The mysteries of metaplasias

“On the other hand”, he continues, “we’re interested in understanding what happens during adolescence in this particular zone. Since the two histological types of cervical cancer express these markers, we suspect that at a given moment, they have a common history. We believe that these cells are multipotent and they can result in glandular cells or epidermoid cells. Therefore, they could well be original (or progenitor) cells that serve as a precursor to the two types of mucosal surface on either side of the junction, the vaginal/ectocervical epidermoid epithelium and endocervical glandular epithelium.”

For the pathologists, the junctions between two different mucosal surfaces protective epithelial tissues are particularly exciting zones “because something is always happening there”. Junctions such as those between the cervix and the vagina, the anus and the rectum, and the oesophagus and the stomach or at an oropharyngeal level [where the mucosa of the mouth (epidermoid epithelium) joins the respiratory epithelium of the trachea], present characteristics of metaplasia… and are particularly liable to the development of cancers. “Up until now, we have simply explained this by the inflammation which, of course, is a predisposing factor, but this explanation is rather brief”, emphasises Michaël Herfs. “What’s very intriguing is that according to Wang’s article (on Barrett’s oesophagus*) and ours, we have also revealed junction cells similar to those of the cervix at the anorectal junction. As for the oropharynx, it is far more difficult to obtain biopsies but I think there are potentially some there as well, and that they could be linked to cancers in the head and neck.”

Interesting indeed: cancers of the anus and oropharynx are currently increasing significantly among youngsters, a progression attributed to widespread practice of certain sexual acts that the stricter morality of the past kept under check… Practices accompanied, of course, by the appearance of HPV infections in these zones which were previously less likely to make the acquaintance of this family of viruses. We may therefore allow ourselves to believe that the discoveries of our young researcher could well be the subject of some very interesting developments.

* in the case of the development of Barrett’s oesophagus cancer, there is no infection by HPV. The trigger is probably the stomach’s pH acidity which induces the metaplastic transformation.