Written by: Six floors | Editor-in-charge: Ke Xin | Image: Huang Zai
Hello, everyone, welcome to the "hard verification science" that everything can be used to do popular science, I am six floors.
On the topic of HPV, we have talked a lot, many friends have seen a lot, and at the same time, for the HPV vaccine, I will also feel overwhelmed, how to say this every day! And the end?
But if we communicate in depth, we may find that many people have a very shallow understanding of HPV and cervical health, or a very fragmented understanding, and it is not very clear to ask a little question. Like what:
How many HPVs are there?
What are the cervix-related?
How does HPV damage the cervix?
How does cervical cancer occur?
How to prevent the occurrence of cervical cancer?
What is the significance of TCT and colposcopic biopsy?
How does the HPV vaccine work?
......
If everyone who is currently in a healthy state can answer these questions accurately, then congratulations, the probability of cervical cancer in your lifetime is almost zero, because you have mastered the method of protecting the cervix.
But if you're not quite sure, then what you're going to talk about next is critical. As you can see, this time I also spent a lot of money to buy a lot of props, ready to discuss the outstanding issues with you.
▲Image source: Weibo @ Mr. Six Floors
I hope that through today's content, we can let everyone more systematically understand the knowledge related to HPV and cervical health, and help everyone better understand themselves and protect themselves.
Without further ado, check it out with me!
What does the cervix look like?
The cervix is the opening of the uterus, but also the end of the yin road, connecting the uterine cavity inward and the communication between the pelvic abdominal cavity and the outside world outward. Therefore, whether it is position or structure, the cervix is a very critical presence.
The surface of the cervix is usually squamous epithelial cells, which cover the surface of the cervix layer by layer like scales, which are used to protect the cervix and resist bacterial infestation, while also reducing the friction between tissues caused by walking, running and jumping and intercourse in daily life.
In addition, in part of the cervical opening, there will be some columnar epithelial cells from the cervical canal.
Generally when our estrogen levels tend to mature and stabilize, they will move towards the cervical opening and the outside. This looks like erosion, but it is actually a normal physiological change, the scientific name is cervical columnar epithelial ectopic, to put it bluntly, it is different kinds of cells moving outward.
▲Image source: Weibo @ Mr. Six Floors
In short, a rumor of "cervical erosion" was resolved by hand, and it was said again: "cervical erosion" is not a disease, the word has been removed from the textbook, and it does not need treatment.
What is hpv virus?
After understanding the cervix, let's talk about the HPV virus.
HPV virus is a large family, there are many virus species in the family, mainly divided into two categories, one is the skin type, one is the mucosal type, and the cervical health is mainly related to the mucosal type.
Among them, according to the degree of risk of causing cervical cancer, it is divided into high-risk types and low-risk types, of which high-risk types are 16, 18, 31, 33, 45, 52, 58, etc.; low-risk types are 6 and 11 types, which usually do not cause cervical cancer, but cause genital warts.
▲Image source: Weibo @ Mr. Six Floors
Here it needs to be explained that the HPV mentioned by obstetricians and gynecologists generally refers to the high-risk HPV virus mentioned earlier, so next, I will refer to this type of high-risk HPV as HPV.
After understanding the above basic information, we can talk about how a healthy cervix gets sick.
How does the cervix get sick?
To put it simply, cervical cancer is developed from cervical lesions, and cervical lesions are produced by a mutated cell at the beginning, so cervical cancer has a process of development and change, not suddenly.
When the first mutated cell appears, it is possible to be discovered and destroyed by the body's immune system, then it is fine, but if the mutated cell survives, then it is possible to continue to develop, from low-grade lesions, to high-grade lesions, and finally cervical cancer.
So how did the cells on the cervix start to mutate? This is related to the HPV we talked about earlier.
We assume that the cervix is the following car, in a healthy state, this car has been parked in the position of the health station, has not been started, will not go anywhere, just stay in the station steadily, many people will not start this car in this life.
▲Image source: Weibo @ Mr. Six Floors
However, there are many locks on each cell that start the mutation process, and once the lock is opened and the cell mutates, the trolley starts to start.
So guess what is the key to unlock the lock? That's right, the high-risk HPV viruses mentioned earlier.
The persistence of these HPVs doesn't cause us any sensations, even if you don't check them, but these viruses constantly stimulate and affect the cells in the cervix, trying to open the lock.
Among them, the two locks numbered 16 and 18 are the most likely to start the key of the car (accounting for about 70 to 80%), which can be said to be two large keys, and from the research point of view, type 16 is mainly for squamous epithelial cells, and type 18 is mainly for columnar epithelial cells.
▲Image source: Weibo @ Mr. Six Floors
▲Image source: Weibo @ Mr. Six Floors
There are several other numbered keys that are also likely to start the car, of which the Type 52 and Type 58 are more widely distributed in the country and need to be paid attention to.
Including some studies, it is also pointed out that the impact of these two types on women's health may exceed the impact of type 18, of course, more research is needed to prove it.
In short, once the lock is opened, the mutated cell is generated, and the subsequent development is divided and multiplied by the mutant cell, that is, the subsequent mutant cells will produce new mutant cells on their own, even if they do not have the influence of HPV.
Seeing this, i think many people have begun to panic, feeling as if they are infected with HPV, in fact, it is not, first do not scare yourself.
Because a large number of studies have proved that the car with the key is not immediately started, some need to be tried repeatedly for a long time, and the "long-term continuation" here is usually discussed in several years.
