Kawaoka K
Nihon Sanka Fujinka Gakkai Zasshi. 1980 Jul;32(7):823-32.
The present study was aimed to evaluate the correlation of histologic findings with colposcopic findings of "punctation" and "atypical vessels". The stereoscopic angioarchitectures of "punctation" and "atypical vessels" were observed clearly by scanning electron microscope, utilizing cast formation technique of blood vessels on hysterectomy specimens. Scanning electron microscopy revealed following characteristic findings. 1) The angioarchitecture of "punctation" is composed of three strata. (a) subepithelial capillary network, (b) capillaries rise into the stromal papillae from subepithelial capillary network. (c) stromal vessels ending in subepithelial capillary network. 2) Stratum (b) is observed as "punctation" on colposcopy. 3) Stratum (b) alterate morphologically as follows; hairpin-like capillaries correspond to "punctation" in inflammation, gathered & twisted hairpin-like capillaries in dysplasia, asparagus-like vessels in C.I.S., cauliflower-like vessels in early invasive cancer, respectively. 4) The mesh of stratum (a) become denser as the lesions advance, and in early invasive cancer, the destruction of stratum (a) begin to appear. 5) The branchings of stratum (c) increase as the lesions advance. 6) Chaotic angioarchitecture is observed in invasive cancer, with complete destruction of stratum (a). 7) The morphologic alteration of stratum (b) is the most remarkable in three strata. Colposcopically, these alterations of angioarchitecture are observed as follows; in "punctation", "red spot" become larger and irregularity increase both in size, shape and arrangement, as the lesions advance, in "atypical vessels", "vascular pattern" increase irregularity both in shape, caliber, continuation and arrangement. As a result, by analysing these scanning electron microscopic pictures and comparing them with their colpophotographs and histologic findings, it can be emphasized that, it might be possible to make histologic diagnosis merely by colposcopy.
本研究旨在评估组织学检查结果与阴道镜检查中“点状”和“非典型血管”表现之间的相关性。利用子宫切除标本上的血管铸型技术，通过扫描电子显微镜清晰观察了“点状”和“非典型血管”的立体血管结构。扫描电子显微镜显示出以下特征性表现。1）“点状”的血管结构由三层组成。（a）上皮下毛细血管网；（b）从上皮下毛细血管网延伸至间质乳头的毛细血管；（c）终止于上皮下毛细血管网的间质血管。2）在阴道镜检查中，（b）层表现为“点状”。3）（b）层形态变化如下：炎症时发夹样毛细血管对应“点状”，发育异常时发夹样毛细血管聚集扭曲，原位癌时呈芦笋样血管，早期浸润癌时呈菜花状血管。4）随着病变进展，（a）层的网孔变得更密集，在早期浸润癌中，（a）层开始出现破坏。5）随着病变进展，（c）层的分支增加。6）浸润癌中观察到血管结构紊乱，（a）层完全破坏。7）（b）层的形态改变在三层中最为显著。在阴道镜下，这些血管结构的改变表现如下：在“点状”中，随着病变进展，“红斑”变大，大小、形状和排列的不规则性增加；在“非典型血管”中，“血管形态”在形状、管径、连续性和排列方面的不规则性增加。结果，通过分析这些扫描电子显微镜图像并将其与阴道镜照片和组织学检查结果进行比较，可以强调，仅通过阴道镜检查可能做出组织学诊断。
