The clinical evaluation of cytological diagnosis during pregnancy in the management of severe dysplasia, carcinoma in situ and invasive cancer complicating pregnancy.
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概要
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1) Cervical smears from 8012 cases during pregnancy from 1984 to 1992 were cytologically classified as follows; Class V 2 cases, IV 5 cases, III b 7 cases, III 13 cases and III a 22 cases. All 49 (0.61%) were requested to undergo directed biopsy under colposcopy, but only 35 (71.4%) received pathological diagnosis. The ultimate pathological diagnosis revealed 10 cervical cancers (2 invasive, 8 carcinoma in situ (CIS)) and 2 severe dysplasia (SD).<BR>2) The alteration of repetitive cytological and pathological diagnosis during pregnancy in 4 out of 9 patients who had terminated their pregnancy, demonstrated a less advanced cytological diagnosis as compared with pathology. This discrepancy might be due to cervical smear sampling errors. Since no progression after delivery was found in 7 patients with CIS or SD, conservative management is indicated for patients with CIS or less advanced lesions during pregnancy.<BR>3) There were 5 cases with SD or more advanced lesions whose cervical smears during pregnancy were negative. The reasons for their mistaken diagnoses were also considered to be sampling errors.<BR>In conclusion, adequate scraping of the cervix might be essential for making an accurate and useful cytological diagnosis during pregnancy, even if a little bleeding is bothersome for patients and their responsible doctors.
- 特定非営利活動法人 日本臨床細胞学会の論文
特定非営利活動法人 日本臨床細胞学会 | 論文
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