Goldmann C, Richter P
Zentralbl Gynakol. 1978;100(1):13-16.
348 cases of carcinoma in situ are reported, which were diagnosed, without exception, by conization from 1966 to 1971. The atypical changes could be removed without leaving any detectable malignant cells in situ in 226 patients (65 per cent). These cases did not need any further therapy. In 45 cases (12,9 per cent) was doubtful if the conization could be performed without leaving malignant cells. In 77 cases (22,1 per cent) the conization was done leaving malignant cells in situ. 49 women of this group had a continued treatment, the vast majority was hysterectomized. All the other cases were strictly controlled. The 5-year healing quotient was 91,7 per cent. 7,1 per cent of the patients have not been heard of again. Only 3 patients (0,9 per cent) suffered a recurrence. They belong, without exception, to the control group in which the carcinoma in situ could not be primarily removed without leaving malignant cells in situ. The significance of an exact method of conization and a careful histotechnical perparation of the specimens in serial sections is especially pointed out. The necessity of a continued treatment by means of hysterectomy with vaginal cuff is stressed in carcinoma in situ which could not be removed without leaving malignant cells in situ.
报告了348例原位癌病例,这些病例均在1966年至1971年期间通过锥切术确诊。226例患者(65%)的非典型病变得以切除,且未留下任何可检测到的原位恶性细胞。这些病例无需进一步治疗。45例(12.9%)患者锥切术后是否未残留恶性细胞存疑。77例(22.1%)患者锥切术后残留原位恶性细胞。该组中有49名女性继续接受治疗,绝大多数接受了子宫切除术。所有其他病例均受到严格监测。5年治愈率为91.7%。7.1%的患者失去联系。仅3例患者(0.9%)复发。无一例外,他们均属于原位癌无法在不残留原位恶性细胞的情况下一次性切除的对照组。特别指出了精确锥切方法以及对标本进行仔细的组织技术处理以制作连续切片的重要性。强调了对于无法在不残留原位恶性细胞的情况下切除的原位癌,通过子宫切除术加阴道断端处理进行持续治疗的必要性。