Ayer B, Pacey F, Greenberg M, Bousfield L
Acta Cytol. 1987 Jul-Aug;31(4):397-411.
Seventy cases of histologically confirmed adenocarcinoma in situ (AIS) of the cervix uteri have been predicted in this laboratory using cytologic criteria, which are illustrated in this paper. The architectural features that were of primary diagnostic importance included an exfoliation pattern consisting of sheets of cells and tissue fragments in the form of cellular strips and rosettes. Nuclear criteria allowed the distinction of AIS into well-differentiated and poorly differentiated types. The former showed nuclear enlargement, an oval nuclear shape, hyperchromasia and moderate-to-coarse granularity as usual features. In the latter, nuclear enlargement was even greater, with an oval-to-round shape, prominent nucleoli and chromatin that was usually only finely granular. Variant patterns of AIS included endocervical, endometrioid and intestinal subtypes, each with characteristic cytologic appearances that correspond closely with their histologic appearances. The evolution of the description of AIS reveals a range of precursor lesions that may match the range of invasive adenocarcinomas originating in the cervix. This suggests that invasive adenocarcinoma of the cervix uteri could be preventable as is its more common squamous counterpart.
本实验室已运用细胞学标准预测出70例经组织学确诊的子宫颈原位腺癌（AIS），本文对此进行阐述。具有主要诊断意义的结构特征包括由细胞片层以及细胞条带和玫瑰花结形式的组织碎片组成的脱落模式。核标准可将AIS区分为高分化型和低分化型。前者通常表现为核增大、核呈椭圆形、核染色质增多以及中度至粗颗粒状。后者核增大更为明显，呈椭圆形至圆形，核仁突出，染色质通常仅呈细颗粒状。AIS的变异模式包括宫颈内膜型、子宫内膜样型和肠型亚型，每种亚型都有与其组织学表现密切对应的特征性细胞学表现。AIS描述的演变揭示了一系列可能与源自子宫颈的浸润性腺癌范围相匹配的前驱病变。这表明子宫颈浸润性腺癌与其更常见的鳞状上皮对应物一样是可以预防的。
