Cervical Flashcards
Cohort effect on cervical cancer?
Sex!
Risk Factors
sex at young age
loads of sexual partners
smoking
long term use of the pill
Endocervix (past cervix)
single layer of columnar epithelium
Ectocervix (outside cervix)
stratified squamous epithelium
superficial, intermediate, parabasal and basal cells
Squamous Columnar Junction
Neck of cervix
abrupt transition of endo to ectocervix
before puberty = SCJ in ENDOCERVIX
post puberty = SCJ eversion - transformation zone
Transformation zone
metaplasia - change of cell types via stimulus
stimulus - low pH
reserve cell division replace endocervix cells
reserve cells differentiate into squamous metaplastic cells until all endocervical cells are replaced
NON-NEOPLASTIC: Cervicitis
inflammation due to irritation, acute or chronic
may be due to herpes virus, HPV
HPV
Flat condyloma - raised, resembles wart. white, visualised with acetic acid
Exophytic condyloma - appear white (surface hyper keratosis)
virus enters through abrasions, must reach dividing basal cells to cause infection
HPV and cancer
HPV proteins E6 + E7 = excessive cell division in basal cells (squamous epithelium) and reserve cells (endocervical epithelium)
Cervical Intraepithelial Neoplasia (CIN)
premalignant condition in squamous epithelium
cervical dysplasia
Transformation zone
CIN Grading
CIN 1: neoplastic cells in lower 1/3 of epithelium
CIN 2: neoplastic cells in lower 2/3 of epithelium
CIN 3: >2/3 of epithelium
Invasive Squamous Cell Carcinoma of the Cervix
Bleeding most common symptom
85% of all cervical cancers - rest are adenocarcinomas
mean age = 56yrs
Staging
- confined to cervix
- spread to vagina and/or lymph nodes
- pelvic wall
- beyond pelvis (bladder, bowel, lungs)
Invasive Endocervical Adenocarcinoma
75% of cases are symptomatic (bleeding)
