Poskanzer D C, Herbst A L
Cancer. 1977 Apr;39(4 Suppl):1892-5. doi: 10.1002/1097-0142(197704)39:4+<1892::aid-cncr2820390823>3.0.co;2-t.
Following the observation that maternal ingestion of diethylstilbestrol was associated with the development of adenocarcinoma of the vagina in young women, analysis of 170 cases of the disease, collected over a two-year period, was undertaken. Details of history of non-steroidal estrogenic intake during pregnancy, its dosage and duration of intake and prevalence of concomitant abnormalities of the vagina and cervix were recorded. This analysis disclosed that dosage and duration of intake do not appear to be vital factors in contributing to the development of carcinoma. A controlled, prospective investigation of prenatal exposure to stilbestrol was also carried out. Vaginal and cervical abnormalities were common among 110 young women exposed to stilbestrol in utero. Biopsy-proved vaginal adenosis was present in 35% of the exposed population as compared with only 1% of the control subjects. Fibrous ridges of the vagina and cervix and failure of the vaginal mucosa and portions of the cervix to stain with iodine were also more frequently observed in the exposed population. While the risk of developing adenocarcinoma appears to be very low, a majority of exposed females do have other abnormalities of the lower genital tract. While some investigators believe that adenosis is a premalignant lesion, at present there is no clear-cut evidence of transition from adenosis to adenocarcinoma.
在观察到母亲摄入己烯雌酚与年轻女性阴道腺癌的发生有关之后，对两年内收集的170例该疾病病例进行了分析。记录了孕期非甾体雌激素摄入史的详细情况、其剂量和摄入持续时间以及阴道和宫颈伴随异常的患病率。该分析表明，摄入剂量和持续时间似乎并非导致癌症发生的关键因素。还对产前接触己烯雌酚进行了一项对照前瞻性研究。在110名子宫内接触己烯雌酚的年轻女性中，阴道和宫颈异常很常见。经活检证实，暴露人群中有35%存在阴道腺病，而对照人群中仅为1%。在暴露人群中，还更频繁地观察到阴道和宫颈的纤维嵴以及阴道黏膜和部分宫颈对碘染色失败的情况。虽然发生腺癌的风险似乎非常低，但大多数暴露女性确实存在下生殖道的其他异常。虽然一些研究人员认为腺病是一种癌前病变，但目前尚无明确证据表明腺病会转变为腺癌。
