Hachisuga T, Sugimori H, Kaku T, Tsuneyoshi M
Department of Obstetrics and Gynecology, Saga Medical School.
Jpn J Clin Oncol. 1992 Dec;22(6):400-5.
In order to elucidate the basis for the development of an endometrial carcinoma, we looked for microcarcinomas measuring < 5 mm in greatest diameter, and studied their histologic characteristics and those of the neighboring endometrium. Using serial step section methods, two microcarcinomas were detected. A microcarcinoma was found in one of 14 uteri resected for atypical hyperplasia and the other was found in one of 114 uteri resected for endometrial carcinoma. The neighboring endometrium of the former was adenomatous and had atypical hyperplasia and that of the latter was atrophic and contained atypical glands characterized by cytologic atypia and not by architectural changes. The findings may suggest endometrial carcinomas to have two pathogenetic forms: a carcinoma associated with hyperplasia and occurring in premenopausal women, a second carcinoma associated with atrophic endometrium and occurring in postmenopausal women. Atypical glands in atrophic endometria may indicate that endometrial specimens from postmenopausal women should be carefully screened for cytologic atypia.
为了阐明子宫内膜癌的发生基础，我们寻找最大直径<5mm的微癌，并研究它们以及邻近子宫内膜的组织学特征。采用连续步移切片法，检测到两例微癌。14例因非典型增生而切除的子宫中，有1例发现微癌；114例因子宫内膜癌而切除的子宫中，有1例发现微癌。前者的邻近子宫内膜呈腺瘤样，有非典型增生，后者的邻近子宫内膜萎缩，有以细胞异型性而非结构改变为特征的非典型腺体。这些发现可能提示子宫内膜癌有两种发病形式：一种与增生相关，发生于绝经前女性；另一种与萎缩性子宫内膜相关，发生于绝经后女性。萎缩性子宫内膜中的非典型腺体可能提示，应对绝经后女性的子宫内膜标本仔细筛查细胞异型性。
