TeamCirisano Teaching Series: Introduction to Cervical & Uterine pathology скачать в хорошем качестве

TeamCirisano Teaching Series: Introduction to Cervical & Uterine pathology

Human papiloma virus (HPV) is the virus that can cause precancerous changes (dysplasia) in the vulva, vagina, and cervix. Changes or dysplasia of the cervical epithelial cells or Cervical Intraepithelial Neoplasia (CIN) are separated into 3 grades: mild(CIN I), moderate (CIN II) and severe (CIN III) dysplasia. The grades are defined by the depth of the epithelial cell layer taken over by these dysplastic cells. When this dysplasia, which is considered "pre-cancer" spans the full thickness of the epithelial cell layer, it is considered to have developed into Carcinoma In Situ (CIS), which is borderline or a non-invasive (does not cross the basement membrane) cancer of the cervix. Most cervical cancer arises at the transformation zone of the cervix. This is the area of cervix from which samples are swabbed/scraped during a Pap smear and is where the endocervix (within the uterus - columnar cells) and ectocervix (towards the vagina - squamous cells) come together and transform or undergo metaplasia from one cell type to the other. The mitotic index therefore at these transformation zones is relatively higher than at other areas of the body. Because of the higher mitotic index, the transformation zone of the cervix is most vulnerable to dysplastic changes. The absolute treatment for pre-cancer (CINI-CINIII) is surgical, may it be cervical laser ablation (CINI), excision using LEEP-loop electrosurgical excision procedure- (CIN II/III) and organ removal-hysterectomy- (CINIII). With invasive cancer, or carcinoma that has crossed the basement membrane of the cervix, hysterectomy with or without radiation/chemotherapy is standard.