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Pathology and Molecular Diagnosis of Cervical Cancer and Precursor Lesions

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Uterine Cervical Cancer

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Abstract

Pathologic diagnosis of cervical neoplasia incorporates the practice of cytopathology, molecular pathology, and surgical pathology. Cervical pathology includes preinvasive squamous lesions (squamous intraepithelial lesions/SIL), invasive squamous cell carcinoma, adenocarcinoma in situ, invasive adenocarcinoma, as well as other less common primary epithelial and mesenchymal tumors. The most common cervical lesions are human papillomavirus (HPV)-associated squamous lesions. A two-tiered diagnostic approach classifying preinvasive lesions into low-grade and high-grade squamous intraepithelial lesions is used in cytopathology and surgical pathology. Low-grade squamous intraepithelial lesions (LSIL), which include condylomata, are the result of productive HPV infection that may be transient and regress. High-grade squamous intraepithelial lesions (HSIL) have a greater risk of progression to invasive carcinoma and require further treatment. Adenocarcinoma in situ, a precursor to invasive adenocarcinoma, is also HPV-associated and may coexist with squamous lesions. HPV testing/genoty** has been incorporated into the Papanicolaou cytology screening and helps stratify patients into those needing further evaluation. The incidence of invasive carcinoma has decreased with the widespread use of cytology testing. A subset of tumors not associated with HPV infection, while rare, may present diagnostic challenges, especially in cytology and small biopsies.

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  1. Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA

    Mariana Canepa, Nimesh R. Patel & Maria Luisa Garcia-Moliner

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  1. Mariana Canepa
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  2. Nimesh R. Patel
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  3. Maria Luisa Garcia-Moliner
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  1. The Joan and Sanford I. Weill Medical College/Graduate School of Medical Sciences, The New York Presbyterian Hospital-Weill Cornell Medical Center, and Sandra and Edward Meyer Cancer Center, Cornell University, New York, NY, USA

    Samir A. Farghaly

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Canepa, M., Patel, N.R., Garcia-Moliner, M.L. (2019). Pathology and Molecular Diagnosis of Cervical Cancer and Precursor Lesions. In: Farghaly, S. (eds) Uterine Cervical Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-02701-8_5

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