And the real long-term sustained infection of people is a minority, most of the time, this key in the process of trying to unlock the lock, they will wear themselves out, after all, the body's own immune system is not vegetarian.
Factual data also show that 70% to 80% of people turn negative themselves about 1 year after infection. That is to say, the key is there, but the lock is not opened at all.
How to tell if the cervix is sick?
Speaking of which, I guess you will be very curious, so how to see if there are keys in my car, and if so, which keys are specific? If there is no key, how can you tell if the car has started?
This involves several of the common tests we mentioned.
The first is to directly check HPV to see if there are these keys on our car, and if so, what keys are available, especially focusing on whether there are two high-risk viruses in 16 and 18.
Secondly, you need to check the TCT at the same time, this examination is the cervical shedding cells, from which to find out whether there are mutated cells, through the cells can determine whether the lock has been opened, whether the car has been started, if started, you can also judge which station it is probably to through the degree of cell mutation.
Again, a biopsy may also be required to look up the yin dao mirror. Because TCT looks at the cells that have fallen off, what if the mutated cells happen to be hidden inside and do not fall off? Wouldn't that be inaccurate? Therefore, it is necessary to do a biopsy of the yin dao mirror.
If TCT is to set up a telescope to see which station the car goes to, then the yindao mirror biopsy is to sit directly on the car to see the stop sign, and automatically report the station name.
Therefore, the yin dao mirror biopsy is the gold standard for clinical diagnosis, generally if you find that there are two keys on the car, 16 and 18, you must do the yin Dao mirror biopsy.
In the past, we used these methods to prevent cervical cancer, but now that we have the HPV vaccine, how does it work in the body, and we continue to find out.
How does the HPV vaccine work in the body?
In fact, it is easy to understand, didn't we say earlier that the HPV virus is like a key to unlock to start this car? The HPV vaccine is equivalent to occupying or plugging the keyhole in advance.
▲Image source: Weibo @ Mr. Six Floors
For example, if you plug the keyhole of type 16 first, so that even if you have a type 16 key later, it cannot be inserted into the keyhole, and the probability of the car being started can be greatly avoided.
In this way, we can simply understand that the bivalent vaccine is to block the two most preventable viruses 16 and 18 first, and the quadrivalent is to plug the other 6 and 11 in addition to these two; and the nine-valent is to block the nine other viruses mentioned earlier.
▲Image source: Weibo @ Mr. Six Floors
▲Image source: Weibo @ Mr. Six Floors
▲Image source: Weibo @ Mr. Six Floors
At this point, you will understand why many areas have begun to vaccinate school children with HPV vaccine, because in principle, it is best to plug those keyholes before there is a key, and it is really not possible to plug the 16 and 18 types first.
But what if you already have the keys when you get vaccinated? At this time, the vaccine can also plug other empty keyholes, such as if you are infected with 16, you can also plug 18 or other types.
What should I do if cervical lesions are found?
We have already talked about how to find and prevent cervical lesions, so what if the inspection finds that the car has started?
Let's take a look at this line again! There are several stops on the entire line: Health – Low Grade Lesions (LSIL/CINI) – High Grade Lesions (HSIL/CINII/CINIII) – Cervical Cancer.
Generally, when the second stop, that is, the time of low-grade lesions, there is still a 70 to 80% probability of turning the front of the car and driving back. So even if you find it, don't panic, just observe closely, no surgery or medication.
▲Image source: Weibo @ Mr. Six Floors
If the second stop has passed by the time of discovery, then basically once found, it is necessary to consider forcibly pulling the handbrake, such as removing the cells and tissues that have produced lesions, and cutting them clean (cone or leep knife), and regularly reviewing to ensure that they return to the healthy station.
▲Image source: Weibo @ Mr. Six Floors
But as long as the car is still there, it is possible to restart. If you start again, or if you've already driven to cervical cancer, consider cutting off the entire car.
▲Image source: Weibo @ Mr. Six Floors
Of course, this is something we all don't want to see.
In short, the process of finding, preventing and treating cervical lesions is probably like this, if you really read this issue and understand it, then you are basically far away from cervical cancer.
Finally, let's answer the doubts of many friends: where does the key to open the car (infected HPV) come from?
Regardless of gender, except for the extremely low probability of mother-to-child transmission (the vast majority of which turn negative during growth), no one is born with HPV. The current testing technology can not trace the specific time of infection, can only say that the virus can not be produced out of thin air, mainly through sexual contact. This has nothing to do with the gender, identity, swearing, etc. of the two parties to the contact, and will spread as long as the conditions are met.
In addition, there is also the possibility of indirect contact transmission, but the transmission conditions are very harsh, requiring mucous membranes or wounds to be exposed to body fluids containing a large amount of active virus for a long time, so the probability is extremely low.
Speaking of this, boys can also check HPV, you can check once a year, if you are negative for three consecutive years, you can change it to check every three years.
Well, the content of this issue is here, I hope that through today's physical demonstration, we can help you more intuitively understand the relationship between HPV and cervical health, so that the fragmented information that has been mastered is more clear, scientific and systematic.
I hope that friends will continue to pay attention to the "Eleventh Clinic", and we will also send you more hard-core science that is helpful to women in the next few days!
If you have something to gain, don't forget to like and follow, or forward to a friend group or circle of friends with one click, so that more friends can benefit and make our personal efforts to eliminate cervical cancer!
If you still have some questions about HPV, or what are your expectations for the next issue of physical science, please move to the message area.
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![Enlarge the cervix and still pinch the flesh? What is the use of this "frightening" gynecological examination?[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)