{"id":6210,"date":"2023-03-17T08:43:05","date_gmt":"2023-03-17T08:43:05","guid":{"rendered":"https:\/\/www.eurocytology.eu\/course\/4-pathogenesis-of-cervical-cancer\/"},"modified":"2023-04-26T08:11:54","modified_gmt":"2023-04-26T08:11:54","slug":"4-pathogenesis-of-cervical-cancer","status":"publish","type":"course","link":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/","title":{"rendered":"4. Pathogenesis of cervical cancer"},"content":{"rendered":"<div data-object_id=\"6210\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6210\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6210\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6210\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nome de utilizador ou endere\u00e7o de email<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Senha<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Manter sess\u00e3o<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Iniciar sess\u00e3o\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/pt-pt\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fpt-pt%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6210%2F\">Register<\/a><\/p><\/div><\/div><\/div><h3 style=\"font-family: Lato, Helvetica, Arial, sans-serif; color: rgb(52, 73, 94);\"><span style=\"font-size: 20px;\">Translated by&nbsp;Raquel Carvalho de Almeida<\/span><\/h3>\n<h3>CIN and squamous cell cervical carcinoma<\/h3>\n<p>\u00c9 amplamente aceito que o carcinoma escamoso invasor do colo uterino, que \u00e9 o tipo histol\u00f3gico mais comum, \u00e9 precedido por um est\u00e1gio pr\u00e9-invasivo da doen\u00e7a, onde as c\u00e9lulas anormais est\u00e3o confinadas ao epit\u00e9lio. &nbsp;O epit\u00e9lio escamoso normal do colo uterino \u00e9 substitu\u00eddo por epit\u00e9lio anormal composto por c\u00e9lulas neopl\u00e1sicas. Este est\u00e1gio de doen\u00e7a n\u00e3o invasiva \u00e9 conhecido como neoplasia intraepitelial cervical (NIC) e est\u00e1 diretamente relacionado aos processos de infec\u00e7\u00e3o e integra\u00e7\u00e3o do HPV como descrito no cap\u00edtulo anterior.<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img fetchpriority=\"high\" decoding=\"async\" alt=\"\" height=\"682\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO\" width=\"1187\" \/><\/a><figcaption>Figure 4.1. Schematic representation of the development of CIN&nbsp;(taken from Figure 1 in Kelloff &amp; Sigman 2007)<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<table border=\"3\" cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td>\n<ul>\n<li>NIC&nbsp;\u00e9 agrupado em tr\u00eas categorias<\/li>\n<li>NIC1&nbsp;(equivalente a displasia leve)<\/li>\n<li>NIC2&nbsp;(equivalente a displasia moderada)<\/li>\n<li>NIC3&nbsp;(equivalente a displasia acentuada e carcinoma in situ combinados)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>NIC1 sobrep\u00f5e-se com a infec\u00e7\u00e3o por HPV e geralmente regride espontaneamente dentro de 9-12 meses.&nbsp; H\u00e1 diversos estudos de seguimento de NIC1 demonstrando um risco altamente vari\u00e1vel de progress\u00e3o para NIC2-3 e um risco consequente de carcinoma invasor em uma pequena minoria de pacientes (Ost\u00f6r 1993; Holowaty 1999; Bansal et al. 2008).&nbsp;<\/p>\n<p>Um grande estudo retrospectivo de seguimento de displasias leve, moderada e severa por Holowaty et al. demonstrou que a maioria dos casos de displasia leve (62.2%) e moderada (53.7%) regrediram (dois esfrega\u00e7os negativos dentro de 2 anos) enquanto a ocorr\u00eancia de progress\u00e3o para displasia moderada ou mais foi de aproximadamente 25% dentro de 5 anos, o que \u00e9 compat\u00edvel com outros estudos. &nbsp;<\/p>\n<p>&nbsp;<\/p>\n<table border=\"3\" cellpadding=\"1\" cellspacing=\"1\" style=\"width: 500px;\">\n<tbody>\n<tr>\n<td>\n<h3>Progress\u00e3o de dysplasia leve (de Holowaty et al.)<\/h3>\n<p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<strong>Moderada<\/strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <strong>Severa<\/strong>+<\/p>\n<p><strong>Dentro de 2 anos<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 11.1%&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2.1%<\/p>\n<p><strong>Dentro de 5 anos<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;20.4%&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 5.5%<\/p>\n<p><strong>Dentro de 10 anos<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 28.8%&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 9.9%<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>Probabilidade de progress\u00e3o depende da persist\u00eancia do HPV, sua integra\u00e7\u00e3o ao genoma do hospedeiro e seu tipo (Jaisamrarn et al. 2013).