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Atypical epithelial changes in the uterine cervix
  1. James A. Kirkland2
  1. Department of Pathology, Queen's College (University of St. Andrews), Dundee


    Atypical epithelium, i.e., epithelium showing changes just insufficient to warrant a diagnosis of carcinoma in situ, was re-studied in surgical material from 66 patients. Most of these specimens had originally been reported as suspicious or potentially malignant. Of the 66 patients, 62 were alive and 46 of these were `untreated' having had no treatment to the cervix since the original operation.

    Thirty-seven of the 66 were examined personally, 28 of these being `untreated'; nineteen were found to have gynaecological abnormalities. Cytological examination was performed on 36, with only one suspicious smear; none of these patients was found to have invasive carcinoma or carcinoma in situ. Of the remaining 25 patients not seen personally, all were considered by their doctors to be free of any significant cervical lesion.

    The incidence of progression from atypical epithelium to carcinoma in situ is so different in the published reports that the definitions must surely be different. Sections from 15 cases of carcinoma in situ were therefore submitted to seven skilled pathologists, and as only 70 out of 105 diagnoses came into this category, the need for agreed definition is obvious.

    The present study shows a depressing persistence of the original or similar complaint. The follow-up (average 7·4 years) suggests that atypical epithelial change is unlikely to progress to carcinoma.

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    • 2 Present address: Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Woodville, South Australia.

    • 1 Part of an M.D. thesis submitted to the University of St. Andrews.