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The squamocolumnar junction, where the columnar secretory epithelium of the endocervical canal meets the stratified squamous covering of the ectocervix, is located at the external os before puberty. As estrogen levels rise during puberty, the cervical os opens, exposing the endocervical columnar epithelium onto the ectocervix.
The squamocolumnar junction, or "transformation zone", is a critical area on the cervix where many precancerous and cancerous lesions most often arise. The ability to see the transformation zone and the entire extent of any lesion visualized determines whether an adequate colposcopic examination is attainable. [citation needed]
[17]: 41 The junction between these two types of epithelia is called the squamocolumnar junction. [17]: 408–11 Underlying both types of epithelium is a tough layer of collagen. [18] The mucosa of the endocervix is not shed during menstruation. The cervix has more fibrous tissue, including collagen and elastin, than the rest of the uterus. [4]
The cervical canal is generally lined by "endocervical mucosa" which consists of a single layer of mucinous columnar epithelium. However, after menopause, the functional squamocolumnar junction moves into the cervical canal, and hence the distal part of the cervical canal may be lined by stratified squamous epithelium (conforming to a "type 3 transformation zone").
CIN most commonly occurs at the squamocolumnar junction of the cervix, a transitional area between the squamous epithelium of the vagina and the columnar epithelium of the endocervix. [2] It can also occur in vaginal walls and vulvar epithelium. CIN is graded on a 1–3 scale, with 3 being the most abnormal (see classification section below).
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