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The cervix or cervix uteri is the lower part of the uterus in the human female reproductive system. The cervix is usually 2 to 3 cm long and roughly cylindrical in shape, which changes during pregnancy. The narrow, central cervical canal runs along its entire length, connecting the uterine cavity and the lumen of the vagina. The opening into the uterus is called the internal os, and the opening into the vagina is called the external os. The lower part of the cervix, known as the vaginal portion of the cervix, bulges into the top of the vagina. The cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago.
The Papanicolaou test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix or colon. Abnormal findings are often followed up by more sensitive diagnostic procedures and, if warranted, interventions that aim to prevent progression to cervical cancer. The test was independently invented in the 1920s by Georgios Papanikolaou and Aurel Babeș and named after Papanikolaou. A simplified version of the test was introduced by Anna Marion Hilliard in 1957.
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse. While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer.
Georgios Nikolaou Papanikolaou was a Greek physician who was a pioneer in cytopathology and early cancer detection, and inventor of the "Pap smear".
Human papillomavirus infection is an infection caused by human papillomavirus (HPV), a DNA virus from the Papillomaviridae family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. However, in some cases, an HPV infection persists and results in either warts or precancerous lesions. These lesions, depending on the site affected, increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth, tonsils, or throat. Nearly all cervical cancer is due to HPV; two strains, HPV16 and HPV18, account for 70% of cases. HPV16 is responsible for almost 90% of HPV-positive oropharyngeal cancers. Between 60% and 90% of the other cancers listed above are also linked to HPV. HPV6 and HPV11 are common causes of genital warts and laryngeal papillomatosis.
Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. The discipline was founded by George Nicolas Papanicolaou in 1928. Cytopathology is generally used on samples of free cells or tissue fragments, in contrast to histopathology, which studies whole tissues. Cytopathology is frequently, less precisely, called "cytology", which means "the study of cells".
Colposcopy is a medical diagnostic procedure to visually examine the cervix as well as the vagina and vulva using a colposcope.
Langerhans cells (LC) are tissue-resident macrophages of the skin, and contain organelles called Birbeck granules. They are present in all layers of the epidermis and are most prominent in the stratum spinosum. They also occur in the papillary dermis, particularly around blood vessels, as well as in the mucosa of the mouth, foreskin, and vaginal epithelium. They can be found in other tissues, such as lymph nodes, particularly in association with the condition Langerhans cell histiocytosis (LCH).
Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. More specifically, CIN refers to the potentially precancerous transformation of cells of the cervix.
Diff-Quik is a commercial Romanowsky stain variant used to rapidly stain and differentiate a variety of pathology specimens. It is most frequently used for blood films and cytopathological smears, including fine needle aspirates. The Diff-Quik procedure is based on a modification of the Wright-Giemsa stain pioneered by Harleco in the 1970s, and has advantages over the routine Wright-Giemsa staining technique in that it reduces the 4-minute process into a much shorter operation and allows for selective increased eosinophilic or basophilic staining depending upon the time the smear is left in the staining solutions.
An anal Pap smear is the anal counterpart of the cervical Pap smear. It is used for the early detection of anal cancer. Some types of human papillomavirus (HPV) can cause anal cancer. Other HPV types cause anogenital warts. Cigarette smokers, men who have sex with men, individuals with a history of immunosuppression and women with a history of cervical, vaginal and vulval cancer are at increased risk of getting anal cancer. Vaccination against HPV before initial sexual exposure can reduce the risk of anal cancer.
The Bethesda system (TBS), officially called The Bethesda System for Reporting Cervical Cytology, is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting Pap smear results. It was introduced in 1988 and revised in 1991, 2001, and 2014. The name comes from the location of the conference, sponsored by the National Institutes of Health, that established the system.
Brachioradial pruritus is an intense itching sensation of the arm usually between the wrist and elbow of either or both arms. The itch can be so intense that sufferers will scratch their own skin to a bleeding condition.
Cervical screening is the process of detecting and removing abnormal tissue or cells in the cervix before cervical cancer develops. By aiming to detect and treat cervical neoplasia early on, cervical screening aims at secondary prevention of cervical cancer. Several screening methods for cervical cancer are the Pap test, liquid-based cytology, the HPV DNA testing and the visual inspection with acetic acid. Pap test and liquid-based cytology have been effective in diminishing incidence and mortality rates of cervical cancer in developed countries but not in developing countries. Prospective screening methods that can be used in low-resource areas in the developing countries are the HPV DNA testing and the visual inspection.
Vaginal adenosis is a benign abnormality in the vagina, commonly thought to be caused by intrauterine and neonatal exposure of diethylstilbestrol and other progestogens and nonsteroidal estrogens, however it has also been observed in otherwise healthy women and has been considered at times idiopathic or congenital. Postpubertal lesions have also been observed to grow de novo. It has a rather common incidence, of about 10% of adult women.
Microglandular hyperplasia (MGH) of the cervix is an epithelial benign abnormality (lesion) associated with gland proliferation. It can terminate in mature squamous metaplasia, and it is suspected reserve cells are involved in this process, perhaps in the form of reserve cell hyperplasia with glandular differentiation.
Miguel A. Sanchez is a board-certified pathologist who specializes in anatomic pathology, clinical pathology and cytopathology. Sanchez is chief of pathology and medical director of The Leslie Simon Breast Care and Cytodiagnosis Center at Englewood Hospital and Medical Center in Englewood, New Jersey. He is best known for his contribution in setting the standards of diagnosis and treatment of breast and thyroid disease praised by the United States Congress in 1994.
