Usefulness of hysteroscopy for detection of cancer in the endocervical canal.

Preoperative hysteroscopic and histologic findings of endocervical cancerous lesions were compared with postoperative histologic findings of cervices. A total of 132 patients consisting of 72 carcinoma in situ, 16 microinvasive carcinoma and 44 invasive squamous cell carcinoma were examined during the 5 years beginning in 1977. The rates of cancerous lesions observed in the endocervix were 33.3% carcinoma in situ, 56.2% microinvasive carcinoma and 72.8% invasive squamous cell carcinoma. The preoperative diagnoses of endocervical lesions were histologically identical with the postoperative ones in 24 (88.9%) of 27 cases of carcinoma in situ, 7 (87.5%) of 8 cases of microinvasive carcinoma and all of 30 cases of invasive squamous cell carcinoma. Mosaics and punctations were noticed in the endocervix near the external os in the early stage of cancer, whereas white epithelia were observed more frequently and, over a wide range in the endocervix. Abnormal gland openings were noticed predominantly in carcinoma in situ. Atypical vessels were recognized mainly in microinvasive carcinoma. Gross irregular and dilated atypical vessels were recognized mainly in microinvasive carcinoma. Gross irregular and dilated atypical vessels, opacity, irregular surface and necrosis were observed predominantly in invasive carcinoma. In conclusion, hysteroscopy is useful in detecting cancerous lesions located in the endocervical canal.