病理学精品课件：e12.pptVIP

（一）Etiology and Pathogenesis 1. HPV infection Epidemiologic data sexually transmitted agent HPV infection 2. Other factors early married multiparturition cervical injury oral contraceptive use associated genital infection cigarette smoking 3. p53 gene mutation 1. Gross （1）Erosive type （2）Fungating type the most common type cauliflower or papillary （3）Infiltrative type （4）Ulcerating type Fungating type 2. Histological types （1）Squamous cell carcinoma： The most common type Cervical epithelial dysplasia Carcinoma in situ invasive carcinoma ① Derived from Transformation zone： Squamocolumnar junction Cervical adenoepithelium Squamous metaplasia ② Early invasive or microinvasive squamous cell carcinoma Carcinoma cell Cross the BM Microscopic invasion of stroma of less than 5mm in depth , diagnosed only by microscopy but showing Squamous cell carcinoma ④ Grading Well-differentiated 20%, keratinizing Moderately differentiated 60%, nonkeratinizing Poorly differentiated 20%, lack of keratinizing small cell (2) Cervical adenocarcinoma ① Age slight older group than squamous car. ② Arising in squamocolumnar junction endocervical glands ③ Grading well differentiated moderately differentiated poorly differentiated Cervical adenocarcinoma 1. Direct spread vagina , peritoneum, rectum urinary bladder, ureters 2. Lymphatic metastasis the most common and important Local and distant LN involved 3. Hematogenous metastasis lung, bone , liver 1. Staging Stage 0：carcinoma in situ Stage Ⅰ：carcinoma confined to the cervix Stage Ⅱ： Car. extend beyond the cervix but not onto the pelvic wall Involve the vagina but not