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what are the causes of chronic cervicitis and chronic cervicitis

what are the causes of chronic cervicitis and chronic cervicitis

The main cause of chronic cervicitis is infection caused by pathogen invasion

First, the cause of the disease

Because acute cervicitis is not treated thoroughly, pathogens are hidden in cervical mucosa to form chronic inflammation, which is more common in childbirth, abortion or operation after cervical injury, and pathogens invade and cause infection. The main pathogens of chronic cervicitis are Staphylococcus, Streptococcus, Escherichia coli and anaerobic bacteria. At present, chronic cervicitis caused by Chlamydia trachomatis and Neisseria gonorrhoeae infection is also increasing. In addition, some viruses such as herpes simplex virus have become common pathogens.

Second, the pathogenesis

1. Cervical erosion (cervical erosion)

The appearance of the cervical vagina at the external mouth of the cervix is a fine granular red area, which is called cervical erosion. At present, the term cervical erosion has been abandoned in the textbooks of obstetrics and gynecology in western China, and it has been renamed as cervical columnar ectopy, which is not a pathological change, but one of the physiological changes of cervix. Mainly based on the following understanding:

(1) Under the microscope, the erosive surface is covered by a complete single-layer columnar epithelium of cervical canal. Because the columnar epithelium is thin and its lower interstitium is red, it looks like erosion to the naked eye, not the true erosion of epithelial shedding and ulcer.

(2) Under colposcopy, it showed the outward migration of the junction of the original scales and columns.

(3) There are lymphocytes as immune response in normal cervical interstitium, and the infiltration of lymphocytes in cervical interstitium does not necessarily mean chronic cervicitis.

2. Cervical hypertrophy

Due to the long-term stimulation of chronic inflammation, cervical tissue is congested and edema, glands and interstitial hyperplasia, and mucus retention may form cysts in the deep part of glands, which makes cervix hypertrophy to varying degrees, reaching 2 ~ 3 times of normal cervix, with increased hardness, but the surface is smooth, and sometimes cervical gland cysts protrude.

3. China divides cervical erosion into

Pathological inflammatory erosion and pseudo-erosion: Only in some physiological conditions, such as adolescent and pregnant women, due to the increase of estrogen level, the columnar epithelium of cervical canal proliferates and moves outward, and it can be seen that the external mouth of cervix is red and fine granular, which is pseudo-erosion of cervix and does not belong to pathological cervical erosion; Others are inflammatory erosion.

According to the depth of cervical erosion, it can be divided into three types:

1) Simple erosion:

At the initial stage of inflammation, the erosive surface was only covered by a single columnar epithelium, and the surface was flat.

2) Granular erosion:

Subsequently, due to excessive hyperplasia of glandular epithelium accompanied by interstitial hyperplasia, the erosive surface is uneven and granular.

3) Mastoid erosion:

Interstitial hyperplasia is obvious, and surface irregularity is more obvious and papillae-like.

According to the size of cervical erosion area, cervical erosion can be divided into 3 degrees:

A. Mild: refers to the erosion surface less than 1/3 of the whole cervical area.

B. Moderate: It means that the erosive surface accounts for 1/3 ~ 2/3 of the whole cervical area.

C. Severe: refers to the erosion surface accounting for more than 2/3 of the whole cervical area.

4. Cervical polyp (cervical polyp)

The local protruding lesions formed by the proliferation of cervical mucosa are called cervical polyps, and polyps often have pedicles protruding from the base to the external mouth of cervix. The mechanism of polyp formation is unclear, which may be related to local chronic inflammatory stimulation. Polyps often occur in prolific women aged 40 ~ 60. Polyps are one or more, with a diameter of about 1cm, red in color, tongue-shaped, smooth or lobulated in surface, soft and brittle, easy to bleed, and slender pedicle. The root is mostly attached to the external mouth of cervix, and a few are on the wall of cervical canal. Under light microscope, the center of polyp is connective tissue with congestion, edema and inflammatory cell infiltration, and the surface is covered with a single layer of high columnar epithelium, which is the same as cervical canal epithelium. Cervical polyps are rarely malignant, and the malignant transformation rate is less than 1%. However, it should be noted that uterine malignant tumors can be polypoid and protrude in cervical orifice, and attention should be paid to differentiation.

5. Cervical mucositis (endocervicitis)

The lesion is limited to cervical mucosa and submucosal tissue, the appearance of cervical vagina is smooth, purulent secretion can be seen at the external mouth of cervix, and sometimes the proliferation of cervical mucosa protrudes outward, showing congestion and redness at the mouth of cervix. Cervical hypertrophy can be caused by congestion, edema, inflammatory cell infiltration and connective tissue hyperplasia of cervical mucosa and submucosal tissue.

6. Cervical gland cyst (Naboth cyst)

In the healing process of cervical erosion, the new squamous epithelium covers the cervical gland orifice or extends into the gland orifice, blocking the gland orifice; The connective tissue hyperplasia or scar formation around the glandular tube compresses the glandular tube, which narrows or even blocks the glandular tube, obstructs the drainage of glandular secretion, and forms cyst by retention. Microscopically, the capsule wall was covered with a single flat cervical mucosal epithelium. During examination, many small cyan-white vesicles with colorless mucus were seen on the surface of cervix. If the cyst is infected, the appearance is white or light yellow vesicles. Cervical gland cyst.

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