Cervical mosaic and an integrated pathophysiological approach to early cervical neoplasia

The increasing concern for the early detection and treatment of cervical intraepithelial neoplasia (CIN) set up the basis for this study, which also considers some epidemiological factors which seem to be related to the genesis of an abnormal uterine cervical colposcopic pattern, the mosaic pattern. We have observed that women with a mosaic pattern show an increasing frequency of premalignant and/or malignant histologic changes up to 40 years of age which then falls abruptly. Sterility and hirsutism were frequent associations, these features suggesting an abnormal hormonal status. An association with infection by Gardnerella vaginalis (15.3%) was noted, and dysplasia increased in frequency to 53% when G. vaginalis was associated with mosaic. Also, 67.25% of women with mosaic showed other concomitant diseases of allergic, immunologic, or infectious type. Based upon these observations, and in an attempt to explain further interrelationships among several factors in the pathogenesis of CIN, an integrated hypothesis which may lead to new therapeutic avenues, both in the prevention and treatment of early cervical cancer, is advanced.