I am new here and I am wondering if anyone can help. I have high risk hpv. My last pap came back with changes so I had to have a colposcopy and biopsy. I was informed that my biopsy was negative for cancer, but it was not totally negative. I was told to just come back in six months for a repeat pap and go from there.
I received a copy of the lab results for my own keeping and I am curious if anyone knows what these results mean. I have tried to look it up online, however, I can't seem to decipher.
Diagnosis: Endocervical and exocervical mucosa with mild chronic cervicitis and squamous metaplasia, negative for displasia.
Immunohistochemical studies for p16/ki67 show negativity for p16 and expression of ki67 limited to the basal cells, excluding dysplasia.
Diagnosis: Endocervical mucosa with stromal decidualization, suggestive of progestin-like effects, negative for dysplasia.
Does anyone have any idea what these results mean? If anyone can help, I would be extremely grateful. Right now I am confused and don't know if I should be worried.
It looks like they found changes to the Endo (inner) and Exo (outer) cervical tissue. Mucosa is the type of skin cells that exist on soft external tissues around orifices. Mucosa is soft, pink, and contains many glands. The skin cells in your mouth, for example, are a type of mucosa. I am pretty sure that "squaumous" describes a type of skin cancer. Metaplasia is the transformation of one type of tissue into another. HPV first transforms the cervical cells into a "precancerous state", though cancer itself has not yet developed. "Negative for dysplasia" is very good. You do not have cervical cancer. Most people do not advance past the metaplasia stage, and the symptoms of HPV go away on their own.
Basal cells are the skin cells located at the deepest part of the epidermis. I do not know what p16 and ki67 are, but it looks like p16 was not detected, and ki67 had a limited presence in the basal cells of the cervix. Explanation of that is at the next level of microbiology, and I could not provide you with a coherent answer of what p16 and ki67 are or mean.
Progestin is a synthetic form of progesterone, and is common in birth control. Stromal decidualization normally happens during pregnancy when progesterone levels are high. Since the progestin in birth control imitates progesterone, the presence of stromal decidualization is normal. Birth control keeps the body in a state similar to early pregnancy, stopping ovulation from occurring, and such a state would bring about stromal decidualization.
Going back to the metaplasia, that is a manifestation of the HPV modifying cervical cells. Some doctors call it "pre-cancerous" because there the initial symptoms that can progress into cancer are there, but the site has not become cancerous, and it is difficult to tell whether or not it will. As long as your immune system is able to prevent them from continuing to morph for an extended period, it will not advance into dysplasia. Your six month follow-up will be to see if the cells have advanced to dysplasia, stayed the same as metaplasia, or have gone away. Ideally the damaged cell tissue will have gone away on its own by then. If not, your doctor may undertake more aggressive measures.