Fowler W C, Schmidt G, Edelman D A, Kaufman D G, Fenoglio C M
Obstet Gynecol. 1981 Dec;58(6):720-4.
The increased occurrence of cervical intraepithelial neoplasia (CIN) in women with in utero exposure to diethylstilbestrol (DES) is described. Among 335 self-referred women exposed to DES, 14.9% (50) had a least 1 cytologic smear interpreted as CIN, and 16.2% (54) had at least 1 biopsy interpreted as CIN. Excluding those with grade 1 CIN, 8.7% (29) had at least grade 2 CIN on biopsy and 4.2% (14) had biopsies interpreted as grade 3 CIN. No invasive lesions were detected. Because the problem of differentiating true intraepithelial neoplasia from morphologically indistinguishable but benign lesions in DES-exposed women remains unresolved, the authors believe a conservative approach to treatment is still indicated. This study supports the recommendation that DES-exposed women merit continued thorough gynecologic evaluation, including regular cytologic evaluation and colposcopy, with biopsies as indicated.
本文描述了子宫内暴露于己烯雌酚（DES）的女性中宫颈上皮内瘤变（CIN）发生率增加的情况。在335名自述暴露于DES的女性中，14.9%（50名）至少有1次细胞学涂片被解读为CIN，16.2%（54名）至少有1次活检被解读为CIN。排除1级CIN患者后，8.7%（29名）活检显示至少为2级CIN，4.2%（14名）活检被解读为3级CIN。未检测到浸润性病变。由于在DES暴露女性中，将真正的上皮内瘤变与形态上难以区分但为良性的病变进行鉴别这一问题仍未解决，作者认为仍需采取保守的治疗方法。本研究支持以下建议：暴露于DES的女性应持续接受全面的妇科评估，包括定期细胞学评估和阴道镜检查，并根据需要进行活检。
