PATH 3610 Lecture Notes - Lecture 14: Squamous Intraepithelial Lesion, Plantar Wart, Sexually Transmitted Infection
NEOPLASIA
- Cancer
- Oncology
- malignant: life-threatening vs. Benign: not life-threatening
Pap smear test
- for people of reproductive age/sexually active, multiple sexual partners
- names after a persons that developed a smearing test
- Papanicoloau cytological test
o Normal
- cell changes (dysplasia)
o ASCUS: mild cell changes
▪ ASCUS = atypical squamous cells of uncertain significance
o LSIL: moderate cell changes
▪ LSIL = low grade squamous intraepithelial lesion
o HSIL: serious cell changes
- Cancer
o Carcinoma in situ (CIN)
o Invasive carcinoma
Pathogenesis – HPV
- 68 types
- plantar warts, common warts (type 1, 2, 4, 7) and anogenital and laryngeal
papillomas, neoplasia
- skin carcinoma, genital carcinoma, cervical carcinoma and vulvar papilloma
are associated with forms of HPV
Pathogenesis – cervical carcinoma
- risk factors
o Early age at first intercourse
o Multiple sexual partners
o Male partner with multiple previous sexual partners
o High risk male sexual partners
o Smoking
o Sexually transmitted diseases
o Human papillomavirus (HPV) infection
▪ Infectious is very high risk situation
Did you know..
- dogma of low prevalence of cervical carcinoma in nuns, virgins and
spinsters doesnt meet scrunity of modern statistics
- HeLa cells (widely used immortal human cell line) were taken from the
cervical carcinoma of Henrietta Lacks in 1951. 50x 10^6 tonnes have been
grown
Pathogenesis
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- >99% of dysplasia, carcinoma in situ and carcinomas have HPV DNA
integrated in host DNA
- HPV 16, 18, 6 and 11 are high risk types
o HPV 16-50%, HPV 18-25% → these two are high risk
- HPV is not the only factor – carcinogens (HPV in 80% of women)
- Gardasil® (HPV 16, 18)
Neoplasia means new growth
- continuous spectrum
o normal – premalignant (field cancerisation) – neoplasia
o hyperplasia – metaplasia – dysplasia – neoplasia
o metaplasia = change from one cell type to another because of injury or
excessive stimulation
o dysplasia = bad growth of cells/tissues
o neoplasia: uncontrolled growth
- scientific vs. popular definitions
o cancer (crab) → clawing at internal organs, cancer can also mean
malignant epithelial neoplasia or carcinoma
o tumour – swelling, common usage for neoplasia & benign neoplasia
▪ Oncology: study of tumors (oncos = tumour)
- Benign vs. malignant (life threatening, lethal)
o Behaviour and histology
o Malignant: all meastatic neoplasms (b/c grow uncontrollably and
spread to distant sites)
Components of a neoplasm
- neoplastic cells – genetic and epigenetic changes passes onto future
generations of cells
o act independently
- stroma and blood vessels
- other cells
o dendritic cells
o lymphocytes
Neoplasia theories
- somatic mutation theory
o genome instability
o DNA mutation changes cell
- Tissue organization field theory
o Alterations in interactions among cells and between cells and their
extracellular matrix
Predisposing to neoplasia
- geographical and environmental factors (sun, obesity, alcohol, smoking, sex)
- age (esp. 55-74 years old)
- heredity (familial polyposis and retinoblastoma – heredity)
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Document Summary
Pap smear test for people of reproductive age/sexually active, multiple sexual partners. Names after a persons that developed a smearing test. Papanicoloau cytological test: normal cell changes (dysplasia, ascus: mild cell changes, ascus = atypical squamous cells of uncertain significance, lsil: moderate cell changes, lsil = low grade squamous intraepithelial lesion, hsil: serious cell changes. Cancer: carcinoma in situ (cin, invasive carcinoma. Dogma of low prevalence of cervical carcinoma in (cid:494)nuns, virgins and spinsters(cid:495) doesn(cid:495)t meet scrunity of modern statistics. Hela cells (widely used immortal human cell line) were taken from the cervical carcinoma of henrietta lacks in 1951. >99% of dysplasia, carcinoma in situ and carcinomas have hpv dna integrated in host dna. Hpv 16, 18, 6 and 11 are high risk types: hpv 16-50%, hpv 18-25% these two are high risk. Hpv is not the only factor carcinogens (hpv in 80% of women)