Zaino R J, Husseinzadeh N, Nahhas W, Mortel R
Int J Gynecol Pathol. 1982;1(2):173-84. doi: 10.1097/00004347-198202000-00005.
The histologic changes within epithelium adjacent to invasive carcinomas theoretically may include the specific lesions that precede the development of the invasive neoplasm, or may reflect the response of host epithelium to the carcinoma or to nonspecific inflammatory stimuli related to ulceration and tissue necrosis. We have studied the vulvar epithelium surrounding squamous carcinomas of 60 women undergoing vulvectomy to determine the frequency and type of potential precursor lesions and their relationship to various biologic parameters. Using modified criteria and nomenclature of the International Society for the Study of Vulvar Disease, we identified some degree of nuclear atypia (either atypical hyperplastic dystrophy or carcinoma in situ) in 72% of patients; in only 3% was there a direct transition from normal epithelium to invasive carcinoma. There was no apparent relationship between the presence of atypia and histologic grade, depth of invasion, size or stage of tumor, or frequency of nodal metastasis. Although direct evidence is lacking, these atypical lesions may serve to identify a population at increased risk for subsequent development of invasive carcinoma.
理论上，浸润性癌旁上皮内的组织学变化可能包括浸润性肿瘤发生之前的特定病变，或者可能反映宿主上皮对癌或与溃疡和组织坏死相关的非特异性炎症刺激的反应。我们研究了60例行外阴切除术的女性鳞状细胞癌周围的外阴上皮，以确定潜在前驱病变的频率和类型及其与各种生物学参数的关系。使用国际外阴疾病研究学会修改后的标准和命名法，我们在72%的患者中发现了一定程度的核异型性（非典型增生性营养不良或原位癌）；只有3%的患者是从正常上皮直接转变为浸润性癌。异型性的存在与组织学分级、浸润深度、肿瘤大小或分期或淋巴结转移频率之间没有明显关系。虽然缺乏直接证据，但这些非典型病变可能有助于识别随后发生浸润性癌风险增加的人群。
