anatomy,etiology,staging,patholgy

1. DR.ARNAB ROY
CERVICAL CANCER
anatomy,etiology,staging,patholgy

2. IMPORTANCE OF CA CERVIX
 CARCINOMA CERVIX( CA CX) IS ITHE MOST COMMON WOMEN
RELATED CANCER IN INDIA, AND SECOND MOST COMMON
WOMEN RELATED CANCER IN THE WORLD.
 IN INDIA 132,000 NEW CASES DIAGNOSED AMOUNTING TO ¼ OF
TOTAL WORLD’S CASES OF CA CX EACH YEAR .
 IN INDIA 74000 DEATHS OCCUR EVERY YEAR FROM CERVICAL
CA AMOUNTING TO 1/3 OF CERVICAL CANCER DEATHS IN THE
WORLD
 INDIAN WOMEN FACE 2.5% CUMULATIVE LIFETIME RISK AND
1.4% DEATH RISK FROM CERVICAL CANCER
 INDIA HAS THE HIGHEST AGE STANDARDISED INCIDENCE OF
CERVICAL CANCER IN SOUTH EAST ASIA AT 22 FOLLOWED BY
BANGLADESH AT 19.2.

3. BRIEF DISCUSSION ON ANATOMY
 UTERUS DEVELOPS FROM THE
PARAMESONEPHRIC DUCT (WOLFIAN DUCT)
 UTERUS IN ADULT :FUNDUS ,BODY AND
CERVIX (cervix uteri :Latin: neck of the uterus)
 USUALLY
ANTI FLEXION IS 170°
ANTIVERSION IS 90°

4. DISCUSSING ADJACENT STRUCTURES

6. SUPPORTS

7. LYMPHATICS

8. PARTS OF CERVIX

9. HISTOLOGY OF NORMAL ECTOCERVIX

10. HISTOLOGY OF NORMAL ENDOCERVIX

11. THE SQUAMOCOLUMNAR JUNCTION

12. THE TRANSFORMATION ZONE

13. IMPORTANCE OF SCJ & TZ
 The cervical SCJ is the site of a recently discovered ‘embryonic’ cell
population that was proposed as the cell of origin for cervical cancer
and its precursors.
 Early in life, embryonic cervical epithelial cells were seen throughout
the cervix and subsequently diminished in number to become
concentrated at the SC junction in the adult.
 The downward or basal (rather than upward or apical) evolution from
progenitor cell to metaplastic progeny was termed reverse or 'top down'
differentiation
 SC junction is uniquely susceptible to carcinogenic HPV infection.
 A similar pattern was noted in high-grade squamous intraepithelial
lesions (HSILs), suggesting that HPV infection of the cuboidal SC
junction cells
 The TZ is the site of origin for > 90% of precancerous lesions and
cancers.

16. ETIOLOGICAL CAUSES
 SEXUALLY TRANSMITED AGENTS: HPV
(16,18,31,33,45) ,POSSIBLY HSV-2
 SMOKING
 CERVICAL TAR EXPOSURE CAUSED BY
BURNING WOOD / COAL IN KITCHEN
 SEXUAL BEHAVIOUR:
1. EARLY MARRIAGE
2. PARITY
3. AGE AT FIRST INTERCOURSE
4. NUMBER OF SEXUAL PARTNERS

17. DIAGNOSTIC WORKUP
 PAP SMEAR IS USUALLY DONE IN ASYMPTOMATIC –USED FOR
SCREENING PURPOSE – REPORTED USING BETHESDA SYSTEM
 CLINICALLY VISIBLE LEISION ON COLPOSCOPY:

19. BETHESDA SYSTEM OF REPORTING PAP SMEAR