Gynecologic cancer disparities in the United States refer to differences in incidence, prevalence, and mortality from gynecologic cancers between population groups. The five main types of gynecologic cancer include cervical cancer, ovarian cancer, endometrial cancer, vaginal cancer, and vulvar cancer. For patients with these and other gynecologic malignancies within the United States, disparities across the care continuum by socioeconomic status and racial/ethnic background have been previously identified and studied. The causes behind these disparities are multifaceted and a complex interplay of systemic differences in health as well as individual patient factors such as cultural, educational, and economic barriers.
David John Webb, is a British physician, scientist and clinical pharmacologist, who currently holds the Christison Chair of Therapeutics and Clinical Pharmacology at the University of Edinburgh.
Peter Maxwell Howley is an American pathologist, virologist, and professor at Harvard Medical School.
References
- ↑ Overy, C.; Wilkinson, A.; Tansey, E.M. (2017). Makers of Modern Biomedicine: A Register (PDF). 63. London: The Trustee of the Wellcome Trust. p. 25. ISBN 978-1-910195-30-7.
- 1 2 3 4 Lois Reynolds; Tilli Tansey, eds. (2009). History of Cervical Cancer and the Role of the Human Papillomavirus, 1960-2000. Wellcome Witnesses to Contemporary Medicine. History of Modern Biomedicine Research Group. ISBN 978-0-85484-123-3. Wikidata Q29581772.
- ↑ "People". www.eurocytology.eu. Retrieved 4 July 2017.
- ↑ Herbert, Amanda (15 January 2008). "A message from the new Editor". Cytopathology. 19 (1): 3. doi:10.1111/j.1365-2303.2007.00546.x.
- ↑ Bulten, Johan; Horvat, Reinard; Jordan, Joe; Herbert, Amanda; Wiener, Helene; Arbyn, Marc (1 June 2011). "European guidelines for quality assurance in cervical histopathology". Acta Oncologica. 50 (5): 611–620. doi:10.3109/0284186x.2011.555779. ISSN 0284-186X. PMID 21314297.
- ↑ Gleeson, Michael; Herbert, Amanda; Richards, Aurelia (2000). "Management Of Lateral Neck Masses In Adults". BMJ: British Medical Journal. 320 (7248): 1521–1524. doi:10.1136/bmj.320.7248.1521. JSTOR 25224713. PMC 1118107 . PMID 10834900.
- ↑ Herbert, A.; Johnson, J.; Patnick, J. (1 October 1995). "Achievable standards, benchmarks for reporting and criteria for evaluating cervical cytopathology". Cytopathology. 6 (5): 301–303. doi:10.1111/j.1365-2303.1995.tb00575.x. ISSN 1365-2303.
- ↑ Herbert, Amanda; Wright, Dennis H.; Isaacson, Peter G.; Smith, John L. (1984). "Primary malignant lymphoma of the lung: Histopathologic and immunologic evaluation of nine cases". Human Pathology. 15 (5): 415–422. doi:10.1016/s0046-8177(84)80074-x. PMID 6373559.
- ↑ Lanham, Stuart; Herbert, Amanda; Basarab, Adriana; Watt, Peter (1 August 2001). "Detection of Cervical Infections in Colposcopy Clinic Patients". Journal of Clinical Microbiology. 39 (8): 2946–2950. doi:10.1128/JCM.39.8.2946-2950.2001. ISSN 0095-1137. PMC 88265 . PMID 11474018.
- ↑ Herbert, Amanda; Holdsworth, Gillian; Kubba, Ali A. (1 January 2008). "Cervical screening: why young women should be encouraged to be screened". Journal of Family Planning and Reproductive Health Care. 34 (1): 21–25. doi: 10.1783/147118908783332078 . ISSN 1471-1893. PMID 18201402.
- ↑ Luxton, Jenny C.; Nath, Rahul; Derias, Nawal; Herbert, Amanda; Shepherd, Philip S. (2003). "Human papillomavirus type 16-specific T cell responses and their association with recurrence of cervical disease following treatment". Journal of General Virology. 84 (5): 1063–1070. doi: 10.1099/vir.0.18931-0 . PMID 12692269.
- ↑ Herbert, Amanda; Stein, K; Bryant, T N; Breen, Catherine; Old, P (1 September 1996). "Relation between the Incidence of Invasive Cervical Cancer and the Screening Interval: Is a Five Year Interval Too Long?". Journal of Medical Screening. 3 (3): 140–145. doi: 10.1177/096914139600300307 . ISSN 0969-1413. PMID 8946309.
- ↑ Herbert, Amanda; Walters, M. T.; Cawley, M. I. D.; Godfrey, R. C. (1 June 1985). "Lymphocytic interstitial pneumonia identified as lymphoma of mucosa associated lymphoid tissue". The Journal of Pathology. 146 (2): 129–138. doi:10.1002/path.1711460208. ISSN 1096-9896. PMID 3891940.
- ↑ Herbert, A.; Gallagher, P. J. (1 November 1982). "Pleural biopsy in the diagnosis of malignant mesothelioma". Thorax. 37 (11): 816–821. doi:10.1136/thx.37.11.816. ISSN 0040-6376. PMC 459433 . PMID 7163999.
