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What Is Squamous Cell Carcinoma Of The Cervix

How Can Squamous Cell Carcinoma Of Cervix Be Prevented

Histopathology Cervix –Squamous cell carcinoma

Some steps for the prevention of Squamous Cell Carcinoma of Cervix include:

  • Use of measures to prevent sexually-transmitted infections, such as usage of condoms, avoiding multiple sexual partners, and circumcision in men
  • Avoidance of smoking
  • Regular screening to detect pre-cancers:
  • The American Cancer Society recommends screening of women from age 21 years
  • A Pap smear is recommended every 3 years, from ages 21-29 years
  • From age 30-65 years, a Pap smear and HPV testing is recommended, once every 5 years
  • More frequent screenings are advised for women having a high-risk for Cervical Cancer
  • Vaccination against human papilloma virus :
  • Two vaccines have been studied and approved for use in the United States – Gardasil and Cervarix
  • Cervarix has been approved for use in females aged 10-25 years, while Gardasil may be used in the 9-26 years age group
  • The American Cancer Society recommends routine vaccination of girls at 11-12 years of age
  • HPV vaccines are not successful against women who are already infected though
  • What Are The Signs And Symptoms Of Non

    Usually, there are no symptoms, during the pre-cancer and early cancer stages . Once, Non-Keratinizing Squamous Cell Carcinoma of Cervix has sufficiently progressed and the presence of large-sized tumors is seen, the following set of signs and symptoms may be observed:

    • Abnormal vaginal bleeding
    • Anemia
    • Loss of weight, loss of appetite

    During the advanced stages of Non-Keratinizing Squamous Cell Carcinoma of Cervix, the following signs and symptoms may be observed:

    • Lower back pain
    • Frequent urination
    • Urinary bladder pain and blood in urine
    • The tumor may spread from the cervix to the ureters leading to decreased urine production by the kidneys and increased blood urea levels
    • Involvement of the pelvic muscles by tumor cells can cause pain radiating along the leg
    • Occasionally, swollen lymph nodes in the groin and lower extremities, may be noted due to tumor metastasis
    • If the urinary bladder is involved, then it may obstruct the bladder and lead to retention of urine
    • Urinary retention can cause the abnormal formation of a fistula in the urogenital area
    • Rectal tenesmus or the urge to keep emptying the bowel, even after it is emptied

    Additional And Relevant Useful Information For Squamous Cell Carcinoma Of Cervix:

    • Studies have shown that the incidence of cervical cancer in a given population may be reduced by as much as 20 times through effective and wide-coverage screening programs

    The U.S. National Breast and Cervical Cancer Early Detection Program aims to provide screening tests for breast and cervical cancer to women in underserved areas, or those without health insurance, either for free or at a low cost. If needed, further testing or treatment expenses may also be covered. The US-based Centers for Disease Control and Prevention may be contacted for more information.

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    What Are The Risk Factors For Squamous Cell Carcinoma Of Cervix

    The following factors increase the risk of Squamous Cell Carcinoma of Cervix:

    • Infection with human papilloma virus types:
    • HPV infection is the most important risk factor predisposing one to cervical cancer
    • The virus is transmitted sexually
    • Different subtypes of the virus exist: Types 16, 18, 31, 33, and 45, are the high-risk types associated with cancer of which HPV-16 is the most common type and HPV-18 the second common type
  • Lack of periodic/regular Pap smear tests
  • Sexual promiscuity and high-risk sexual behavior
  • Poor immune system: HIV infection or AIDS, organ transplantation, immunosuppressant medications, greatly increase risk for chronic infection
  • Smoking
  • Use of oral contraceptives for long time duration
  • Having the first child at a young age and having had multiple pregnancies
  • Presence of other sexually transmitted infections
  • Chronic inflammation, in some cases
  • Family history of cervical cancer: This is a relatively low strength risk factor
  • A diet lacking fruits and vegetables
  • Poverty or poor socioeconomic status
  • It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

    Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

    What Is The Prognosis Of Squamous Cell Carcinoma Of Cervix

    Squamous cell carcinoma of the cervix
  • An early diagnosis and prompt treatment of the tumor generally yields better outcomes than a late diagnosis and delayed treatment
  • The combination chemotherapy drugs used, may have some severe side effects . This chiefly impacts the elderly adults, or those who are already affected by other medical conditions. Individuals, who tolerate chemotherapy sessions better, generally have better outcomes
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    Squamous Cell Carcinoma And Adenocarcinoma

    Cervical cancer is divided into two main types: squamous cell carcinoma and adenocarcinoma. Each is distinguished by the appearance of cells under a microscope.

