Ishii Y, Fujii M
Division for Medical Examination, Tokyo Kenbikyo-in Foundation, Japan.
Acta Cytol. 1997 Jul-Aug;41(4):1095-102. doi: 10.1159/000332794.
To establish qualitative criteria for diagnosing complex hyperplasia, complex atypical hyperplasia and well-differentiated adenocarcinoma in endometrial cytology.
The frequency of appearance of papillary and arborescent cell clusters and the morphology of type A stromal bundles in arborescent cell clusters were examined in 59 samples of complex hyperplasia, 23 of complex atypical hyperplasia, 77 of well-differentiated adenocarcinoma and 40 of normal endometrium.
Papillary cell clusters were observed in all samples of hyperplasia and adenocarcinoma. The rate of observation of arborescent cell clusters increased proportionately to the progress from complex hyperplasia to complex atypical hyperplasia to well-differentiated adenocarcinoma. No arborescent cell clusters were found in normal endometrium. Primary branching and the number of layers of type A stromal bundles also increased with the progress toward complex hyperplasia and well-differentiated adenocarcinoma. Secondary and further branching was observed in large numbers in cases of adenocarcinoma.
For detection of complex hyperplasia or lesions beyond it in endometrial cytology, it is important to observe the presence of papillary clusters. For differentiation of the various lesions, it is important to observe the presence of arborescent clusters as well as type A stromata inside the clusters.
建立子宫内膜细胞学中复杂性增生、复杂性非典型增生及高分化腺癌的诊断定性标准。
在59例复杂性增生、23例复杂性非典型增生、77例高分化腺癌及40例正常子宫内膜样本中，检查乳头状及树枝状细胞团的出现频率以及树枝状细胞团中A型间质束的形态。
在所有增生及腺癌样本中均观察到乳头状细胞团。树枝状细胞团的观察率随着从复杂性增生到复杂性非典型增生再到高分化腺癌的进展而按比例增加。在正常子宫内膜中未发现树枝状细胞团。随着向复杂性增生和高分化腺癌进展，A型间质束的一级分支及层数也增加。在腺癌病例中大量观察到二级及更高级别的分支。
对于子宫内膜细胞学中复杂性增生或其以上病变的检测，观察乳头状细胞团的存在很重要。对于区分各种病变，观察树枝状细胞团以及细胞团内A型间质的存在很重要。
