Obata N, Sasaki A, Takeuchi S, Ishiguro Y
Nihon Sanka Fujinka Gakkai Zasshi. 1987 May;39(5):771-6.
We studied 94 cases of adenocarcinoma of the uterine cervix, with emphasis on early diagnosis of cervical adenocarcinoma, histopathologically. The results are as follows: The number of cases was 4 in Stage 0 (adenocarcinoma in situ, ACIS), 51 in Stage I, and 39 in Stage II. The proportion of ACIS to invasive adenocarcinoma was 4 of 94 (4.26%) and was significantly lower than that of cervical squamous cell carcinoma. Thirty-nine cervical biopsies of 29 cases, taken 1-3 years prior to the clinical presentation of cancer, were available for study. In 2 of 16 "negative specimens", areas of glandular dysplasia were found on review. Areas of ACIS and adenocarcinoma with early stromal invasion were also found on review in 5 and in 2 of 14 specimens diagnosed as atypical glands, respectively. This study strongly suggests that "atypical glands" such as glandular dysplasia and ACIS are precursor lesions of invasive adenocarcinoma of the uterine cervix and that the delay in diagnosing cervical adenocarcinoma may be due partly to "underdiagnosis" of cervical biopsy specimens.
我们研究了94例子宫颈腺癌病例,重点是从组织病理学角度对子宫颈腺癌进行早期诊断。结果如下:0期(原位腺癌,ACIS)有4例,I期有51例,II期有39例。ACIS与浸润性腺癌的比例为94例中的4例(4.26%),明显低于子宫颈鳞状细胞癌。有29例患者在癌症临床表现出现前1至3年进行的39次宫颈活检可供研究。在16份“阴性标本”中的2份中,复查时发现了腺上皮发育异常区域。在分别诊断为非典型腺体的14份标本中,复查时在5份中发现了ACIS区域,在2份中发现了伴有早期间质浸润的腺癌区域。本研究强烈提示,腺上皮发育异常和ACIS等“非典型腺体”是子宫颈浸润性腺癌的前驱病变,子宫颈腺癌诊断延迟可能部分归因于宫颈活检标本的“诊断不足”。