Hughes R G, Colquhoun M, Alloub M, Chetty U, Smart G E
Lothian Area Colposcopy Clinic, Elsie Inglis Maternity Hospital, Spring Gardens, Edinburgh, UK.
Br J Cancer. 1993 May;67(5):1082-5. doi: 10.1038/bjc.1993.198.
Twenty-six patients with treated breast cancer who had been randomised previously to receive combination chemotherapy including alkylating agents (n = 14) or to undergo oophorectomy (n = 12) following surgery underwent cytological and colposcopic screening of the uterine cervix. Colposcopically directed cervical punch biopsies were taken from all patients in whom a colposcopic abnormality was detected. Breast cancer patients were compared with 79 controls with normal cervical cytology and no known breast malignancy. Colposcopically directed punch biopsies were taken from the cervical transformation zone of all controls. Significantly more breast cancer patients who had received chemotherapy (43%) than controls (10%) had CIN (P < 0.01) and significantly more patients who had received chemotherapy (14%) than controls (3%) had CIN 2 or 3 (P < 0.05). The proportion of breast cancer patients in the oophorectomy group with CIN (17%) did not differ significantly from the control group. No case of CIN was detected by cervical cytology. This study suggests that breast cancer patients receiving combination chemotherapy including alkylating agents are at increased risk of CIN, and that cervical cytology alone may be an inadequate form of screening for these patients.
26例曾接受过治疗的乳腺癌患者，此前被随机分为两组，一组接受包括烷化剂在内的联合化疗（n = 14），另一组在手术后接受卵巢切除术（n = 12），这些患者均接受了子宫颈细胞学和阴道镜检查。对所有检测到阴道镜异常的患者进行了阴道镜引导下的宫颈活检。将乳腺癌患者与79名宫颈细胞学正常且无已知乳腺恶性肿瘤的对照者进行比较。对所有对照者的宫颈转化区进行了阴道镜引导下的活检。接受化疗的乳腺癌患者中CIN的发生率（43%）显著高于对照组（10%）（P < 0.01），接受化疗的患者中CIN 2或3的发生率（14%）显著高于对照组（3%）（P < 0.05）。卵巢切除组乳腺癌患者中CIN的比例（17%）与对照组无显著差异。宫颈细胞学检查未发现CIN病例。这项研究表明，接受包括烷化剂在内的联合化疗的乳腺癌患者发生CIN的风险增加，仅宫颈细胞学检查可能不足以对这些患者进行筛查。