    Squamous cell carcinomas begin in the thin, flat cells that line the bottom of the cervix. This type accounts for about 90 percent of cervical cancers, according to the ACS.

    Adenocarcinomas of the cervix develop in the glandular cells that line the upper portion of the cervix. Cervical adenocarcinomas make up most of the remaining cervical cancer cases.

    Both types of cervical cancer may come with symptoms, such as:

    • Changes in vaginal bleeding or discharge, including bleeding after sex
    • Lower abdominal/pelvic pain
    • Pain with sex

    Cervical cancers may be diagnosed with a pelvic exam. During this procedure, a medical tool called a speculum is inserted into the vaginal opening to dilate the walls, allowing the doctor or nurse to look inside the vagina and cervix for any abnormalities or signs of cancer. The procedure often includes a Pap test, which involves gently swabbing the surface of the vagina or cervix to collect cells. These cells are then analyzed in a laboratory. In addition to detecting cancer, this test may also reveal the presence of human papillomavirus , which is linked with cervical cancer.

    Treatment options for cervical cancer include:

    Regardless of the type, the outlook of these cancers depends largely on how far they spread. According to the ACS:

    Clear Cell Cervical Cancer

    Clear cell cervical cancer is rare. It is tested for in a similar way to other cervical cancers.

    Clear cell cervical cancer is more common in women and people with a cervix whose mothers had a drug called diethylstilbestrol when pregnant.

    Early stage cell clear cervical cancers are usually treated with a surgery called radical hysterectomy and lymph node dissection. Sometimes chemotherapy together with radiotherapy is given as well. This can help to reduce the risk of cervical cancer coming back.

    If clear cell cervical cancer spreads outside of the cervix, chemotherapy may be given to control the cancer.

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    Citation Doi And Article Data

    Citation:DOI:The RadswikiRevisions:see full revision historySystem:

    • Squamous cell carcinoma of the uterine cervix
    • SCC cervix
    • Squamous cell carcinoma of cervix
    • Squamous cell carcinoma of uterine cervix

    Squamous cell carcinoma of the cervix is the most common histological subtype of cervical cancer and accounts for 80-90% of cases.

    Pathology

    Most cervical squamous cell carcinomas grow at the squamocolumnar junction . In younger women, the SCJ is located outside the external uterine os, and the tumor tends to grow outward . In elderly patients, the SCJ is located within the cervical canal and the cancer tends to grow inward along the cervical canal .

    Variants

    Squamous Cells Cervical Cancer And Hpv

    Histopathology Cervix- -Squamous cell carcinoma

    Most cervical cancers and pre-cancers are caused by infections with human papillomavirus . HPV infects and transforms the squamous cells of the cervix. It can also infect and transform the cells of other tissues in the body.

    The 2020 cervical cancer screening guidelines from the American Cancer Society recommend people with a cervix get HPV primary testing rather than a Pap test every five years, starting at age 25 and continuing through 65. More frequent Pap tests are considered acceptable when there is no access to HPV primary testing.

    Depending on circumstances, over time, healthy cells may replace these transformed cells or they may continue growing abnormally and become cancerous.

    Most cervical HPV infections do not lead to cervical cancer. The body is often capable of eliminating these infections on its own.

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    Evaluation By The General Practitioner

    Hayes Martin stated that an adult patient who presents with a palpable lateral neck mass, whether solid or cystic, should be considered to have a metastatic lymph node until proven otherwise .

    In the typical patient with NCUP, the lymph nodes, located in the upper part of the neck, are clearly abnormal in size, shape or consistency. The palpable mass may be firm or, if cystic, may have a tense or soft consistency. On careful questioning, the patient may have symptoms referable to a head and neck primary tumor, such as a sore throat when swallowing, ear pain, new nasal obstruction, voice change, etc. They also may have a history of tobacco and alcohol abuse or 10 or more lifetime sexual partners. The absence of suspicious history or symptoms does not, however, rule out cancer.

