Dysplasia, Carcinoma In Situ and Micro-Invasive Carcinoma of the Cervix Uteri

Abstract

The provocative title and the impressive list of contributors make this a very interesting work to review. Basic concepts, diagnosis, and treatment are discussed by histologists, pathologists, and gynecologists. Fluhmann, von Haam, and Old define the terms—reserve cell hyperplasia, squamous metaplasia, and epidermization—and discuss their clinical implications. Differences of opinion are inevitable. Reagan discusses a series of 120 women who were observed for periods up to nine years with cellular evidence of dysplasia but without biopsy; in 60% of the cases the cellular abnormalities disappeared. Koss, however, states that the border-line lesions (dysplasia) were only steps in carcinogenesis and should not be considered separately. Meigs describes "micro-invasive carcinoma"—both its histological pattern and its treatment. Interestingly, he concludes with the thought that the term should be discarded, stating that in most cases the lesion seemed to be either carcinoma in situ or definite invasive carcinoma. The clinical approach to diagnosis is