Epithelial cells are a type of flat cells that are found on various surfaces of the body such as the skin. They are also found on the surface of the cervix which is the opening that leads to your uterus. A commonly used tool to screen for abnormalities in the cervix is the Pap smear test which detects any epithelial cell abnormality. Depending on the results, repeated testing may be required to determine your options for treatment.
What Does Epithelial Cell Abnormality Mean?
The meaning of epithelial cell abnormality depends on its type. One of the examples is cervical dysplasia which means that the cervical cells are growing abnormally in number or appearance. In this case, epithelial cell abnormality means unusually shaped or sized cells on the cervix in vagina. Continuous and uncontrolled growth of abnormal cells may begin in women between the age of 25 and 35. Although they may not have any symptoms initially, abnormal cell proliferationcan lead to cancer over a number of years.
A Pap smear helps detect unusual changes in the size and/or shape of the cells on the surface of your cervix. The abnormality may indicate that you have a pre-cancerous or a cancerous growth that needs further evaluation and treatment. Pre-cancerous cells may lead to the development of cancer, but if treated immediately, it may be of no serious consequence.
Talk to your doctor about your Pap smear results if you don’t understand the meanings. In most cases, abnormal findings on a Pap smear turn out to be completely benign (not cancerous) and is highly treatable. However, regular Pap testing is important to ensure that abnormal changes do not cause serious problems in the future.
What Are the Types of Epithelial Cell Abnormality?
1. Atypical Squamous Cells (ASC)
Atypical cells are abnormal and can be classified as either Atypical Squamous Cells of Undetermined Significance which do not usually lead to serious problems, or Atypical Squamous Cells with possible High-Grade Changes which may be pre-cancerous cells. Your doctor may recommend a colposcopy, a diagnostic test to examine the cervix directly for lesions.
2. Squamous Intraepithelial Lesions (SIL)
These are growths on your cervix that may be categorized into low or high risk changes, depending on their likelihood of developing into cancer. SIL may warrant further examination through colposcopy and biopsy to determine the risk associated with the epithelial cell abnormality.
3. Squamous Cell Carcinoma
This is the most common type of cancer of the cervix which can even lead to death if not treated early. Doctors would perform colposcopy and biopsy to determine the stage of the cancer. If classified as "in situ," the cancerous cells have not spread into the surrounding tissues. However, at stages two to four, the cancer cells may have spread beyond the cervix.
4. Atypical Glandular Cells (AGC)
In many cases, the abnormality of atypical glandular cells in the cervix or the uterus is not a serious problem, but sometimes it can be pre-cancerous. A biopsy may be done to confirm the diagnosis.
This is an uncommon type of epithelial cell abnormality that affects glandular cells. Similar to squamous cell cancer, further testing is required to determine the cancer stage and treatment options.
Treatments for Epithelial Cell Abnormality
In this procedure, your doctor takes a closer look at your cervix. It also cleans the cervix with acetic acid and takes a piece of tissue (biopsy) for laboratory analysis. Colposcopy is painless and simple, but you will be asked to avoid sexual intercourse, douching or using tampons for a week after biopsy is done.
This procedure allows a large sample of abnormal tissue to be taken for laboratory analysis to determine if you have invasive cancer. After colposcopy, a cone-shaped tissue containing abnormal cells is taken from the cervix. Conization is usually done under anesthesia and can be curative if all the affected cells are removed. However, there are some risks associated with anesthesia and the procedure, which may affect fertility.
In this procedure, a cryoprobe that is cooled with carbon dioxide is used to touch the abnormal area of the cervix, resulting in the freeze and death of abnormal cells. You will experience a watery discharge for weeks after cryocauterization.
4. Laser Therapy
Laser therapy uses light that is produced by electricity and runs through a gas (carbon dioxide) to vaporize the abnormal cells. The laser beam comes from a wand (micromanipulator), which is directed to the abnormal cervical tissue. This procedure is painful, so it is done under general anesthesia. Although it causes less cervical scarring, it is expensive and requires a lot of skill.
5. Large-Loop Excision of the Transformation Zone
This technique removes the area where the cells transform to the uterine lining (cervical transformation zone), using electrocautery through a thin wire loop. It allows the collection of a tissue sample for lab analysis and can be done under local anesthesia. Frequent follow-ups are necessary after this procedure, including colposcopy and the Pap smears. It is now the most frequently used treatment for epithelial cell abnormality.