    If a patient has a clinical presentation and imaging typical of lymphoma, with widespread adenopathy, sometimes exhibiting splenic, liver, bone marrow or lung involvement, and sometimes with type B constitutional symptoms , this represents an appropriate clinical scenario for open cervical lymph node biopsy . If not, it would be preferable to presume carcinoma initially and avoid open or even core biopsy as an initial test.

    Ultrasound-guided FNA of the neck mass for cytology is also appropriate prior to referral, but core needle biopsy should be deferred until after evaluation by the specialist and complete head and neck physical examination including fiberoptic nasopharyngo-laryngoscopy .

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    What Are The Risk Factors For Non

    The following factors increase the risk of Non-Keratinizing Squamous Cell Carcinoma of Cervix:

    • Infection with human papilloma virus types
    • Lack of periodic/regular Pap smear tests
    • Sexual promiscuity and high-risk sexual behavior
    • Poor immune system: HIV infection or AIDS, organ transplantation, immunosuppressant medications, greatly increase risk for chronic infection
    • Smoking
    • Use of oral contraceptives for long time duration
    • Having the first child at a young age and having had multiple pregnancies
    • Presence of other sexually transmitted infections
    • Chronic inflammation, in some cases
    • Family history of cervical cancer: This is a relatively low strength risk factor
    • A diet lacking fruits and vegetables
    • Poverty or poor socio-economic status

    It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

    Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

    What Is Cervical Squamous Cell Carcinoma

    Facts about Squamous Cell Carcinoma of Cervix

    1979

    According to GLOBOCAN database, the second most common cancer among Indian women is cervical cancer. Cervix is the lower portion or mouth of the uterus facing in the vagina.

    Cervical cancer is classified into two main types the most common type is squamous cell carcinoma which develops in the exocervix and has features of squamous cells when looked under a microscope, and adenocarcinomas that develop from the mucus-producing gland cells of the endocervix .

    What are squamous cells?

    Epithelium is a type of tissue that lines the outer surfaces of our bodys organs and inner surfaces of many internal organs. Epidermis, which is the outermost skin layer, is an example of epithelium.

    Epithelial cells can be of three different shapes, namely, squamous, cuboidal and columnar. In simple epithelium, any one of these shapes of cells is arranged in a single layer while in the stratified epithelium, there are two or more layers of cells.

    Epithelial cells make up all glands in the body. These cells perform many functions including protection, secretion, sensing, absorption and transportation between cells.

    Squamous cells have a scale-like, flat appearance and their width is more than their height. The word squamous is derived from a Latin word squama which means fish or serpent scales.

    What is cervical cancer?

    Cervical cancer is grouped into two types: squamous cell carcinoma and adenocarcinoma based on how the cancer cells look under a microscope.

    Precancerous changes

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    Squamous Cell Carcinoma And Variants

    Editorial Board Member: Editor-in-Chief: Topic Completed:Minor changes:CopyrightPage views in 2020:Page views in 2021 to date:Cite this page:

    • An invasive epithelial tumor composed of neoplastic cells with varying degrees of squamous differentiation
    • Most common type of cervical carcinoma
    • Nearly all cases are associated with high risk human papillomavirus and arise from a precursor lesion, high grade squamous intraepithelial lesion
    • Predominantly associated with HPV 16 and HPV 18
    • More common in low resource countries and women without adequate cytologic screening
    • Variable morphology with several histologic variants described
    • ICD-O: 8070/3 – squamous cell carcinoma, NOS
    • ICD-10: C53.1 – malignant neoplasm of exocervix
    • ICD-11: 2C77.Z – malignant neoplasms of cervix uteri, unspecified
    • Fourth most common type of cancer and cause of cancer mortality among women worldwide in 2018
    • Most common type of cervical carcinoma
    • Most patients are 40 – 54 years old
    • Significant disparities in incidence and mortality between low resource countries versus high resource countries
    • Incidence varies from 100 per 100,000 in unscreened women to 1 – 5 per 100,000 in highly screened women
    • Approximately 75% decrease over the past 50 years in countries with cervical cancer screening programs
    • Approximately 76& #37 of recent cases occur in countries without screening programs
    • In high resource countries, more common in women who failed to receive screening or follow up

