子宮零期 頸部癌의 臨床 및 病里組織學的 考察

Abstract

[한글]

[영문]

The terms "Carcinoma in situ", "intraepithelial carcinoma", "non-in-vasive carcinoma", and "stage O cancer" have been used to denote the same pathological process in the epithelium of the cervix uteri.

Since 1910 when Rubin described his first two cases of "incipient carcinoma", this condition has been accepted by increasing numbers of clinicans and pathologists as the morphological sequence of events through which the squamous

epithelium of the cervix progress before it becomes invasive.

Because of this, and because of the increasing number of women who die of carcinoma of the cervix, the methods used for early deteotion, diagnosis, treatment, and follow-up of carcinoma in situ have been studied by many authors.

There are many reports and clinical reviews on carcinoma in situ of the cervix in other countires but none yet in Korea in spite of great interest in the subject. It is the purpose of this paper to study clinical pictures and pathological findings and compare them with those of other authors.

The author selected a total of 67 cases of carcinoma in situ of the cervix which were admitted to the Medical Center of Yonsei University over the last five and a half years, from Jan. 1, 1961 to June 30, 1966.

The results were obtained as follows:

1. Most of cases were detected by Pap. smear or punch biopsy at the first visit.

2. 87.2% of 47 cases showed suspicious and positive Pap. smear and the fales negative diagnosis was 12.8%.

3. The average age incidence was 45 years and was 3 years less than that of invasive cancere.

4. There was minimal to moderate erosion of the cervix in about 50% of cases and 11.9% were normal in gross appearance.

5. 38.8% of all cases had no specific gynecological complaints and in about 70% the chief symptom was abnormal vaginal bleeding.

6. The pathological findings of post-cone hysterectomy specimens showed no residual cancer in 61.8%, residual cancer in 32.7%, atypical hyperplasia in 3.6%, and microscopic invasion in 1.9% respectively.

7. The post-operative morbidity revealed no relationship with the time interval between conization and hysterectomy. There was no significant difference in morbidity compared with the control group. Also although no effect on morbidity was achieved from prophylactic antibiotics, it has been suggested that further study be made with more cases.

8. 36 patients among 60 cases which received adequate treatment were followed for 1.7 years on the average, and have lived without recurrence to the present, but further close observation will be needed.