Cervical HPV Dysplasia Carcinoma

Question 1

which stages make up the normal progression from healthy cervix to cervical cancer?

Answer 1

healthy cervix–>infected with HPV–>precancerous lesion—>cancerous lesion

Question 2

what is the histological grading system for squamous cervical lesions?

Answer 2

HPV

CIN-1 (cervical intraepithelial lesion-1) *synonymous with previous stage

CIN-2 (dysplastic)

CIN-3 (dysplastic)

Question 3

how does the histological grading correlate with the cytological grading?

Answer 3

low-grade squamous intraepithelial lesion (HPV and CIN-1)

high-grade squamous intraepithelial lesion (CIN-2 and CIN-3) *pre-cancers

Question 4

Most prevalent subtypes of HPV associated with cervical cancer?

Answer 4

HPV-16 and HPV-18 (highly assoc with adenocarcinoma and squamous cell carcinoma of cervix) and HSIL (high squamous intraepithelial lesions).

NB: Giardisil protects against 6,11, 16, and 18

Question 5

describe the histopathological progression/stages of cervical HPV from cervical condyloma to adenocarcinoma?

Answer 5

Cervical condyloma–>
Flat condyloma (pleimorphic epithelium)–>
CIN 1 (may see some dysplastic features)—>
CIN 2 (true pre-neoplastic lesion)—>
CIN 3 (dysplastic features extend through epithelium) –>
Squamous cell carcinoma –>
Adenocarcinoma in situ —>
Adenocarcinoma (malignant counterpart of ACIS)

Question 6

T/F majority of HPV infections are subclinical and transient

Answer 6

TRUE. only 10-20% go on to develop chronic infections and dysplasia

Question 7

what is the function of E6 and E7 in HPV genome?

L1 and L2?

Answer 7

E for Early genes—> translated to cell regulatory proteins.

E6 protein products interact with p53 and
E7 with retinoblastoma.
NB: E6 and E7 are upregulated in epithelium of cells where the viral genome and been integrated into the host genome.

L1/L2 interract with capsid proteins.