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Old 05-14-2008, 05:56 PM   #1
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HGSIL & LEEP questions.

My name is Katie. Approximately 8 months ago I had my annual pap and results came back abnormal, which did not make me take notice as I have always had abnomal paps since the first. I was informed that I was HPV positive and with the abnormal pap I needed a colposcopy and biopsy. The results of which came back normal and was told I should now have paps semi-annually.
About 2 months ago I had my second pap, although the results have, what I call escalated, to LGSIL. This meant another colposcopy and biopsy. During the procedure I was able to look at the screen and view my cervix with the rest of the staff on hand. The physician informed me she saw nothing to worry about, but we went ahead with the biopsy just to make sure. Unfortunately for me the results came back HGSIL. I now have to go for a LEEP in the end of June, because it was the earliest I could be scheduled. I am reading up and doing as much research on the subject so I know what is happening and where I should have concerns. But there isn't really one site that puts the acronyms in definitions and places them in any sort of severity level. I can understand that LGSIL is lesser than HGSIL, but what is CIN, VIN, or CIS I keep reading about?
I recently just read that there can be a correlation between long term birth control use and cervical dysplasia as well. This will be my 7th year on the same birth control and wonder if this played a role. This one site is the only one I have found that also says that high risk HPV, which I have, and hgsil wil usually lead into cervical cancer. No other site uses "usually". I just want to know where I stand in the severity of things. Is all of this bad? How does having a LEEP effect me having childre? I am only 26, almost 27 and want to finish school before children. With the fear of cancer risk looming in my mind, will it change my life plans? Any answers would be great.

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Old 05-14-2008, 06:29 PM   #2
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Re: HGSIL & LEEP questions.

Pepper, I am just a little further along this road than you. I still don't understand the lgsil and hgsil, but think it refers to abnormal squamous cells. I don't know a lot about squamous cells except to say they are the cells on the exocervix (outer cervix). I've also read that 90% of women who have atypical pap/biopsy results have atypical squamous cells. Atypical squamous cells are more common and slower growing than atypical glandular cells.

That's about all I know. My diagnosis history began with a positive HPV/DNA test, clear paps (for 20+ years), clear colposcopy and no biopsy taken, but doctor also did an ECC. The ECC came back adenocarcinoma in situ and atypical glandular epithelial lesions. That lead to a cone biopsy and endocervical adenocarcinoma Ia1. Remember, my atypical cells are different from yours (the way I understand what you've written). The good news is that my only treatment will be a hysterectomy (cervix and uterus only) no chemo and no radiation. I am 44 and do not plan to have children.

I'm sure someone else will come a long and give you better information than I've given to you. I really just wnat to let you know you are not alone in this. (((hugs)))

Old 05-14-2008, 06:45 PM   #3
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Re: HGSIL & LEEP questions.

Hi're right...there's alot out there and sometimes difficult to figure it all out. I'll do my best and I'm sure others will chime in as well.

HPV is a virus. There are many strains of the virus some are considered HIGH RISk and others are considered LOW RISK. Both kinds can cause cellular changes on the cervix however the HIGH RISK strains cause changes that if not monitored or treated can progress to cancer. I'm told this progression is usually very slow and can take many years. The good news is there is alot that can be done during that time to stop the progression and remove the dysplasia. The low risk HPV can cause changes but these changes are not thought to progress.

Now when changes occur on the cervix, the PAP or colposcopy will grade the changes. PAPS(screening) are not as accurate as colposcopy with biopsy (diagnostic). The changes or dysplasia are classified as
1. ASCUS-atypical (mild abnormality)
2. CIN 1 (LGSIL)
3. CIN 11
4. CIN 111 (HGSIL)
5.CIS- Carcinoma In Situ--Cancer in its place (i.e has not spread)
6.Invasive Cancer

The options for dealing with the changes (dysplasia) include "waiting and watching"--usually for ASCUS or LGSIL, then LEEP, Cryo, Cone, Hysterectomy etc. for higher grades and/or CIS.

From your post, it sounds like you have hrHPV (high risk) with moderate+ dysplasia and to treat it your doc wants to perform LEEP. This procedure from what I understand is highly successful. There are several women on the board who have had the procedure so hopefully they can weigh in more on the procedure.

Hopefully this helps somewhat. Take care!

Old 05-14-2008, 07:11 PM   #4
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Re: HGSIL & LEEP questions.

Originally Posted by Pickle Eyes View Post
I don't know a lot about squamous cells except to say they are the cells on the exocervix (outer cervix).
Pickle-thanks for the extra info, and for you I can try to explain squamous cells a little bit. Squamous cells are a type of epithelial cell (skin cell) that covers any open area of your body. Such as skin, mouth, trachea, vagina, etc. They are just called squamous becuase the word refers to the shape of the cell. They are usually in areas to protect against friction, among other things, so they are constantly being regrown. It's another way to say they are surface cells. You may already know this, but I am just offering the knowledge I have, which is little. Thanks for the support.

Last edited by mod_007; 05-15-2008 at 12:36 PM. Reason: Breach of posting rules - do not make claims of specialist knowledge

Old 05-14-2008, 07:14 PM   #5
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Re: HGSIL & LEEP questions.

Mommy&Wifey- so is HGSIL considered pre-cancerous? Or more of a sign of pre-cancerous? All the sites are half one way, half the other. Plus you can't really believe everything you read online anyway. I know to verfiy sources and check medical journals for better and more accurate information. Also, thankyou so much for helping clear some of it up. The list you made helps a great deal.

Old 05-15-2008, 03:23 PM   #6
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Re: HGSIL & LEEP questions.

Hi...glad it helps. My understanding is that all levels are considered PRE cancer except ofcourse invasive cancer. Even CIS is considered pre- cancer. The name is misleading because CIS or Carcinoma In Situ literally means "cancer in its place" but I'm told it is not yet considered "cancer". As for the grade "list" I posted, the only difference in the grades is the depth of the cervix that is involved. The grade is higher the deeper the abnormalities are so CIN III would involve more of the cervix than CIN I. However, treatment at those levels is still pretty successful. Even CIS, because it hasn't spread, can be treated albeit usually with the more extreme solution-- hysterectomy. The good news is there is plenty of time and options to get this before it gets to full blown cancer and even then treatment is possible.

Take care and keep us posted.

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