&nbsp;<\/p>\n<ul>\n<li>HPV16 e 33 t\u00eam o maior risco de progress\u00e3o para NIC3<\/li>\n<li>HPV16 e 31 t\u00eam a menor probabilidade de regress\u00e3o<\/li>\n<\/ul>\n<p>NIC1 pode ocorrer no epit\u00e9lio escamoso maduro ou imaturo e \u00e9 definido por pleomorfismo nuclear com atividade mit\u00f3tica confinada \u00e0s camadas basal e parabasal com ou sem coilocitose.<\/p>\n<h4>&nbsp;<\/h4>\n<h4><strong>NIC de alto grau<\/strong><\/h4>\n<p><strong>NIC2 e NIC3<\/strong>&nbsp;s\u00e3o abordados como NIC de \u2018alto grau\u2019 e geralmente tratados por excis\u00e3o ou abla\u00e7\u00e3o quando diagnosticados \u00e0 colposcopia.<\/p>\n<p><strong>NIC2<\/strong>&nbsp;\u00e9 uma les\u00e3o intermedi\u00e1ria e h\u00e1 evid\u00eancia do estudo ALTS de que cerca de 40% tem resolu\u00e7\u00e3o espont\u00e2nea mas tinha menor chance de t\u00ea-la quando associada ao HPV16 (Castle et al. 2009). &nbsp;O estudo retrospectivo por Holowaty et al. (1999) demonstrou que a maioria dos casos de displasia moderada regrediram (53.7%) enquanto a progress\u00e3o foi mais prov\u00e1vel do que para a displasia leve.<\/p>\n<p>&nbsp;<\/p>\n<table border=\"3\" cellpadding=\"1\" cellspacing=\"1\" style=\"width: 357px;\">\n<tbody>\n<tr>\n<td style=\"width: 348px;\">\n<h3>Progress\u00e3o de dysplasia moderada (from Holowaty et al.)<\/h3>\n<p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<strong>Severa+<\/strong><\/p>\n<p><strong>Dentro de 2 anos<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;16.3%<\/p>\n<p><strong>Dentro de 5 anos<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 25.1%<\/p>\n<p><strong>Dentro de 10 anos &nbsp;<\/strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;32.0%<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>A taxa atuarial cumulativa de progress\u00e3o aos 5 anos por 100 mulheres de displasia moderada (1.2) para c\u00e2ncer invasivo foi intermedi\u00e1ria entre displasia leve (0.4) e severa (3.9).&nbsp; (Ver Holowaty&nbsp;et al. 1999 para dados completos com intervalos de confian\u00e7a.)<\/p>\n<p>NIC2&nbsp;\u00e9 definido por pleomorfismo nuclear com atividade mit\u00f3tica estendendo-se aos dois ter\u00e7os superiores do epit\u00e9lio. Geralmente h\u00e1 pouca ou nenhuma coilocitose.<\/p>\n<p>Devido \u00e0 sua posi\u00e7\u00e3o intermedi\u00e1ria entre NIC1 e NIC3 em termos de risco de progress\u00e3o e da import\u00e2ncia cl\u00ednica de decidir se NIC2 deve ser abordado como uma les\u00e3o pr\u00e9-maligna de alto grau, a imuno-histoqu\u00edmica utilizando inibidor p16 de quinase ciclina-dependente (p16INK4A) \u00e9 agora recomendado nos EUA para aumentar a precis\u00e3o do diagn\u00f3stico e definir o NIC de alto grau (Galgano&nbsp;et al. 2010; Darragh&nbsp;et al. 2012). &nbsp;<\/p>\n<p>&nbsp;<\/p>\n<table border=\"3\" cellpadding=\"1\" cellspacing=\"1\" style=\"width: 500px;\">\n<tbody>\n<tr>\n<td>\n<p>Colora\u00e7\u00e3o por P16INK4A&nbsp;ajuda a distinguir NIC2 de<\/p>\n<ol>\n<li>NIC1 em metaplasia imatura<\/li>\n<li>Simuladores n\u00e3o-neopl\u00e1sicos como metaplasia escamosa imatura, metaplasia atr\u00f3fica e reparo<\/li>\n<\/ol>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<figure>&nbsp;<\/figure>\n<p><strong>NIC3<\/strong>&nbsp;\u00e9 definido por pleomorfismo nuclear envolvendo toda a espessura do epit\u00e9lio escamoso com atividade mit\u00f3tica em todos os n\u00edveis.&nbsp;<\/p>\n<p>Risco de progress\u00e3o \u00e9 maior para NIC3 e a varia\u00e7\u00e3o inter-observador \u00e9 consideravelmente menor que para NIC1 e NIC2 (Stoler et al. 2001).&nbsp; Carcinoma microinvasivo \u00e9 quase sempre visto num contexto de NIC3 disseminado demonstrando adicionalmente seu potencial maligno.&nbsp; O risco exato \u00e9 dif\u00edcil de calcular porque a maioria dos casos de NIC3\/carcinoma in situ \u00e9 tratada quando diagnosticada.<\/p>\n<p><strong>Figure 4.4 (a-c). CIN3 and occult cancer<\/strong><\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"1079\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2208_1427301883.png?itok=YotbPrWj\" width=\"1440\" \/><\/a><figcaption>(a) Foco de invas\u00e3o estromal inicial&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"1411\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2209_1427301934.png?itok=VxNV0b9N\" width=\"1440\" \/><\/a><figcaption>(b) LIEAG (favorecendo NIC3) em um esfrega\u00e7o vaginal<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"500\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2210_1427301981.png?itok=6GzI_g2e\" width=\"848\" \/><\/a><figcaption>(c) stage IA carcinoma (microinvasive) developing in widespread CIN3.