The transition from preinvasive to invasive disease is a crucial juncture in the development of cervical cancer. The clinical experience that microinvasive lesions carry a better prognosis justifies a separate diagnostic category.
Besides clinical ad diagnostic problems, the microinvasive cervical cancer presents morphological peculiarities.
To investigate the clinical and pathological aspects of microinvasive cervical carcinoma, a retrospective study was made on 40 cases, histologically reconfirmed surgical specimens, which had been treated during the period from March, 1980 to
March,
1992
at Department of Obstetrics and Gynecology, Pusan Paik Hospital, Inje University.
@ES The results obtained were as follows;
@EN 1. Mean age of 40 patients was 44.6 year old., all were multipatous. Nineteen cases belonged to I a and 21 cases to I a2.
2. Main presenting symptoms were leukorrhea and/or genital bleeding and the majority of patients showed cervical erosion on gross finding.
3. The corresponding rate of Pap. smear to histologic diagnosis was approximately 67.5%. However, corresponding rate within one histologic grade was about 85%.
4. According to the colposcopic examination, less than half of the examined cases revealed suspected abnormal findings suggesting invasive lesion.
5. As to the reports of punch biopsy, 64.8% of cases showed microinvasive and/or invasive lesion. With additional diagnostic conization of cervix, the preoperative diagnosis were correct in 82.5%.
6. Histopathological reevaluation of specimens revealed positive correlation between depth of stromal invasion and width of lesion, confluent growth pattern, number of invasive foci, and invasion of capillary―like space, respectively.
7. One case, belonged to I a2 and treated by simple total abdominal hysterectomy, showed recurrence.
In conclusion, preoperative correct diagnosis of microinvasive cervical cancer was not easy. Based upon meticulous analysis of Pap. smear, colposcopy and biopsy findings, more liberal use of diagnostic conization should be done for correct
diagnosis.
Infering from the recurrence case, it seemed to be desirable that, in addition of invasion, other factors such as capillary―like space invasion, number of invasive foci, width of lesion confluent pattern should be considered on decision of
surgical
treatment.
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