Topic 52: Cervical Disease And Neoplasia Today

The transformation of normal cervical epithelium into a neoplastic state typically occurs at the transformation zone—the area where glandular columnar cells meet squamous cells. Persistent infection with high-risk HPV types, most notably HPV 16 and 18, is the necessary precursor for nearly all cervical cancers. These viruses integrate into the host genome, leading to the overexpression of oncoproteins E6 and E7, which inactivate tumor suppressor proteins p53 and Rb, respectively. This disruption of the cell cycle allows for the accumulation of genetic mutations and the eventual development of Cervical Intraepithelial Neoplasia (CIN). Screening and Diagnosis

These often represent transient HPV infections and are typically managed with observation, as a high percentage regress spontaneously. Topic 52: Cervical Disease and Neoplasia

When screening results are abnormal, colposcopy allows for direct visualization of the cervix under magnification. Aceto-white changes and abnormal vascular patterns (punctation or mosaicism) guide the clinician to perform targeted biopsies, which provide the definitive histological diagnosis of CIN 1, 2, or 3. Management of Neoplasia The transformation of normal cervical epithelium into a