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<div data-object_id=\"6210\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6210\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6210\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6210\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nome de utilizador ou endere\u00e7o de email<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Senha<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Manter sess\u00e3o<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Iniciar sess\u00e3o\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/pt-pt\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fpt-pt%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6210%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>Translated by&nbsp;Raquel Carvalho de Almeida CIN and squamous cell cervical carcinoma \u00c9 amplamente aceito que o carcinoma escamoso invasor do colo uterino, que \u00e9 o tipo histol\u00f3gico mais comum, \u00e9 precedido por um est\u00e1gio pr\u00e9-invasivo da doen\u00e7a, onde as c\u00e9lulas anormais est\u00e3o confinadas ao epit\u00e9lio. &nbsp;O epit\u00e9lio escamoso normal do colo uterino \u00e9 substitu\u00eddo por [&hellip;]<\/p>\n","protected":false},"featured_media":0,"parent":6164,"menu_order":0,"template":"","meta":[],"tags":[],"course_area":[121],"authors":[],"class_list":["post-6210","course","type-course","status-publish","hentry","course_area-citologia-cervical"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>4. Pathogenesis of cervical cancer - Eurocytology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"4. Pathogenesis of cervical cancer - Eurocytology\" \/>\n<meta property=\"og:description\" content=\"Translated by&nbsp;Raquel Carvalho de Almeida CIN and squamous cell cervical carcinoma \u00c9 amplamente aceito que o carcinoma escamoso invasor do colo uterino, que \u00e9 o tipo histol\u00f3gico mais comum, \u00e9 precedido por um est\u00e1gio pr\u00e9-invasivo da doen\u00e7a, onde as c\u00e9lulas anormais est\u00e3o confinadas ao epit\u00e9lio. &nbsp;O epit\u00e9lio escamoso normal do colo uterino \u00e9 substitu\u00eddo por [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/\" \/>\n<meta property=\"og:site_name\" content=\"Eurocytology\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-26T08:11:54+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tempo estimado de leitura\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/\",\"url\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/\",\"name\":\"4. Pathogenesis of cervical cancer - Eurocytology\",\"isPartOf\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO\",\"datePublished\":\"2023-03-17T08:43:05+00:00\",\"dateModified\":\"2023-04-26T08:11:54+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#breadcrumb\"},\"inLanguage\":\"pt-PT\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-PT\",\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage\",\"url\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO\",\"contentUrl\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.eurocytology.eu\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Courses\",\"item\":\"https:\/\/www.eurocytology.eu\/course\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Citologia cervical\",\"item\":\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"4. Pathogenesis of cervical cancer\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.eurocytology.eu\/#website\",\"url\":\"https:\/\/www.eurocytology.eu\/\",\"name\":\"Eurocytology\",\"description\":\"The Eurocytology project is supported by the Leonardo da Vinci program with the aim of increasing access to training in clinical cytology and of harmonising training in this important specialty of pathology throughout the EU.