Mattingly R F, Stafl A
Am J Obstet Gynecol. 1976 Nov 1;126(5):543-8. doi: 10.1016/0002-9378(76)90745-6.
The occurrence of columnar epithelium in the vagina (vaginal adenosis) in young women with intrauterine exposure to diethylstilbestrol (DES) during the first trimester of pregnancy was observed in 231 patients (82 per cent of 280 cases who underwent colposcopic study). Extension of columnar epithelium onto the portio of the cervix was present in the remaining 18 per cent of the cases. Abnormal colposcopic findings were present in the transformation zone in 96 per cent of the patients with vaginal adenosis. Directed biopsy revealed four cases of vaginal and/or cervical squamous carcinoma in situ (CIS), two cases of severe dysplasia, five cases of moderate, and 29 cases of mild dysplasia. The prevalence of CIS in DES-exposed girls (1.4 per cent) was nearly five times the prevalence rate of CIS in a control group of 5,808 DES-unexposed women (0.44 per cent). This finding correlates well with the hypothesis that the genesis of squamous intraepithelial neoplasia is specifically related to the extent and surface area of the vaginal transformation zone. An unusual case of invasive squamous carcinoma in a DES-exposed young girl is presented, which represents the initial observation of this association to date.
在231例患者中观察到，妊娠头三个月宫内接触己烯雌酚（DES）的年轻女性出现阴道柱状上皮（阴道腺病）（在接受阴道镜检查的280例病例中占82%）。其余18%的病例存在柱状上皮延伸至宫颈阴道部的情况。96%的阴道腺病患者在转化区有异常阴道镜表现。直接活检发现4例阴道和/或宫颈原位鳞状癌（CIS）、2例重度发育异常、5例中度发育异常和29例轻度发育异常。DES暴露女孩中CIS的患病率（1.4%）几乎是5808名未暴露于DES的女性对照组中CIS患病率（0.44%）的五倍。这一发现与鳞状上皮内瘤变的发生与阴道转化区的范围和表面积特别相关的假设高度相关。本文报告了1例DES暴露的年轻女孩发生浸润性鳞状癌的罕见病例，这是迄今为止对这种关联的首次观察。
