abbreviated HGSIL) is a type of abnormal growth of
squamous cells on the surface of the cervix. Squamous
cells are flat, scale-like types of epithelial cells.
Epithelial cells are cells that help absorb, move, and
distribute some of the fluids and nutrients in the body.
The cervix is a small, cylinder-shaped organ that forms
the lower part and neck of the uterus. The uterus is a
hollow organ in a female's body where the egg is
implanted and the fetus develops.
There are high grade squamous intraepithelial lesions and low grade squamous
intraepithelial lesions. The terms "high grade" and "low grade" (in reference to squamous
intraepithelial lesions) refers to how abnormal the cells are and how much of the cervix is
A high grade squamous intraepithelial lesion is one in which the cells are very abnormal
(commonly abbreviated LGSIL) is one in which the cells are not very abnormal and not
much of the cervix is affected.
HOW ARE HIGH GRADE SQUAMOUS INTRAEPITHELIAL
High grade squamous intraepithelial lesions are usually diagnosed
with a Pap smear or colposcopy. A Pap smear is a type of test
used to detect abnormal changes in cells. This is done by scraping
away loose cells from the cervix, spreading (smearing) it on a glass
slide, and examining it under a microscope. A colposcopy is a
visual examination of the vagina and cervix with a lighted
magnifying instrument, known as a colposcope. The vagina is an
opening in the female's body that is part of the reproductive
The definitive way to diagnose a high grade squamous intraepithelial lesion is with a biopsy done during
a colposcopy. A biopsy is the process of removing living tissue or cells from organs or other body parts
of patients for examination under a microscope or in a culture to help make a diagnosis, follow the
course of a disease, or estimate a prognosis. A culture is an artificial way to grow cells or tissues in the
The above procedures are usually performed by an OB/GYN, which stands for obstetrician and
science that deals with the care of women and their fetuses during pregnancy and childbirth, and during
the events that come before and soon after birth. A gynceologist is a physician who specializes in
gynecology, which is the science that deals with the health care of women, including diseases and
normal physical care of the female reproductive system.
DOES HAVING A HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESION MEAN THAT CANCER IS
Having a high grade squamous intraepithelial lesion does not mean that cancer is present. Cancer is an
abnormal growth of new tissue characterized by uncontrolled growth of abnormally structured cells that
have a more primitive form. The presence of high grade squamous intraepithelial lesions represents
changes in cells that can occur before cancer is present. Thus, high grade squamous intraepithelial
lesions are often seen by doctors as warnings that cancer of the cervix may occur at a later date.
It should be noted that the chances of having a high grade intraepithelial lesion showing up on a Pap
smear with invasive cancer of the cervix already being present is less than 1%. Also, only about 1.5%
of women with a high grade intraepithelial lesion that shows up on a Pap smear will progress to cancer
of the cervix within the next 24 months.
HOW ARE HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESIONS TREATED?
Since high grade squamous intraepithelial lesions can progress to cancer of the cervix, it is important for
them to be treated. The results of the colposcopy, and not the Pap smear, will provide the basis for
treatment. This is because a colposcopy (combined with a biopsy) is a more definitive test than the Pap
The goal of treatment is to destroy and/or remove the abnormal cells on the cervix so that new healthy
cells will grow over the area where the abnormalities were present. Squamous intraepithelial lesions can
be destroyed by applying below-freezing temperatures to them, by using lasers, or by applying heat
and/or electrical currents. If abnormal areas of tissue need to be totally removed, a colposcopy is often
used as a visual aid during surgery. Removal of the tissue can take place during the biopsy or at a later
time if the patient desires.
It is important to note that if there is disease inside the canal (passageway) of the cervix, doctors do not
freeze the disease tissue. Freezing is generally used in small areas of abnormality (even if they are
severe) that do not enter the canal of the cervix. Freezing tissue usually only takes a few minutes to do
in the doctor's office. Healing from this freezing procedure will take about 3 weeks. A watery liquid will
usually come out of the vagina during the healing process after the freezing procedure.
Destroying tissue with laser or heated electrical current is usually more appropriate for larger areas of
abnormality. Presently, this is the most frequently used treatment for high grade intraepithelial lesions.
Larger abnormal areas (even if they are mildly abnormal) are more than an inch wide, more than a half
inch from the bone by the cervix, or in more than two quadrants of the cervix. A quadrant is a division
into four areas. Abnormal areas that enter the canal of the cervix generally respond best to treatment
with laser therapy or electrical current.
The abnormal cells that are removed are usually located at the transformation zone of the cervix. The
transformation zone is located in the outside of the cervix or in the canal of the cervix. The
transformation zone is the area where tall cells shaped like a column (known as columnar cells) are
transformed (changed) into flat cells known as squamous cells. It is in the transformation zone that
abnormalities develop. In general, any procedure that destroys squamous intraepithelial lesions on the
cervix cures the condition in about 85% of the cases.
WHAT IS THE ORIGIN OF THE TERM, HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESION?
High grade squamous intraepithelial lesion comes from the Old English word "heh" meaning "tall," the
Latin word "gradus" meaning "a step," the Latin word "squama" meaning "scale," the Latin word "intra"
meaning "within," the Greek word "epi" meaning "upon," the Greek word "thele" meaning "nipple," and the
Latin word "laesus" meaning "an injury." Put the words together and you have "tall a step scale within
upon nipple an injury."