Nagai S, Sawada T
Nihon Sanka Fujinka Gakkai Zasshi. 1983 Dec;35(12):2283-90.
The usefulness of endometrial cytology was studied for the purpose of early diagnosis of endometrial carcinoma in 423 patients. In the cytological examination, 15 patients were either "suspicious" or "positive". Histological findings revealed adenomatous hyperplasia in 6, atypical hyperplasia in 3 and endometrial carcinoma in 3 patients. All of these patients with positive histological findings had "suspicious" or "positive" in cytological examination. None had false negative. "Suspicious" or "positive" endometrial cytology was delineated in histologically positive lesions including endometrial carcinoma, atypical hyperplasia and adenomatous hyperplasia. Many cells with various acinous patterns were observed in patients with diseases more serious than atypical hyperplasia. The nuclei became larger and irregular in proportion to the progression of the lesion, though hypercytochromia of the nuclear chromatin was most marked in patients with adenomatous hyperplasia. There was a significant difference in the number of nucleoli between cells of adenomatous hyperplasia and those of atypical hyperplasia and endometrial carcinoma. Also, there was an apparent difference in the size and irregularity of the nucleoli between atypical hyperplasia and endometrial carcinoma. Phagocytosis of white blood cells was frequently observed in patients with endometrial carcinoma. Therefore, it is believed that endometrial cytology is useful not only in screening endometrial carcinoma and related diseases but also to some degree in the estimated diagnosis of these lesions.
为了早期诊断子宫内膜癌,对423例患者的子宫内膜细胞学检查的效用进行了研究。在细胞学检查中,15例患者结果为“可疑”或“阳性”。组织学检查结果显示,6例为腺瘤样增生,3例为非典型增生,3例为子宫内膜癌。所有组织学检查结果阳性的患者在细胞学检查中均为“可疑”或“阳性”。无一例假阴性。在包括子宫内膜癌、非典型增生和腺瘤样增生等组织学阳性病变中均发现了“可疑”或“阳性”的子宫内膜细胞学表现。在比非典型增生更严重的疾病患者中观察到许多具有各种腺泡模式的细胞。随着病变进展,细胞核变大且形态不规则,不过核染色质的深染在腺瘤样增生患者中最为明显。腺瘤样增生细胞与非典型增生及子宫内膜癌细胞的核仁数量存在显著差异。此外,非典型增生与子宫内膜癌的核仁大小及不规则程度也存在明显差异。子宫内膜癌患者经常观察到白细胞吞噬现象。因此,人们认为子宫内膜细胞学不仅在筛查子宫内膜癌及相关疾病方面有用,而且在一定程度上对这些病变的诊断也有帮助。