The significance of tissue cell changes preceding uterine cervix carcinoma

UTERINE CERVIX CARCI-T noma develops through stages of atypical hyperplasia and noninvasive carcinoma arose from the observations that invasive carcinoma was frequently associated with adjacent areas of atypical hyperplasia and carcinoma without stromal infiltration253 30-32 and that invasive carcinoma occurred in patients with previously noninvasive epithelial lesions.3,6,8~l 3 9 .~~8 * 3% 33In the series of cases citcd in the literature, however, not all of the patients who had epithelial dysplasia developed invasive carcinoma during periods of from 9 to 12 years.11, 1 5 9 32, 33 While an average duration of 10 years was suggested earlier for the transformation of noninvasive to invasive carcinoma,24~ 25 it seems that this transition occurs more rapidly.5~18 The absence of tumor progression in some patients does not necessarily invalidate the concept of noninvasivc carcinoma transformation but may require further elucidation to ascertain which of the epithelial lesions are potentially malignant.Previous analysis of data €rom this survey18 revealed that 9 cases of "carcinoma in situ" and 2 cases of invasivc carcinoma had developed among 23 patients with an initial diagnosis of dysplasia.Of 20 cases of "carcinoma in situ," invasivc carcinoma occurred in 5 women.Thus, lcsions with an identical initial diagnosis had undcrgone different courses of development.The histological re-evaluation of the first biopsied sections failed to reveal a correlation with the subsequent bchavior of the lesions.However, retrospective examination of previously biopsied specimens from patients with invasive carcinoma may not always reveal the true state of the initial lesion2*~ 29 since stromal From the Department of Pathology, The Mount Sinai Hospital, 100th St. and Fifth Ave., New York 29, N.Y.