The Reserve Cell in the Uterine Cervix: aspects of development, differentiation and diagnosis

Carcinoma of the uterine cervix is worldwide the second most common cancer in women. It has been approximately 150 years since the first description of uterine cervical carcinoma, a century since the description of its precursor lesions, and half a century since the introduction of the method proposed by Papanicolaou for detecting cervical neoplasms by cytologic screening. In time investigators have proposed a multitude of histologic and cytologic terms for cervical precursor lesions, have devised methods and techniques for diagnosis and treatment, and have identified the causative agent i.e. human papillomavirus (HPV).
Subclinical cervical HPV infection causes typical cytological and histological features called koilocytosis. Koss was one of the first to relate koilocytosis to condylomas and associated these with premalignant cervical lesions, zur Hausen (Nobel Prize winner 2008) was the first to relate HPV to cervical cancer. From that moment HPV was the major subject for investigators in the search for answers in cervical carcinogenesis. In the 1980’s and 1990’s new molecular and cell biological techniques developed rapidly and made it possible to detect HPV DNA in tissue and cell samples, to identify the many HPV subtypes and to study the effect of HPV on the cell cycle and the process of apoptosis. These techniques are now widely applied for diagnostic purposes, allowing a beter recognition of the HPV-infected lesions. Resulting in a better prognostication and giving rise to more molecular approaches that complement the (immuno) histochemical and cytochemical protocols.