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HPV, or human papillomavirus, is stealthy. The most common sexually-transmitted infection, it invades the body without the person's knowledge because it has no symptoms. In 90 percent of cases, the immune system is able to track down and destroy the virus naturally within two years. But sometimes HPV has a way of sneaking past the body's natural defenses, causing health issues, such as cervical cancer.
Scientists from BWH, Harvard Medical School (HMS) and the Agency for Science Technology and Research in Singapore (ASTAR) recently made an important discovery with the potential to change the way patients with HPV are treated.
"We have found a discrete population of cells that are located in a specific area of the cervix that could be responsible for most, if not all, of HPV-associated cervical cancers," said Christopher Crum, MD, director of BWH Women's and Perinatal Pathology.
Location, Location, Location
Crum and colleagues, Wa Xian, PhD, of the BWH Department of Pathology and the Institute of Medical Biology at ASTAR, and Frank McKeon, PhD, of HMS and the Genome Institute of Singapore, discovered that a population of cells found only in a region of the cervix, called the squamo-columnar junction, has the potential of becoming cancerous when infected with HPV, while cells located elsewhere in the cervix do not.
Michael Herfs, PhD, a visiting fellow from the University of Liege, was the lead author of the study, which was recently published in the Proceedings of the National Academy of Science.
The squamo-columnar junction sits between the part of the cervix that opens to the vagina and the part that opens to the uterus. Drawing on observations from a prior discovery by the Xian/McKeon laboratory of a similar junction in the esophagus, the researchers found that the cells in this junction have unique genes similar to those found in aggressive cervical tumors.
This finding may guide cancer treatment since the genes of these cells may help physicians distinguish benign tumors from potentially dangerous, precancerous ones.
When treating precancers, physicians usually aim to remove all precancerous tumors. However, even after removal, there is still the risk that tumors may return.
But the researchers found that when they removed cells from the squamo-columnar junction, they did not return. Such an observation opens up intriguing prospects for cancer prevention by removing the cells before they have a chance to become cancerous.
The removal of these cells in young women before they are subject to HPV infection or precancerous changes could potentially reduce the risk of cervical cancer, but further research is needed to evaluate the benefits and risks of this potential therapy, according to Crum and colleagues.