Cervical cancer

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Cervical cancer

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Questions

USMLE® Step 1 style questions USMLE

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A researcher is studying the molecular mechanism through which HPV infection leads to cervical cancer. He has developed an in vitro model that involves transfecting cervical epithelial cells grown in culture flasks with a lentivirus carrying the HPV E6 and E7 genes. The expression of protein E6 and E7 in infected cells is subsequently confirmed using fluorescence microscopy. Which of the following best describes the role these proteins play in the pathogenesis of cervical cancer?  

External References

First Aid

2024

2023

2022

2021

Cervical cancer p. 663

carcinogens causing p. 221

epidemiology of p. 660

epithelial histology p. 644

HIV-positive adults p. 174

hydronephrosis with p. 618

oncogenic microbes and p. 222

papillomaviruses p. 161

HIV (human immunodeficiency virus) p. 173

cervical cancer and p. 663

Smoking

cervical cancer and p. 663

Vaginal bleeding

cervical cancer p. 663

Transcript

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Cervical cancer is a cancer of the female reproductive system that originates in the cervix.

It’s one of the most common cancers in women and it’s usually the result of an infection by the human papillomavirus, or HPV.

It has also played a huge role in scientific research thanks to cervical cancer cells from a woman called Henrietta Lacks, which were the first human cells to be grown in a laboratory and which continue to be used to this day in labs around the world.

The cervix is also called the neck of the uterus, and it protrudes into the vagina.

The interior cavity of the cervix is called the cervical canal and it can be divided into two sections.

The endocervix is closer to the uterus, not visible to the naked eye, and it’s lined by columnar epithelial cells that produce mucus.

The ectocervix is the continuous with the vagina and it’s lined by mature squamous epithelial cells.

Where the squamous epithelium of the ectocervix and the columnar epithelium of the endocervix meet, there’s a line called the squamocolumnar junction.

And right where the two types of cells meet, there’s the transformation zone - which is where sub-columnar reserve cells multiply and transform into immature squamous epithelium through a process called metaplasia.

Normally, mature cells are stuck in the G1, or Growth 1, phase of the cell cycle, which is when cells grow take care of regular cellular business, like synthesizing proteins and producing energy.

Eventually, whenever new cells are needed, they’ll exit G1 and keep going through the rest of the cell cycle to eventually divide in two new identical daughter cells.

Sometimes though, cells can be pushed out of G1 and go through the cell reproduction cycle faster than the body needs new cells.

This uncontrolled growth and multiplication is called dysplasia and it’s exactly how cervical cancer develops from precancerous cells.

Dysplasia in the epithelial layer of the cervix, also called cervical intraepithelial neoplasia or squamous epithelial lesion, usually starts in the basal layer of the transformation zone, typically in the immature squamous epithelium there.

Summary

Cervical cancer is a type of cancer that affects the cervix, which is the lower part of the uterus. The most common symptoms are vaginal bleeding and discharge. Other symptoms can include pain during sex, pelvic pain, and problems urinating.

Cervical cancer is caused by HPV (human papillomavirus), a sexually transmitted infection that can now be prevented by having an HPV vaccine. Screening tests can detect precancerous lesions on the cervix and get treated before they turn into cancer.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Control of HPV Infection and Related Cancer Through Vaccination" Viruses and Human Cancer (2013)
  6. "Colposcopy to evaluate abnormal cervical cytology in 2008" American Journal of Obstetrics and Gynecology (2009)
  7. "Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case-control study" BJOG: An International Journal of Obstetrics & Gynaecology (2013)
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