Premium
A Clinicopathological Study of Postoperatively Upgraded Early Squamous‐Cell Carcinoma of the Uterine Cervix
Author(s) -
Yoshida Manabu,
Jimbo Haruko,
Shirai Takako,
Takahashi Michiko,
Shiromizu Kenji,
Kuwabara Yoshinori
Publication year - 2000
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2000.tb01319.x
Subject(s) - medicine , endocervix , stage (stratigraphy) , cervix , uterine cervix , cervical cancer , carcinoma , gynecology , basal cell , radiology , cancer , pathology , paleontology , biology
Objective: To investigate the clinicopathological backgrounds and diagnostic problems of postoperatively upgraded early squamous‐cell carcinomas of the uterine cervix Patients and Methods: A total of 23 patients with postoperatively upgraded early squamous‐cell carcinomas who were treated at the Saitama Cancer Center during the period of January 1, 1976, through December 31, 1991, were analyzed clinicopathologically. We reexamined the Pap smears (ectocervix, endocervix), colposcopic findings, punch biopsies, and histological findings of the operative specimens. All patients were divided into one of 3 groups based on each patient's main location of the carcinoma of the cervix: Type A: ectocervical type; Type B: endocervical type; or Type C: combined (ectocervical and endocervical) type. Clinical staging of the uterine cervical carcinomas was done in accordance with the 1994 FIGO rules. Results: The numbers of patients were: Type A, 2; Type B, 10; Type C, 11. Of the 23 patients, 21 (91.3%) had lesions in the endocervical portion at least. Fifteen patients (65.2%) complained of atypical vaginal bleeding. Colposcopic findings suggesting an invasive carcinoma appeared for only 6 patients (26.1%). A cytological reevaluation revealed that the endocervical findings were much stronger than the ectocervical ones in 10 (66.7%) of 15 patients whose smears of both sites could be rechecked. Conclusions: Even if the preoperative diagnosis was early cervical carcinoma, CIS or Stage Ia1, the signs of atypical vaginal bleeding suggested that the final clinical stage would be upgraded after an operation. Furthermore, when the endocervical cytological findings were much more exaggerated than the ectocervical ones, the possibility of deeply invaded endocervical lesions should be considered.