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Why Do Human Papillomavirus Infections Induce Sharply Demarcated Lesions of the Cervix?

Reich, Olaf MD1; Pickel, Hellmuth MD1; Regauer, Sigrid MD2

Journal of Lower Genital Tract Disease: January 2008 - Volume 12 - Issue 1 - p 8-10
doi: 10.1097/LGT.0b013e31806dba20
Original Articles
Spanish Translation

Chronic infections with high-risk human papilloma virus (HPV) have been established to cause cervical cancer. The causal pathogenesis of cervical carcinoma is believed to be the result of the proliferation of one or, at most, a few HPV-transformed cells. So far, it has not been possible to identify and analyze these early initial lesions or cell clusters. Invasive cervical cancer arises in cervical intraepithelial neoplasia, which in turn develops preferentially in squamous metaplasia in clearly demarcated fields. These fields are the main salient morphologic characteristic in cervical intraepithelial neoplasia and can be recognized colposcopically as well as histomorphologically. The precise mechanism for the development of separate, well-delineated fields in HPV-related intraepithelial neoplasia and the variable susceptibility of stem or reserve cells for different HPV genotypes remains unsolved. In cervical carcinogenesis, the link between formal pathogenesis apparent as colposcopic and histomorphologic changes and the causal pathogenesis of HPV-induced genetic changes is still missing and an issue for future research.

Although the molecular mechanisms of chronic infection with high-risk human papillomavirus (HPV) have been well established in the pathogenesis of cervical cancer, the morphologic finding of cervical intraepithelial neoplasia in sharply defined fields it is not understood. The link between causal and formal cervical carcinogenesis is still missing.

1Department of Obstetrics and Gynecology and 2Institute of Pathology, Medical University Graz, Austria

Reprint requests to: Olaf Reich, MD, Department of Obstetrics and Gynecology, Medical University Graz, Auenbruggerplatz 14, A-8036 Graz, Austria. E-mail:

In memoriam Professor Erich Burghardt, consummate colposcopist and clinical pathologist who died in May 2006.

©2008The American Society for Colposcopy and Cervical Pathology