Herbst A L
Cancer. 1981 Jul 15;48(2 Suppl):484-8. doi: 10.1002/1097-0142(19810715)48:1+<484::aid-cncr2820481308>3.0.co;2-x.
Currently, over 400 cases of clear cell adenocarcinoma of the vagina and cervix occurring in females born after 1940 have been accessioned into the Registry for Research on Hormonal Transplacental Carcinogenesis. Cases have been identified throughout the United States as well as Australia, Canada, Mexico, and Europe. Intrauterine exposure to DES and similar nonsteroidal estrogens have been uncovered in about two-thirds of the cases with an available maternal history. A peak in the age incidence curve of the DES-related cases has been observed at about 19 years with the age range being 7-30 years. The five-year survival for 400 patients has been 80%. Numerous nonmalignant epithelial changes have been observed. It appears that there has not been an increase in the occurrence of premalignant or malignant squamous cell lesions among the DES exposed. Premature birth has been more common among DES-exposed women. For those in whom there is evidence of a midpregnancy loss or premature ripening of the cervix during pregnancy, a cerclage procedure has been effective in producing a desirable outcome.
目前，超过400例1940年后出生的女性发生的阴道和宫颈透明细胞腺癌已被纳入激素经胎盘致癌作用研究登记处。病例已在美国以及澳大利亚、加拿大、墨西哥和欧洲被确认。在约三分之二有可用母亲病史的病例中，发现了子宫内接触己烯雌酚和类似非甾体雌激素的情况。与己烯雌酚相关病例的年龄发病率曲线在约19岁时出现峰值，年龄范围为7至30岁。400名患者的五年生存率为80%。观察到许多非恶性上皮变化。似乎在接触己烯雌酚的人群中，癌前或恶性鳞状细胞病变的发生率没有增加。早产在接触己烯雌酚的女性中更为常见。对于那些在孕期有中期妊娠丢失或宫颈过早成熟证据的女性，宫颈环扎术已被证明能产生理想的结果。
