HPV associated squamous cell carcinoma



HPV associated squamous cell carcinoma is a type of cancer that starts in squamous cells, which are flat cells that line many parts of the body. It is caused by infection with the human papillomavirus (HPV), a common virus that can cause changes in these cells over time. This type of cancer is different from cancers caused by other factors, such as smoking or alcohol, because it has distinct biological features and often responds well to treatment.

What are the symptoms of HPV associated squamous cell carcinoma?

The symptoms of HPV associated squamous cell carcinoma depend on where in the body the cancer develops. Common symptoms include:

  • Cervix: HPV associated squamous cell carcinoma of the cervix often does not cause symptoms in the early stages. In later stages, symptoms may include abnormal vaginal bleeding (such as after sex or between periods), unusual vaginal discharge, or pelvic pain.
  • Vagina or vulva: Symptoms may include itching, pain, or a lump in the vaginal or vulvar area, or changes in the color or texture of the skin.
  • Anal canal: Symptoms can include pain, itching, bleeding, or a lump in the anal area, as well as changes in bowel movements.
  • Oropharynx (throat): Symptoms may include a persistent sore throat, difficulty swallowing, hoarseness, or a lump in the neck caused by swollen lymph nodes.

If you experience any of these symptoms for more than two weeks, it is important to see a doctor for further evaluation.

What causes HPV associated squamous cell carcinoma?

This cancer is caused by high-risk types of HPV, especially HPV-16 and HPV-18. HPV spreads through direct contact, including sexual activity. The virus can cause changes in the DNA of squamous cells, leading to uncontrolled cell growth and, eventually, cancer. While many people are exposed to HPV, most will not develop cancer. Factors such as a weakened immune system or long-term HPV infection may increase the risk.

Where in the body is HPV associated squamous cell carcinoma found?

HPV associated squamous cell carcinoma most commonly develops in the cervix and the oropharynx (throat, including the tonsils and the base of the tongue). It can also arise in the vagina, vulva, and anal canal. These areas are lined by squamous cells that can be affected by high-risk HPV.

What does metastatic HPV associated squamous cell carcinoma mean?

Metastatic means the cancer has spread from its original location to other body parts, such as nearby lymph nodes or distant organs. When this happens, the cancer may require more intensive treatment. However, even metastatic HPV associated squamous cell carcinoma often responds well to treatment compared to non-HPV-related cancers.

How is this diagnosis made?

The diagnosis of HPV associated squamous cell carcinoma depends on the location of the tumor:

  • Cervix and anal canal: Pap smears are commonly used as a screening test to detect abnormal cells caused by HPV. A biopsy may be performed to confirm the diagnosis if abnormal cells are found.
  • Other locations (e.g., oropharynx, vulva, vagina): A biopsy is usually performed to remove a small sample of tissue for examination under a microscope.

Pathologists use this tissue to confirm the presence of squamous cell carcinoma and determine if it is associated with HPV.

What does HPV associated squamous cell carcinoma look like under the microscope?

Under the microscope, this cancer often shows clusters of abnormal squamous cells growing irregularly. The tumor cells typically lack keratin (a protein found in normal squamous cells) and have large, irregularly shaped nuclei. These features are consistent with a non-keratinizing type of squamous cell carcinoma commonly associated with HPV.

What additional tests may be ordered to confirm the diagnosis?

Pathologists often use immunohistochemistry (IHC) to test for a protein called p16, which is produced in high amounts by HPV-infected cells. A positive p16 test strongly suggests that the cancer is associated with HPV. Other tests, such as in situ hybridization or polymerase chain reaction (PCR), may be used to detect HPV DNA or RNA in the tumor directly.

What is the prognosis for a person diagnosed with HPV associated squamous cell carcinoma?

HPV associated squamous cell carcinoma generally has a better prognosis than cancers not related to HPV. Most patients respond well to treatment, including surgery, radiation, or chemotherapy. Survival rates are high, especially for cancers diagnosed early. However, lifestyle factors like smoking can negatively affect prognosis, so quitting smoking is strongly recommended.

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