Transitional cell metaplasia of the uterine cervix is related to human papillomavirus

Ng, Wai-Kuen; Cheung, Leslie K. N.; Li, Albert S. M.; Cheung, Florence M. F.; Chow, Janson C. Y.

doi:10.1002/cncr.10722

Cited by 22 publications

(10 citation statements)

References 35 publications

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“…The majority of the biopsies showing discrepancies in Histology 2a vs 2b presents small areas of metaplastic atypia, difficult to fit into the CIN groups (Geng et al, 1999;Montes et al, 1999;Ng et al, 2002;Zuna et al, 2002). The discrepancy in the relative frequency of 'normals' between Histology 2a and 2b is due to the fact that in 2b the emphasis was on representativeness for the transformation zone.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

et al. 2004

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In this study, we investigated the presence of E6/E7 transcripts of seven common high-risk human papillomavirus (HPV) types in 190 cervical biopsies. The RNA-based real-time nucleic acid sequence-based amplification assay (NASBA) and type-specific PCR, both detecting HPV 16, 18, 31, 33, 45, 52, and 58, as well as consensus PCR, were performed on all 190 biopsies. High accordance between type-specific and consensus PCR confirms that the HPV types included in this study are the most common types present in cervical dysplasia. Furthermore, we see a clear increase in the incidence of HPV, both DNA and RNA, along with the histological severity of dysplasia. HPV RNA was detected in all but two PCR-positive cases, confirming that the virus exerts E6/E7 mRNA expression in cases of high-grade dysplasia. Out of 19 women given a normal or borderline diagnosis at conisation, only four were found HPV positive, which may suggest that unnecessary conisations can possibly be reduced by introducing HPV testing into the preoperative routine assessment. Human papillomavirus (HPV) infections are associated with the development of cervical neoplasia and are a necessary factor in the aetiology of cervical carcinoma (Walboomers et al, 1999;Bosch et al, 2002;zur Hausen, 2002). The most frequent HPV types found in high-grade cervical intraepithelial dysplasia (CIN II/III) and in cervical carcinomas are HPV 16, 18, 31, 33, and 45, which are often referred to as high-risk HPV or cancer-associated HPV types. However, the association between a positive HPV DNA test and the risk of subsequent development of dysplasia is partly unknown; the presence of HPV DNA does not necessarily indicate a risk for developing a more severe lesion. In fact, HPV is a very common virus among sexually active women and most infections are transient and asymptomatic (zur Hausen, 1991;Ho et al, 1998;Moscicki et al, 1998). Only very few infections cause morphologic changes in the epithelium and only a small percent of these will eventually develop cervical cancer (Bosch et al, 1995). On the other hand, several studies have shown that in cervical carcinogenesis, the expression of HPV E6 and E7 ORF is required for cell transformation and immortalisation (zur Hausen, 1988;Munger et al, 1989;Stoler et al, 1992). Consequently, persistent expression of these oncogenes may serve as an indicator of progression to CIN and invasive cancer (Sotlar et al, 1998), and detection of E6 and E7 mRNA transcripts may therefore be of higher prognostic value than the detection of HPV DNA. Moreover, new methods for preservation of RNA in cells have made gene expression analysis more feasible.In this study, we investigated the presence of high-risk HPV E6/E7 transcripts in cervical biopsies from patients undergoing conisation. The analysis was performed on a biopsy taken from the ectocervix/transformation zone at the time of conisation, and the pathological diagnosis of this particular biopsy was not always representative for the existing lesion that was later revealed in the cone. This s...

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Section: Discussionmentioning

confidence: 99%

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

et al. 2004

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“…Human papillomavirus (HPV) is an oncogenic virus that is strongly associated with squamous cell dysplasia of female uterine cervix and its progression to cervical carcinoma. Cervical transitional cells in the squamocolumnar junction are well‐known targets for HPV infection and potential cancerous transformation 1 . It has also been suggested that the progenitor cells in esophageal squamous cell carcinoma (ESCC) and possibly Barrett's esophagus (BE) resemble those of cervical cancer 2,3 .…”

