われわれの子宮癌クリニックにおける子宮癌検診成績

特に細胞診成績を中心として

抄録

In our uterine cancer clinic in the section of gynecology, Kyoto 1st Red Cross Hospital, we have been making particular efforts to detect uterine cancer at the early stage, by means of a systematic examination including vaginal smear test, colposcopy, and punch biopsy. We statistically summarized the results of the examination of uterine cancer on the patients who visited our clinic during recent 2 years (1968, -1969). Particular attention was paid to the results by the cytological diagnosis. The conclusion are summarized as follows;
1) The subject examined in this study was mainly a woman who was not younger than 30 years old. Total number of the patients was 3268, whose 71% was occupied by the women aged from 30 years old to 49 years old.
2) Concerning the subjective symptom when the patient visited our clinic to receive cancer examination, abnormal genital bleeding was first ranked complain at the frequency of 28% of the total cases. While 19% of the patients received cancer examination without any particular subjective symptoms. It should be promoted in future that more frequent number of women willingly receive the cancer examination before complaining any subjective symptoms.
3) Cytological diagnosis were fiven to 3268 cases, whose 92.5% (3025 individuals) were negative in cyto-diagnosis, whils 3% (98 individuals) were suspected positive and another 4.5% (145 individuals) were positive in cyto-diagnosis.
4) Histological examination was also applied to 1130 patients had received cytological diagnosis. The results proved that a reliability of the cytological diagnosis with vaginal smear could be estimated at about 91% in accuracy. The accuracy of the cytodiagnosis in the patients who were diagnosed cancer after the systemic examination was estimated at 96.4%, while the one of patients who were free of cancer by the same examination was estimated at 98.3%.
5) Our cancer clinic found 166 cases of the uterine cancer (including 10 cases of dysplasia) during this period of examination. The items of an account were; carcinoma in situ-7 cases, Iastage-36 cases, Ib stage-31 cases, II stage-78 cases, III stage-11 cases and IV stage-2 cases.
6) The ratio of detection of uterine cancer summarized as 87.5% in carcinoma in situ, 94.4 % in Ia stage, 100% in Ib stage, 97.5% in II stage, 90.9% in III stage and 100% in IV stage, (dysplasia was detected by cytological diagnosis at the ratio of 80%).
7) For clinical diagnosis, the cervical-erosion, especially the one of relatively slight degree was proved in most of the cases of uterine cancer at early stage.
8) The colposcopy was applied to the patients (1249 women), who were suspected uterine cancer by the cytological diagnosis or were found cervical-erosion by the gynecological examination. The uterine cancer was detected by colposcopy at the level of 89% in accuracy, thus proving lower reliability as compared to the cyto-diagnosis.