[Histopathological studies on cancer evolution of the cervix uteri (author's transl)]

With selected operation materials of 118 cases with cervical cancers (Stage I & II), histologic criteria for the growth pattern was newly established. The cancer lesions were histologically divided into 4 forms for the growth pattern: superficial, exophytic, endophytic and cleft type. To attain acceptable classification of the histologic growth pattern based on morphological characteristics, the application of the present criteria was made on 62 cases in which cancer entirely involved the cervical canal. The results indicated easy applicability resulting in the uniformity of the cases as so defined, without any uncorresponded cases. Thus, total 180 cases consisted of 2 cases of superficial growth type, 54 of exophytic, 96 of endophytic and 28 of cleft type. In 96 cases of the endophytic type, crater carcinoma due to ischemic necrosis of cancer nests was not observed, except for 28 cases in which spontaneous regression was resulted from excess parakeratosis of cancer cells. A possibility exists that noduloinfiltrative or flat infiltrative type in the usual gross classification included cancer originating from clefts of endocerical glands (cleft cancer-type). Regardless of the histologic growth patterns, the cancer evolution was constantly shown as "mole" mode with a fan fashion toward the endocervix, and then with arch curve along the margin of the myometrium, because of the natural barrier. Final conclusions drawn from the results were as follows: The primary cancer lesion was constituted by the fundamental proliferation of papillomatous cancer sheets, combined with growth patterns. A remarkable diversity between histologic features of Stage Ia and those of Stage II raised a new proposal regarding re-evaluation of staging.