Section: Introductionmentioning

confidence: 99%

“…Cervical transitional cells in the squamocolumnar junction are well-known targets for HPV infection and potential cancerous transformation. 1 It has also been suggested that the progenitor cells in esophageal squamous cell carcinoma (ESCC) and possibly Barrett's esophagus (BE) resemble those of cervical cancer. 2,3 Given these similarities and the possibility of HPV exposure to the upper gastrointestinal (GI) tract through oral transmission, HPV has been examined as a possible risk factor for esophageal cancer as well as BE.…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus and the risk of Barrett's esophagus

El–Serag

Hollier

Gravitt

et al. 2012

Diseases of the Esophagus

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SUMMARY Human papillomavirus (HPV) is strongly associated with squamous esophageal cancer. The potential role of HPV in Barrett's esophagus (BE) has been examined but remains unclear. The aim of the study was to determine the prevalence of HPV in esophageal and gastric tissues obtained from patients with and without BE. We designed a cross-sectional study was conducted with prospective enrollment of eligible patients scheduled for esophagogastroduodenoscopy (EGD). All participants had biopsies of endoscopic BE, squamous-lined esophagus, and stomach. Immunohistochemistry (IHC) on formalin-fixed and paraffin-embedded tissue was conducted using monoclonal antibodies. Polymerase chain reaction (PCR) for HPV was performed on DNA extracted from esophageal biopsies snapped frozen within 30 minutes after endoscopic capture. The Roche HPV Linear Array Assay with PGMY primers that has high sensitivity for detecting 37 types of HPV was used. A total of 127 subjects were included: 39 with definitive BE had IHC done on samples from non-dysplastic BE, squamous esophagus, gastric cardia, and gastric body; and 88 control patients without BE had IHC done on squamous esophageal samples, gastric cardia, and gastric body. HPV was not detected in any of the samples in either group. For confirmation, HPV DNA PCR was performed on randomly selected samples from 66 patients (both esophagus and BE from 13 patients with BE, and 53 esophagus from patients without BE); no sample had HPV DNA detected via PCR in the presence of adequate quality control. HPV infection does not play a role in the formation of non-dysplastic Barrett's esophagus in men in the United States.

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“…[14] Most of the TCM express the urothelial immunophenotype Cytokeratin 7 and 20; this fact supports the former theory. [18] The factors responsible at the gene level for expression of this cell type are not known.…”

Section: Discussionmentioning

confidence: 99%

Urothelial cells in smears from cervix uteri

Palaoro¹,

Guerra²,

Angeleri³

et al. 2012

J Cytol

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Objectives:To establish the cytological criteria to identify the urothelial cells in cervical smears in order to avoid mistakes in the cytological diagnosis.Materials and Methods:Cervical smears from 34 post menopausal women with vesicovaginal fistulas, advanced bladder prolapse and genital erosive lichen planes (vulvar kraurosis) (Group 1) and transitional cell metaplasia of the cervix (TCM, Group 2) were stained with Papanicolaou technique. The cervical samples were taken during the routine annual examination for prevention of the uterine cancer.Results:The smears of cervix from Group 1 showed urothelial cells from the three layers of the transitional epithelium. The umbrella cells are the bigger ones with relatively large nuclei. Frequently, they are multinucleated with single or multiple nucleoli and a typical “frothy” cytoplasm (cytoplasmic vacuoles). The cells of the Group 2 showed nuclei with oval to spindled shapes, some tapered ends, less cytoplasm than squamous metaplastic cells, powdery chromatin, small nucleoli and nuclear grooves.Conclusions:The umbrella cells may be mistaken for dysplastic cells originating in low grade squamous intraepithelial lesions lesions (LSILs) due to their nuclear and cytoplasm sizes. Therefore, it is important to know the possibility of their appearance in the cervical smears, especially in post menopausal patients in order to avoid a false diagnosis of an intraepithelial lesion. It is unlikely that deeper cells of urothelium would be confused with high grade squamous intraepithelial lesion (HSIL) cells. However, their presence might be a reason of mistake in the diagnosis. TCM is an under-recognized metaplastic phenomenon of the cervix and vagina, which is a mimicker of high-grade squamous intraepithelial lesion. The differential characteristic between umbrella cells, cells from TCM and the deeper urothelial cells, and LSIL and HSIL are detailed in the present paper.

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Transitional cell metaplasia of the uterine cervix is related to human papillomavirus

Cited by 22 publications

References 35 publications

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

Human papillomavirus and the risk of Barrett's esophagus

Urothelial cells in smears from cervix uteri

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