Liu W M, Chao K C, Kan Y Y, Yuan C C, Chen C J, Ng H T
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, National Yang-Ming Medical College Taipei, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1990 Sep;46(3):167-71.
This retrospective study collected the surgical tissues and the clinical records of 197 surgically treated patients with microinvasive carcinoma of the cervix, which was defined as a limited microinvasion not more than 3 mm in depth regardless of lymph-vascular involvement. Depth of invasion was 1 mm or less in 13.2% and 1.1 to 3 mm in 86.8%. The mean age was 47.2 years. About half of the patients were asymptomatic but suspected cytologically. Random cervical biopsy alone was inadequate for diagnosis. Cone biopsy demonstrated an accuracy of 94% in diagnosis, but failed to eliminate microinvasive carcinoma in 23.0% of the hysterectomy specimens. In 14 cases, the invasion was more extensive in the uterus than in the cone. A positive correlation has been found between the diagnostic rate of conization and the depth of stromal invasion. Cervical conization, while relatively accurate in assessing the existence of stromal invasion that characterizes microinvasion, failed to diagnose those with deeper stromal invasion, especially beyond 1 mm. The recommended approach in diagnosing microinvasion is careful colposcope-directed cone biopsy and proper examination of the conization specimen in order to exclude the possibility of more advanced disease.
这项回顾性研究收集了197例经手术治疗的宫颈微浸润癌患者的手术组织和临床记录，宫颈微浸润癌的定义为深度不超过3mm的局限性微浸润，无论是否有淋巴血管浸润。浸润深度在1mm及以下的占13.2%，1.1至3mm的占86.8%。平均年龄为47.2岁。约一半患者无症状，但细胞学检查可疑。单纯随机宫颈活检不足以确诊。锥形活检诊断准确率为94%，但在23.0%的子宫切除标本中未能排除微浸润癌。在14例病例中，子宫内的浸润比锥形切除标本中的更广泛。已发现锥形切除的诊断率与间质浸润深度之间存在正相关。宫颈锥形切除在评估作为微浸润特征的间质浸润的存在方面相对准确，但未能诊断出间质浸润更深的患者，尤其是超过1mm的患者。诊断微浸润的推荐方法是仔细的阴道镜引导下锥形活检和对锥形切除标本进行适当检查，以排除更晚期疾病的可能性。
