Peters R K, Thomas D, Skultin G, Henderson B E
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033.
Am J Obstet Gynecol. 1988 Apr;158(4):926-35. doi: 10.1016/0002-9378(88)90096-8.
A study was conducted to determine if invasive cervical cancer diagnosed shortly after negative cytologic test results represents a demographically or epidemiologically distinct subgroup of these tumors. A total of 200 patients with invasive squamous cervical cancer and matched, neighborhood control subjects were interviewed. Cytology reports for smears taken 5 years before diagnosis were obtained, and reportedly negative smears were solicited and reevaluated. Thirty-three patients (group 1) had had one or more negative smears within 5 years and no previous abnormal cytologic results. At diagnosis cancers in group 1 had progressed further than those of patients with nondiagnostic positive smears (group 2, n = 43) but not as far as those of patients with no cytologic tests done within 5 years (group 3, n = 96). Age and social class were the same in groups 1 and 2, but both groups were younger and better educated than group 3. Otherwise group 1 did not differ from the other groups and the same risk factors prevailed roughly equally in all three groups. Therefore cervical tumors diagnosed soon after negative cytologic test results do not appear to differ etiologically from other squamous carcinomas at this site, and the failure of screening to detect these tumors is probably due to rapid progression through the preinvasive stages and/or failure to shed cancer cells in quantities sufficient for detection by routine cytologic screening.
开展了一项研究，以确定在细胞学检查结果为阴性后不久被诊断出的浸润性宫颈癌是否代表这些肿瘤在人口统计学或流行病学上的一个独特亚组。总共对200例浸润性宫颈鳞癌患者以及匹配的社区对照对象进行了访谈。获取了诊断前5年所取涂片的细胞学报告，并对据报道为阴性的涂片进行了征集和重新评估。33例患者（第1组）在5年内有一次或多次涂片结果为阴性，且既往无异常细胞学结果。在诊断时，第1组患者的癌症进展程度比涂片结果无法诊断为阳性的患者（第2组，n = 43）更严重，但不如5年内未进行细胞学检查的患者（第3组，n = 96）。第1组和第2组的年龄和社会阶层相同，但这两组都比第3组更年轻且受教育程度更高。除此之外，第1组与其他组没有差异，并且相同的危险因素在所有三组中大致同等普遍。因此，在细胞学检查结果为阴性后不久被诊断出的宫颈肿瘤在病因学上似乎与该部位的其他鳞癌没有差异，筛查未能检测到这些肿瘤可能是由于其在浸润前期迅速进展和/或未能脱落足够数量的癌细胞以供常规细胞学筛查检测到。
