Structural Variations of Cervical Cancer and Its Precursors Under the Influence of Exogenous Hormones

  • G. Dallenbach-Hellweg
Part of the Current Topics in Pathology book series (CT PATHOLOGY, volume 70)


Besides the widespread use of hormones for contraception, pure estrogens are given to relieve menopausal symptoms and progestogens are prescribed for the treatment of endometriosis and endometrial carcinoma. In recent years this has provided opportunities for studying certain structural differentiations which emerge during the process of carcinogenesis in the cervix. These observations are based on prolonged study of the different effects of estrogens and progestogens on the squamous epithelium of the ectocervix and the mucosa of the endocervical canal. Estrogens stimulate proliferation of the stratified squamous epithelium of the ectocervix, but not that of the columnar epithelium of the endocervix. Progestogens stimulate the columnar epithelium and the reserve cells beneath it,’but not the squamous epithelium. When an epithelial defect develops on the external surface of the cervix because of erosion of the vulnerable columnar epithelium that has grown out at that site as the result of ectopia, under estrogenic stimulation it becomes reepithelialized mainly by the stratified squamous epithelium: the defect is covered by regenerative epithelium (Fig. 1), which grows over it from outside and spreads upward, i.e., from the external surface into the cervical canal. Under conditions of progestogenic stimulation, on the other hand, proliferation of the reserve cells of the cervical mucosa in the form of reserve cell hyperplasia (Fig. 2) often precedes regeneration of the squamous epithelium.


Oral Contraceptive Squamous Epithelium Intraepithelial Neoplasia Uterine Cervix Mucoepidermoid Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Boddington MM, Spriggs AI, Cowdell R (1976) Adenocarcinoma of the uterine cervix: cytological evidence of a long preclinical evolution. Brit J Obstet Gynaec 83:900PubMedCrossRefGoogle Scholar
  2. Büttner HH, Kyank H (1973) Adenocarcinoma in situ der Cervix uteri nach 11 Jahren gefolgt von invasivem Adenocarcinom. Z Krebsforsch 80:197CrossRefGoogle Scholar
  3. Burghardt E (1966) Das Adenocarcinoma in situ der Cervix. Arch Gynäk 203:57CrossRefGoogle Scholar
  4. Candy, Abell MR (1968) Progestogen-induced adenomatous hyperplasia of the uterine cervix. JAMA 2023:323CrossRefGoogle Scholar
  5. Carter B, Thomas WL, Parker RT (1949) Adenocarcinoma of the cervix and of the cervical stump. Am J Obstet Gynaec 57:37–5Google Scholar
  6. Christopherson WM, Nealon N, Gray LA (1979) Noninvasive precursor lesions of adenocarcinoma and mixed adenosquamous carcinoma of the cervix uteri. Cancer 44:975PubMedCrossRefGoogle Scholar
  7. Czernobilsky B, Kessler I, Lancet M (1974) Cervical adenocarcinoma in a woman on long-term contraceptives. Obstet Gynec 43:517PubMedGoogle Scholar
  8. Dallenbach-Hellweg G (1972) Therapieschäden in der Gynäkologie. Morphologische Beobachtungen über die Auswirkungen weiblicher Sexualhormone und von Stoffen mit ähnlicher Wirkung. Verh Dtsch Ges Path 56:252Google Scholar
  9. Davis JR, Moon LB (1975) Increased incidence of adenocarcinoma of uterine cervix. Obstet Gynec 45:79PubMedGoogle Scholar
  10. Friedell GH, McKay DG (1953) Adenocarcinoma in situ of the endocervix. Cancer 6:887PubMedCrossRefGoogle Scholar
  11. Gall SA, Bourgeois CH, Maguire G (1969) The morphologic effects of oral contraceptive agents on the cervix. JAMA 207:2243PubMedCrossRefGoogle Scholar
  12. Gallup DG, Abell MR (1977) Invasive adenocarcinoma of the uterine cervix. Obstet Gynec 49:596PubMedGoogle Scholar
  13. Hamperl H (1965) Vor- und Frühstadien des Portio-Carcinoms. Geburtsh u Frauen-heilk 25:105Google Scholar
  14. Hellweg G (1957) Über Schleimbildung in Plattenepithelcarcinomen, insbesondere an der Portio uteri (Mucoepidermoidcarcinome). Z Krebsforsch 61:688–715PubMedCrossRefGoogle Scholar
  15. Krimmenau R (1966) Adenocarcinoma in situ, beginnende adeno-carcinomatöse Invasion und Microcarcinoma adenomatosum. Geburtsh u Frauenheilk 26:1297Google Scholar
  16. Kyriakos M, Kempson RL, Konikov NF (1968) A clinical and pathologic study of endocervical lesions associated with oral contraceptives. Cancer 22:99PubMedCrossRefGoogle Scholar
  17. Lauchlan SC, Penner DW (1967) Simultaneous adenocarcinoma in situ and epidermoid carcinoma in situ: report of 2 cases. Cancer 20:2250–2254PubMedCrossRefGoogle Scholar
  18. Maqueo M, Azuela JC, Calderón JJ, Goldzieher HW (1966) Morphology of the cervix in women treated with synthetic progestins. Am J Obstet Gynec 96:994PubMedGoogle Scholar
  19. Mingeot R, Fievez CI (1974) Endocervical changes with the use of synthetic steroids. Obstet Gynec 44:53PubMedGoogle Scholar
  20. Nichols TM, Fidler HK (1971) Microglandular hyperplasia in cervical cone biopsies taken for suspicious and positive cytology. Am J Clin Path 56:424–429PubMedGoogle Scholar
  21. Qizilbash AH (1975) In-situ and microinvasive adenocarcinoma of the uterine cervix. Am J Clin Path 64:155–170PubMedGoogle Scholar
  22. Sachs H, Würthner K (1972) Zytologische, histologische und zytofotometrische Befunde eines Adenocarcinoma in situ der Cervix uteri. Geburtsh u Frauenheilk 32: 846Google Scholar
  23. Talbert JR, Sherry JB (1969) Adenocarcinoma-like lesion of cervix, a “ttpill-induced” problem? Am J Obstet Gynec 105:117PubMedGoogle Scholar
  24. Taylor HB, Irey NS, Norris HJ (1967) Atypical endocervical hyperplasia in women taking oral contraceptives. JAMA 202:637–639PubMedCrossRefGoogle Scholar
  25. Weisbrot IM, Stabinsky C, Davis AM (1972) Adenocarcinoma in situ of the uterine cervix. Cancer 29:1179PubMedCrossRefGoogle Scholar
  26. Werner R, Dinges HP (1976) Über durch Ovulationshemmer verursachte spezifische Veränderungen der Cervix uteri. Zbl Gynäk 98:919Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1981

Authors and Affiliations

  • G. Dallenbach-Hellweg

There are no affiliations available

Personalised recommendations