Impact of Human Papillomavirus Research on the Histopathologic Concepts of Genital Neoplasms

Abstract

Carcinoma of the uterine cervix is known to be closely associated with sexual promiscuity, age at first sexual experience, and multiple pregnancies (Stern et al. 1967; Kessler 1981). Based on the observed absence of cervical cancer among nuns, relationship between sexual intercourse and cervical cancer was suggested by the pioneering report of Rigoni-Stern in 1984. Since the nineteenth century many etiologic agents, mainly sexually transmitted diseases, have been proposed as causes or uterine cancer. Among them have been syphilis (Røjel 1953; Moghissi et al. 1968), gonorrhea (Sebastian et al. 1978; Furgyik and Astedt 1980), Trichomonas vaginalis (Bechtold and Reicher 1952; Hulka and Hulka 1967), cytomegalovirus (Fletcher et al. 1986), Chlamydia trachomatis (Hare et al. 1982; Schachter et al. 1982), semen (Singer et al. 1976), and, more recently, herpes simplex hominis type 2 (HSV 2) virus (Rawls et al. 1968; Naib et al. 1969). Considerable research efforts have been made during the last two decades to prove the relationship between HSV 2 and cervical cancer. HSV 2 infection of the cervix has shown a high association with cervical cancer (Rawls et al. 1968; Naib et al. 1969; Nahmias et al. 1974; Kessler 1974). Further, patients with cervical cancer have been found to have a higher incidence of antibodies in their blood against HSV 2 than controls (Aurelian et al. 1973). However, neither integration of HSV 2 genomes to the host cancer cells nor molecular mechanisms of HSV 2 enhancing transcription of oncogenes of the host cells have been proven except in a few instances, and the “herpes theory” of cervical carcinogenesis has lost it supporters.