Cervical Anatomy and HPV Impact

Cervical Anatomy

• The cervix is the "neck" of the uterus.
• It's divided into the exocervix (visible vaginally) and endocervix.
• The exocervix is lined with squamous epithelium.
• The endocervix is lined by columnar epithelium.
• The transformation zone is where the exocervix and endocervix meet.

HPV and Cervical Cancer

• HPV is a sexually transmitted DNA virus that infects the lower genital tract, often the cervix's transformation zone.
• HPV infection often resolves, but persistent infection increases cervical dysplasia risk (precancerous changes).
• Cervical dysplasia risk is tied to HPV type, determined by DNA sequencing.
  • High-risk HPV types (16, 18, 31, 33) are more dangerous.
  • Low-risk HPV types (6, 11) are less risky.
• High-risk HPV produces proteins (E6 and E7) that harm tumor suppressor proteins (p53 and Rb), increasing cervical intraepithelial neoplasia (CIN) risk.

Cervical Intraepithelial Neoplasia (CIN)

• CIN is characterized by disordered cell maturation, nuclear atypia, and increased mitosis in the cervical epithelium.
• CIN progresses in stages (CIN I to CIN III, and carcinoma in situ - CIS).
• CIN I involves less than 1/3 of the epithelial thickness.
• CIN II involves less than 2/3 of the epithelial thickness.
• CIN III involves nearly the whole epithelial thickness.
• CIS is carcinoma that hasn't invaded surrounding tissues.
• Progression to invasive cancer isn't always inevitable.

Cervical Carcinoma

• Invasive cervical cancer arises from the cervical epithelium.
• It's most common in women aged 40-50.
• Common symptoms are vaginal bleeding (especially after sex), and cervical discharge.
• Key risk factors are high-risk HPV infection, smoking, and immunodeficiency.
• Most cancers are squamous cell carcinoma (around 80%) or adenocarcinoma (about 15%).

Cervical Cancer Screening

• Screening aims to detect precancerous changes (CIN) before they progress to cancer.
• Screening starts at age 21, initially every three years.
• The Pap smear is the standard method. Cells from the transformation zone are collected and examined under a microscope.
• Dysplastic cells can be low-grade (CIN I) or high-grade (CIN II or III).
• Pap smears are effective, but inadequate sampling or limited effectiveness for some cancers (adenocarcinoma) can be issues.

Cervical Cancer Prevention

• Vaccination against HPV can help prevent infections.
• The quadrivalent vaccine covers HPV types 6, 11, 16, and 18.
  • Antibodies produced protect against certain infections and cancers.

Explore the intricate anatomy of the cervix and its significance in cervical health. This quiz delves into the relationship between HPV and cervical cancer, focusing on the transformation zone and the risk factors associated with different HPV types. Test your knowledge on cervical intraepithelial neoplasia (CIN) and its implications for women's health.