patients with lichen sclerosus. Precancerous vaginal lesions are divided into: 1) LSIL, previously classed as VaIN 1, and 2) HSIL, prior VaIN 2/3. The analogous division refers to cervical pathologies: 1) LSIL, i.e. all CIN 1 and p16-negative CIN 2 lesions, and 2) HSIL, i.e. CIN 3 and p16-positive CIN 2 lesions. The new nomenclature enables better understanding of the etiology and natural history of the diseases, and helps select appropriate management. The introduction of changes to the common terminology requires education of the medical staff.

Słowa kluczowe
LSIL, HSIL, gynecologic terminology