자궁경부 세포진에서 종양소인의 출현에 대한 분석

Abstract

Tumor diathesis is defmed as a host response to tissue destruction by infiltrative growth of cancer. It is observed in smears as eosinophilic or cyanophilic granular proteineous material, Cytoplasmic debris, hemosiderin, fibrin, nuclear fragments and cells with karyorrhexis. The purpose of this study was to determine the prevalence and cytologic features of tumor diathesis in cervicovaginal smears from patients with invasive squamous cell carcinoma. Cervicovaginal smears of 63 patients with squamous cell carcinoma histologically confmnedwere reviewed to evaluate the presence of macro/micro tumor diathesis(MaTD/MiTD). Original cytologic diagnoses were HSIL with carcinoma in situ in 21 cases(33.3%), microinvasive carcinoma in 13 cases(20.6%) and invasive carcinoma in 29 cases(46%). Tumor diathesis was posÍtive in 49 cases(77.8%), lltεgative in 10 cases(15.9%) of smears with invasive squamous cell carcinoma and 4 cases(6.3%) were undetermined. Both MaTD and MiTD were seen in 36 cases(73.5%), only MaTD was 9 cases(18.4%) and MiTD was 4 cases(8.2%). As increasing the invasion depth, prevalence of tumor diathesis was increased, but it was not statistically significant(p>0.005). Twelves of control group were diagnosed asinvasive squamous cell carcinoma cytologically, but they were histologically confmned as carcinoma in situ. Tumor diathesis was positive in 9 cases(75%) of the 12 smears, it was supposed of intraglandular karyorrhetic necrotic material in the glandular involvement with carcinoma in situ. Although tumor diathesis is an important criterion of invasive carcinoma, the smear should be very carefully searched the presence of invasive carcinoma cells.