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Malignant lesions of the CERVIX. Dr . Saadeh Jaber OBGYN consultant 2010. Epidemiology. Cervical cancer is the 2 nd most common cancer in the women worldwide Rare before 20yrs ,,, mean age is 47yrs. Factors associated with high risk. Multiple sexual partners. Human papillomavirus(HPV).
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Malignant lesions of the CERVIX Dr . SaadehJaberOBGYN consultant 2010
Epidemiology • Cervical cancer is the 2nd most common cancer in the women worldwide • Rare before 20yrs ,,, mean age is 47yrs
Factors associated with high risk Multiple sexual partners
Human papillomavirus(HPV) • Infection with HPV is one of the major factors leading to CC Type16 and18 Type6 and 11
Pathophysiology The area between the original SCJ and the new SCJ Is called the transformation zone (ectropion)
Cervical Intraepithelial Metaplasia • 3 grades --> depending on • the degree of cytological atypia • thickness of the epi involved
Screening and Cytology The Papanicolaou test ((Pap smear)) • The test was named after the Greek doctor GeorgiosPapanikolaou • A SCREENING TEST used to detect premalignant and malignant processes in the cervix. • A tool is used to gather cells from the ectocervix, and the endocervix • The cells are examined under a microscope
Pap smear Conventional smear Liquid Based smear
Treatment of CIN • Observation mild dysplasia (CIN I) may regress spontaneously • Active treatment higher grades CIN II / CIN III
Invasive Cancer • Pathological features • 2 main types Squamous cell carcinoma --> most cases Adenocarcinoma --> 15 – 20% • Most occur at the SCJ • Melanoma and sarcoma occur rarely
Invasive Cancer • Patterns of spread
Invasive Cancer • Staging Cervical cancer is the only gynecological malignancy that is not surgically staged