Three classes of abnormal cell differentiation are dysplasia, metaplasia, and anaplasia. Dysplasia indicates an abnormal arrangement of cells, usually arising from a disturbance in their normal growth behaviour. Some dysplasias are precursor lesions to cancer, whereas others are harmless and regress spontaneously. For example, dysplasia of the uterine cervix, called cervical intraepithelial neoplasia (CIN), may progress to cervical cancer. It can be detected by cervical smear cytology tests
Metaplasia is the conversion of one cell type into another. In fact, it is not usually the differentiated cells themselves that change but rather the stem cell population from which they are derived. Metaplasia commonly occurs where chronic tissue damage is followed by extensive regeneration. For example, squamous metaplasia of the bronchi occurs when the ciliated respiratory epithelial cells of people who smoke develop into squamous, or flattened, cells. In intestinal metaplasia of the stomach, patches resembling intestinal tissue arise in the gastric mucosa, often in association with gastric ulcers. Both of these types of metaplasia may progress to cancer.
Anaplasia is a loss of visible differentiation that can occur in advanced cancer. In general, early cancers resemble their tissue of origin and are described and classified by their pattern of differentiation. However, as they develop, they produce variants of more abnormal appearance and increased malignancy. Finally, a highly anaplastic growth can occur, in which the cancerous cells bear no visible relation to the parent tissue.