Neoplasia- Cervical cancer, threatment

9 important questions on Neoplasia- Cervical cancer, threatment

Of what do most cervical cancers result/exist?

Virtually all cervical cancers result from a persistent infection with certain high risk types of the human papilloma virus (hrHPV) family.

Epidemiology of Cervical cancer

  • Third most common cancer in woman world wide
  • large majority (85%) of the global burden occurs in the less developed regions; cytological screening less / not available
  • 600-700 cases a year
  • mortality: 200-250 woman
  • 5 yr survival: 67%

Which three stages do we recognise?

Metaplasia-Dysplasia-Malignant Neoplasia
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Which of the three stages can be classified as premalignant cervical disease?

Dyplasia

What is the human papilloma Virus (HPV)?

  • Circular ds-DNA virus
  • Infection through sexual 80%
  • 80% of infections is cleared
  • over 100 HPV-types identified, 40 types infect the genital tract
  • Low-risk HPV: 6,11
  • High-risk HPV: 16,18 (12 types classified)
  • Possible high-risk HPV (8 types classified)

Effects of HPV E6 & E7 deregulation

  • Hyperactivity of viral oncogenes (E6/E7) represents the trigger for malignant transformation
  • The binding of tumor suppressor gene products, Rb by E7 and P53 by E6, is a major cause of malignant transformation in cells.
  • Complex formation of E6 and E7 with other cellular proteins lead to:
    • a disturbed chromatin remodelling
    • modulation of the DNA methylation machinery
    • altered expression of miRNA's
    • Etc..

Other factors inducing/increasing risk of getting cervical cancer are?

  • Promiscuity increases the risk for the STD
  • Immune suppression
  • Smoking: risk increased by 1.5x

How much of all hrHPV infections is covered by the vaccin against hrHPV 16 & 18 ?

70%

At what zone is the cervical smear taken?

Examination by a  cervical smear is at the transformation zone.

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