\",\"publisher\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.eurocytology.eu\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"pt-PT\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.eurocytology.eu\/#organization\",\"name\":\"Eurocytology\",\"url\":\"https:\/\/www.eurocytology.eu\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-PT\",\"@id\":\"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png\",\"contentUrl\":\"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png\",\"width\":250,\"height\":76,\"caption\":\"Eurocytology\"},\"image\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"4. Pathogenesis of cervical cancer - Eurocytology","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/","og_locale":"pt_PT","og_type":"article","og_title":"4. Pathogenesis of cervical cancer - Eurocytology","og_description":"Translated by&nbsp;Raquel Carvalho de Almeida CIN and squamous cell cervical carcinoma \u00c9 amplamente aceito que o carcinoma escamoso invasor do colo uterino, que \u00e9 o tipo histol\u00f3gico mais comum, \u00e9 precedido por um est\u00e1gio pr\u00e9-invasivo da doen\u00e7a, onde as c\u00e9lulas anormais est\u00e3o confinadas ao epit\u00e9lio. &nbsp;O epit\u00e9lio escamoso normal do colo uterino \u00e9 substitu\u00eddo por [&hellip;]","og_url":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/","og_site_name":"Eurocytology","article_modified_time":"2023-04-26T08:11:54+00:00","og_image":[{"url":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO"}],"twitter_card":"summary_large_image","twitter_misc":{"Tempo estimado de leitura":"5 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/","url":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/","name":"4. Pathogenesis of cervical cancer - Eurocytology","isPartOf":{"@id":"https:\/\/www.eurocytology.eu\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage"},"image":{"@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage"},"thumbnailUrl":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO","datePublished":"2023-03-17T08:43:05+00:00","dateModified":"2023-04-26T08:11:54+00:00","breadcrumb":{"@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#breadcrumb"},"inLanguage":"pt-PT","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/"]}]},{"@type":"ImageObject","inLanguage":"pt-PT","@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#primaryimage","url":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO","contentUrl":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2204_1427301614.png?itok=dmTNaryO"},{"@type":"BreadcrumbList","@id":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/4-pathogenesis-of-cervical-cancer\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.eurocytology.eu\/"},{"@type":"ListItem","position":2,"name":"Courses","item":"https:\/\/www.eurocytology.eu\/course\/"},{"@type":"ListItem","position":3,"name":"Citologia cervical","item":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/"},{"@type":"ListItem","position":4,"name":"4. Pathogenesis of cervical cancer"}]},{"@type":"WebSite","@id":"https:\/\/www.eurocytology.eu\/#website","url":"https:\/\/www.eurocytology.eu\/","name":"Eurocytology","description":"The Eurocytology project is supported by the Leonardo da Vinci program with the aim of increasing access to training in clinical cytology and of harmonising training in this important specialty of pathology throughout the EU.","publisher":{"@id":"https:\/\/www.eurocytology.eu\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.eurocytology.eu\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"pt-PT"},{"@type":"Organization","@id":"https:\/\/www.eurocytology.eu\/#organization","name":"Eurocytology","url":"https:\/\/www.eurocytology.eu\/","logo":{"@type":"ImageObject","inLanguage":"pt-PT","@id":"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/","url":"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png","contentUrl":"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png","width":250,"height":76,"caption":"Eurocytology"},"image":{"@id":"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course"}],"about":[{"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/types\/course"}],"version-history":[{"count":1,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/revisions"}],"predecessor-version":[{"id":6850,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6210\/revisions\/6850"}],"up":[{"embeddable":true,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6164"}],"wp:attachment":[{"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/media?parent=6210"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/tags?post=6210"},{"taxonomy":"course_area","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course_area?post=6210"},{"taxonomy":"authors","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/authors?post=6210"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}