Brémond A, Frappart L, Migaud C
J Gynecol Obstet Biol Reprod (Paris). 1985;14(8):1025-31.
The authors describe two types of micro-invasive carcinomas of the cervix: carcinomas in situ with early stromal invasion and carcinomas with definite micro-invasion. It is only if slices are taken every 250 microns through the cone that has been removed that a precise diagnosis of the lesion can be obtained and therefore treatment planned correctly for the illness. The following details are indispensable to decide what to do: the volume of the lesion in cubic mm, the depth of penetration in the chorion and the presence or absence of vascular and lymphatic invasion of the connective tissue of the cervix. Cytology is insufficient for accurate diagnosis and that is also true of directed colposcopy biopsies. This latter anyhow is not precise enough to evaluate what the treatment of the lesion should be. In the light of the observations that they have analysed and on reviewing the literature the authors have made a protocol for treatment. This is, for carcinoma in situ with early stromal invasion, conisation as long as the piece removed is entirely at the edges in healthy tissue is sufficient. In micro-invasive carcinomas of less than 500 cubic mm penetrating to a depth of less than 3 mm and without vascular or lymphatic invasion, total hysterectomy is the treatment of choice.(ABSTRACT TRUNCATED AT 250 WORDS)
原位癌伴早期间质浸润和明确微浸润癌。只有对切除的锥形组织每隔250微米切片，才能对病变做出精确诊断，从而为疾病正确制定治疗方案。决定治疗方案时，以下细节必不可少：病变体积（立方毫米）、绒毛膜浸润深度以及宫颈结缔组织有无血管和淋巴浸润。细胞学检查不足以进行准确诊断，直接阴道镜活检也是如此。后者无论如何都不够精确，无法评估病变应采取何种治疗。根据他们分析的观察结果并查阅文献，作者制定了一个治疗方案。对于原位癌伴早期间质浸润，只要切除的组织完全处于健康组织边缘，锥形切除就足够了。对于体积小于500立方毫米、浸润深度小于3毫米且无血管或淋巴浸润的微浸润癌，全子宫切除术是首选治疗方法。（摘要截选于250词）
