Abstract
The cellular, histological and clinical features of 72 cases of microinvasive carcinoma of the cervix were studied. The diagnosis of microinvasive carcinoma was made by application of the criteria of the Japanese Cervical Cancer Committee to classify cervical section of conized cervices; microinvasive carcinoma was defined as squamous cell carcinoma with histologically confirmed stromal invasion to a depth of 3 millimeters or less measured from the basement membrane of the overlying surface layer. Patients with vessel permeation or confluent invasion were excluded.
The accuracy of cytology with spatula was 72.2% in microinvasive cancer.
The cytologic findings of mitroinvasive cancer showed appearance of intermediated and surperficial type malignant cells aside from deep layer type malignant cells. A few bizarre cells and picnotic nuelei were more eminent in microinvasive carcinoma than CIS. Many of the atypical cells appeared in aggregates and large cancer cell-clusters were evident in 70% of the samples. The cellular debri was seen in 36% of the cases. These findings were helpful as an indicator of microinvasive carcinoma.
Modalities of treatment used for microinvasive carcinoma of the cervix were extended radical hysterectomy in 52 cases, sub-extended hysterectomy in 4 cases, and simple hysterectomy in 16 cases. Lymph node metastasis was not found in any of these patients and the 5-year-survival rate was 100%. Simple hysterectomy seemed justified for the patients without vessel permeation or confluent invasion at the conized cervices.
However, hysterectomy dose not mean the end of follow-up since there appears to be a significant risk of recurrences or new foci of disease in the vaginal vault after hysterectomy.
