High grade lesions

[Funtk]

Hi,

i have 2 abnormal pap tests in a row (low grade squamous intraepithelial lesion- LGSIL), one was done a year ago, another one is just a month ago. I have high risk hpv but i am not sure which type (used to be type 52 but i am not sure right now). I also had a biopsy last year and it was negative. My questions are:

1) Can LGSIL turn into normal cells in my case (with 2 abnormal pap smears)?
2) Can LGSIL stay till the rest of my life without turning neither into normal cells or HGSIL? (High grade lesion)
3) What is the % that LGSIL turn into HGSIL and how long could it take?

Thank you everybody for your comments and responces.

[Funtk]

Thank you so much, it's very helpful.

[Hollyv]

I think the MD poster may have given you some inaccurate information when she said, “will not resort to normal cells”—I’m not even sure what will not resort to normal cells means but if she meant they will not return to normal cells that is not true. If you have had a Pap that indicated LSIL, that would indicate in 80% of the population that you had HPV—not everyone with LSIL has HPV. It would appear from your posting that you must have had a PCR test at some point that indicated that you had HPV 52. A Pap test is a screening test and so is an HPV test. They are testing you to see if you may be at risk for cervical cancer. Cervical cancer is rare in the US. If you had a biopsy as you say you did and there is no abnormal cells then there is no abnormal cells. Low grade squamous intraepithelial cells or LSIL that are found on biopsy (very different than a Pap) are referred to as CIN 1 or cervical intraepithelial neoplasia. You were normal on biopsy therefore you have normal cervical cells. Even if you had CIN 1 on biopsy this can return to normal. CIN 2 sometimes returns to normal and CIN 2 sometimes goes on to CIN 3 (which would be a precancer that they would treat with a LEEP) and they sometimes treat CIN 2 with a LEEP depending on your history and your age. Under 30 years of age they try to only do a LEEP if they really need to.

Answers to your questions:
1. Yes, LSIL is a very low level of abnormal and can go back to normal.
2. You would not have LSIL for the rest of your life, you will either go back and have normal Paps which happens most of the time or they will continue to watch you and if the level increases, they will want you to have a LEEP to get rid of the abnormal cells. You would have to abnormal cells on your biopsy with a colposcopy for them to do a LEEP, this would not be done for a LSIL Pap smear.
3. Usually LSIL means an HPV infection and this usually reverses and goes back to normal in 6-24 months. Your Dr. will probably want you to have a Pap every 6-12 months.

You should speak with your Dr. the next time and have him/her fully explain this to you so that you can understand this better and what your Pap results mean.

Good Luck.

[Funtk]

thank u very much

[Bhupinder Kaur, MD]

Hello,
Having a low grade squamous intraepithelial lesion does not mean that cancer is present.The presence of low grade squamous intraepithelial lesions represents changes in cells that may occur before cancer is present. It may convert itself to high grade squamous intraepithelial lesion but will not resort to normal cells.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.