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Molecular Pathogenesis, Detection and Clinical Management of Pre-invasive Cervical Lesions

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Pre-Invasive Disease: Pathogenesis and Clinical Management

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Abstract

The major public health burden of cervical cancer and its associated lesions warrants the development of effective preventive measures and successful therapies. Cervical cancer is the second most common female cancer worldwide, with approximately 493,000 diagnoses and 270,000 deaths annually. The disease can be detected early by cervical cytology in the pre-malignant phase, in the form of high-grade squamous intraepithelial lesions, and treated by a variety of methods including loop electrosurgical excision procedure. As human papillomavirus (HPV) has been identified as the major causative agent of cervical dysplasia and cervical cancer, HPV DNA testing and genotyping are also valuable in enhancing the sensitivity and specificity of cervical cancer screening. Advances in the understanding of HPV pathogenesis have led to the concept that persistent infection with high-risk HPV (hrHPV) genotypes is recognized as a necessary though not sufficient step in causing cervical cancer. This has led to the identification of tumor-promoting markers that may be required in cervical carcinogenesis. Further investigation of these markers may potentially be useful for risk stratification in screening. The knowledge of HPV virology and its role in cervical carcinogenesis leads to the potential prevention and treatment of cervical cancer. The current status of HPV vaccines is also discussed.

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Acknowledgements

This review is not intended to be an encyclopedic one, and the authors apologize to those not cited. This work was supported by the NCI SPORE in Cervical Cancer P50 CA098252, NCI 1RO1 CA114425-01 and 1RO1 CA118790.

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  1. Department of Pathology, The Johns Hopkins Medical Institutions, Cancer Research Building II, Rm 309, 1550 Orleans Street, Baltimore, MD, USA

    T-C Wu

  2. Department of Obstetrics and Gynecology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    T-C Wu

  3. Department of Molecular Microbiology and Immunology, The Johns Hopkins Medical Institutions, Orleans Street, Baltimore, MD, USA

    T-C Wu

  4. Department of oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    T-C Wu

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  1. Wen-Chung Chen
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    Rebecca C. Fitzgerald

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Chen, WC., Ma, B., Mao, CP., Wu, TC. (2011). Molecular Pathogenesis, Detection and Clinical Management of Pre-invasive Cervical Lesions. In: Fitzgerald, R. (eds) Pre-Invasive Disease: Pathogenesis and Clinical Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6694-0_21

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