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  • Title: [The extent of the atypical squamous epithelium of the cervix uteri (author's transl)].
    Author: Holzer E, Picked H.
    Journal: Arch Geschwulstforsch; 1975; 45(1):79-91. PubMed ID: 1156120.
    Abstract:
    210 cone biopsies were examined. In 27 cases a dysplasia of low degree and in 30 cases a dysplasia of higher degree was found to be the maximal epithelial lesion; a carcinoma in situ was found in 87 cases and an early stromal invasion in 66 cases. The examinations were performed in sagittal sections of the central areas of cone specimens. In each section the lengths of all atypical epithelial extensions were measured. In cases with different atypical epithelial in the same section, e.g. different dysplasias or carcinomata in situ, the extent of the atypical epithelium was defined as the total sum of all respective epithelial lengths. Moreove,the sum of these lengths is considered as a parameter of the surface area of an atypial field and is expressed as a percentage of the total epithelial cone surface. It was observed that in any given lesion, the higher the maximal epithelial atypia, the more frequent the coincidence of different types of atypia. The coincidence was most frequent in early stromal invasion. These results are in conflict with the present theory that carcinoma in situ orginates from dysplasia: under that assumption the dysplasias would have to become less frequent with the occurence of a carcinoma in situ. The average surface area of an atypical epithelium is greatest in cases of early stromal invasion; it is significantly greater in cases of carcinomata in situ than in dysplasias. The extent of the atypical epithelial fields can be attributed to two factors: On the one hand, the coincidence of different types of atypical epithelium is directly proportional of the degree at atypia; on the other hand, areas of carcinomata in situ were in themselves more extensive than areas of dysplasias. Expansion variations were also shown in different types of dysplasias. However, no differences in expansion could be observed in carcinomata in situ with and without stromal invasion. In early stromal invasion the significant increase in surface-area was almost exclusively due to the coincidence of carcinomata in situ with dysplasias. It is evident that a positive correlation exists between the tendency toward invasive growth and the extent of the atypical epithelium. Finally, the degree of the epithelial atypia appears to be a function of the extent of the atypical epithelium on the surface of the cervix.
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