[High risk factors in the spread of cervix carcinoma]

The author studied clinicopathological parameters in patients with uterine cervical carcinoma in order to find the useful factors which would enable pretreatment estimation of the cancer spread. The following results were obtained. Histologically characteristic features of the primary lesions in the majority of the patients with Virchow's node metastases were lobular type according to the classification used in our department, L form in CPL classification, slight stromal reaction, large cancer nest, and loose connectivity between the cancer nest and stroma. In addition, they had a high incidence of clinical signs and data such as febrile condition, and increased ESR and CRP value. The percentage of comedo type gradually increased as the cancer spread (23.4%) in primary lesions, 40.5% in pelvic lymph nodes, 73.3% in Virchow's nodes). In the operated cases (stages Ib, IIa and IIb) with pelvic lymph node metastases, histological factors such as comedo type, L form, and loose connectivity, and at least one of the clinical characteristics were found more frequently than in cases without the metastases. In the irradiated cases (stages Ib, IIa and IIb) that died within 5 years, factors such as lobular type, loose connectivity and more than one clinical characteristics were seen more frequently than in cases that survived for more than 5 years. By giving appropriate points to items in the 3 most important histological factors (type, CPL classification and connectivity), grading of each group of cases was made; the high risk groups in both operated and irradiated cases scored significantly higher than the respective control groups. These suggests that some of the above parameters may be useful in evaluating the spread of carcinoma of the cervix.