KIRKLAND J A
J Clin Pathol. 1963 Mar;16(2):150-4. doi: 10.1136/jcp.16.2.150.
Atypical epithelium, i.e., epithelium showing changes just insufficient to warrant a diagnosis of carcinoma in situ, was re-studied in surgical material from 66 patients. Most of these specimens had originally been reported as suspicious or potentially malignant. Of the 66 patients, 62 were alive and 46 of these were ;untreated' having had no treatment to the cervix since the original operation.Thirty-seven of the 66 were examined personally, 28 of these being ;untreated'; nineteen were found to have gynaecological abnormalities. Cytological examination was performed on 36, with only one suspicious smear; none of these patients was found to have invasive carcinoma or carcinoma in situ. Of the remaining 25 patients not seen personally, all were considered by their doctors to be free of any significant cervical lesion. The incidence of progression from atypical epithelium to carcinoma in situ is so different in the published reports that the definitions must surely be different. Sections from 15 cases of carcinoma in situ were therefore submitted to seven skilled pathologists, and as only 70 out of 105 diagnoses came into this category, the need for agreed definition is obvious. The present study shows a depressing persistence of the original or similar complaint. The follow-up (average 7.4 years) suggests that atypical epithelial change is unlikely to progress to carcinoma.
对非典型上皮组织，即显示出的变化程度刚不足以诊断为原位癌的上皮组织，在66例患者的手术材料中进行了重新研究。这些标本大多数最初被报告为可疑或潜在恶性。在这66例患者中，62例存活，其中46例“未接受治疗”，自初次手术后未对宫颈进行过任何治疗。66例中有37例接受了亲自检查，其中28例“未接受治疗”；发现19例有妇科异常。对36例进行了细胞学检查，只有1例涂片可疑；这些患者中未发现有浸润癌或原位癌。在其余25例未亲自检查的患者中，他们的医生均认为其无任何明显的宫颈病变。已发表的报告中，非典型上皮组织进展为原位癌的发生率差异很大，所以定义肯定不同。因此，将15例原位癌的切片提交给7位经验丰富的病理学家，在105次诊断中只有70次属于这一类别，显然需要有一致的定义。本研究显示最初的主诉或类似主诉持续存在，令人沮丧。随访（平均7.4年）表明非典型上皮变化不太可能进展为癌。