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    Tumors With A Small Round Blue Cell Appearance

    • As mentioned above, non-keratinizing SCC may be composed of small cells and should not be misinterpreted as the following lesions. For immunohistochemical differential diagnoses, see Table 7.1.
    • Small cell neuroendocrine carcinomas may show small areas of dirty tumor necrosis within the infiltrating tumor cell nests. The majority, but not all, of tumors express neuroendocrine markers, with CD56 and synaptophysin being the most sensitive. p63 is almost always negative. TTF-1 is not uncommonly positive and does not help to exclude a pulmonary primary.
    • Lymphomas may primarily or secondarily occur within the cervix [

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    Effects On Pituitary System

    commonly develops after radiation therapy for sellar and parasellar neoplasms, extrasellar brain tumours, head and neck tumours, and following whole body irradiation for systemic malignancies. Radiation-induced hypopituitarism mainly affects and . In contrast, and deficiencies are the least common among people with radiation-induced hypopituitarism. Changes in -secretion is usually mild, and vasopressin deficiency appears to be very rare as a consequence of radiation.

    Lesions Mimicking Invasive Disease

    Histopathology Cervix– Squamous cell carcinoma
    • Tangential cutting of metaplastic squamous epithelium and decidual change of cervical stroma. Both lesions have no nuclear atypia and low levels of mitotic activity. p16 is negative and decidual cells are positive for vimentin.
    • Squamous epithelial hyperplasia with pseudoinvasion is a lesion that most commonly occurs within the ectocervix and represents a reactive change this harbors no nuclear atypia, shows low mitotic activity, and is negative for p16.
    • Placental site nodule may mimic a squamous lesion because of its eosinophilic appearance and sometimes marked nuclear pleomorphism. The intermediate trophoblastic cells of PSN are positive for CK 8/18 and GATA-3 as well as HPL, whereas CIN and SCC are negative. p16 may show focal patchy positivity in PSN as opposed to block staining.
    • CIN 3 with extensive endocervical gland involvement can be mimicked by a rare but challenging pattern of invasion in SCC and is discussed in the paragraph of the morphologic appearance of non-keratinizing SCC .

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    Risk Factors For Cervical Cancer

    The number one predisposing factor for cervical cancer is infection with the Human Papilloma Virus . Any factor which increases a womans risk of contracting Human Papilloma Virus will increase the risk of cervical cancer. These following factors increase a womans risk of getting Human Papilloma Virus :

    • Intercourse without barrier contraceptives.
    • Sex with a partner that has penile warts.
    • Cigarette smoking doubles a womans risk of getting cervical cancer.

    What Are The Causes Of Squamous Cell Carcinoma Of Cervix

    The human papilloma virus infection is a major cause behind the development of Squamous Cell Carcinoma of Cervix.

    • Under normal circumstances, certain genes called tumor suppressor genes, keep a check on the growth and division of cervical cells
    • HPV infection has been found to disrupt some tumor suppressor genes, thus allowing cervical cells to grow and multiply uncontrollably
    • Other factors that aid in cancer development are yet to be fully explained

    Almost all cervical cancer types are attributed to human papilloma virus infections around 15 different HPV types have been implicated. In rare instances, cervical cancer can occur without a preceding HPV infection. In such cases, the cause of the condition is unknown.

    • HPVs are known to have carcinogenic potency, meaning they have the potential to cause cancer
    • Of HPVs, HPV-16 and HPV-18 are most common, indicating that they have a more potent threat
    • 7 in 10 cancers are due to these two virus types
    • HPV-16 is causative for most cases of SCC, just as HPV-18 is for adenocarcinoma
    • However, HPV-18 is also responsible for SCC, but not to a great extent though

    Research has shown that the human papilloma virus causes the development of cervical cancer in the following manner:

  • The next step is the persistence of HPV infection and formation of premalignant lesions : Several years of persistent HPV infection can result in the development of precursor to cancer
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