J. Jpn. Soc. Clin. Cytol. 2002; 41 (3): Key words: Interphase cytogenetics-cervical smears-diagnostic cytology
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1 J. Jpn. Soc. Clin. Cytol. 2002; 41 (3): Key words: Interphase cytogenetics-cervical smears-diagnostic cytology
2 Fig. 1 Population screening of cervical cancer (Japan Anti-Cancer Association) Fig. 2 Comparison with various classifications of precancerous and cancerous lesions of the cervix
3 Table 1 The 1988 Bethesda System for Reporting Cervical/Vaginal Cytological Diagnoses EPITHELIAL CELL ABNORMALITIES Squamous Cell Atypical squamous cells of undetermined significance (recommended follow-up and/or type of further investigation: specify) Squamous intraepithelial lesion (SIL) (comment on presence of cellular changes associated with HPV if applicable) Low-grade squamous intraepithelial Cellular changes associated with HPV lesion, encompassing: Mild (slight) dysplasia/cervical intraepithelial neoplasia grade 1 (CIN 1) High-grade squamous intraepithelial lesion, encompassing: Moderate dysplasia/cin 2 Severe dysplasia/cin 3 Carcinoma in situ/cin 3 Squamous cell carcinoma
4 第41巻 第3号,2002年 199 E Denature Anneal target DNA to chemically E modified (e. g. with biotin) probe Detect with fluorescent (e. g. FITC-avidin) DNA reagent against chemical modification Counter-stain E uorescent with reagent a second fl (e. g. PI) Fig. 4 Exaniple of micrescopic on papanico- laou staining versus FISH. Signals of chromosome 1/17 were visualized with FITC (red). (green)/rhodamin a Table 2 b Fig. 3 Cases with 1 copy/nucleus (%) *Mann -Whitney U test (stat view II) **Also significant to moderate dysplasia ( p<0.01) Chromosome staining using fluorescence in situ hybridization (personal communication to Z. Darzvnkiewicz) copy数5個 Table 3 Cases with more than 3 copies/nucleus (%) 以 上 の 細 胞 が 出 現 す る こ と で あ る.DNA ploidyと の 関 連 性 か ら み る と染 色 体 の 倍 加 の 理 論 と背 反 的 にmonosomyが 徐 々に 増加 す る理 由 は 明 らか で は な い. IV.コ ンセ ン サ ス シ ンポ ジ ウ ム の 結 論 子 宮 頸 部 前 癌 病 変 と して の 異 形 成 の 診 断 に 対 す る 細 胞 診 の 役 割 は 大 き い が,熟 練 者 の 主 観 に よ っ て,核 の 形 態 変 化 を 中 心 に 判 定 す る こ と は,良 性 悪 性 境 界 病 変 の 解 明 に は,限 *Mann -Whitney U test (stat view II) **Also significant to mod erate dysplasia (p<0.01) 界 が あ る.Papanicolaou標 れ ら の 細 胞 を 簡 易 化 し たFISH法 copy数 い,し 本上のこ に よっ て染 色体 の の 異 常 と して 客 観 的 に 判 定 で き る 価 値 は 大 き か も,routine workと して 通 常 の 検 査 室 で 行 う こ とが で き る 細 胞 癌 化 の 本 質 と もい え る 染 色 体 の 数 的 異 常 や 転 座 を分 裂 細 胞 の み な らず,問 期 核 で 常 に 確 認 で き る価 値
5 133. The 9.49 } 2.59/9.72 } 1.40 (%, No.1/No.17) cells showed an aneuploid pattern in CIN 1, 22.5 } 3.98/15.5 } 3.02 in CIN 11, /45.1 } 5.61 in severe dysplasia and } 6.32/48.9 } } 7.55 in Ca. in situ. The loss of chromosomes in CIN 111 and the gain of chromosomes in Ca. in situ cases should be noted (p<0.01). 1) Richart, R. M. A modified terminology for cervical intraepithelial neoplasia. Obstet. Gynecol 1990; 75: 131 2) Koss, L. G., Stewart, FW., et al. Some histological aspects of behavior of epidermoid carcinoma in situ and related lesions of the uterine cervix. Cancer 1963; 16: 1160 ` ) Fu, Y. S., Reagan, J., Richart, R. M. Precursors of cervical cancer. Cancer Surv. 1983; 2: 359 `382. Abstract Recent criticism of cervical diagnostic cytology has focused on ambiguous terminology and classification in cervical intraepithelial neoplasia (CIN). From the outset of Bethesda system development as a new classification, it has required reevaluation and revision. Neither be precisely described based on cellular morphology and clinical behavior, however. Fluorescence in situ hybrlidization (FISH) is a powerful tool for detecting chlomosomal abnormalities in interphase cells. FISH with chromosomal-specific repetitive DNA probes was applied to cervical smears of CIN 1, 11, and 111 to detect numerical aberrations of chromosomes 1 and 17. FISH was applied to the same specimens after Pap staining, and copies in marked atypical and abnormal cells were counted. 5) zur Hausen, H. Human papillomaviruses in the pathogenesis of anogenital cancer. Virology 1991; 184: ) National Cancer Institute Workshop: The 1988 Bethesda System for reporting cervical/varginal cytological diagnosis. JAMA 1989; 262: 931 `934. 7) The Bethesda System for Reporting Cervical/Varginal Cytologic Diagnosis: National Cancer Institute workshop, Acta cytol. 1993; 37: 115 `124. 9) Hariu, H., Matsuda, M. Cervical cytology by means of fluorescence in situ hybridization with a set of chromosome specific DNA probes. J. Obstet Gynecol Res. 1996; 22: 163 `170.
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九州大学学術情報リポジトリ Kyushu University Institutional Repository Diagnosis and management for cervical cancer 加耒, 恒壽九州大学医学部保健学科看護学専攻発達看護学 平田, 伸子九州大学医学部保健学科看護学専攻発達看護学 北原, 悦子九州大学医学部保健学科看護学専攻発達看護学 新小田, 春美九州大学医学部保健学科看護学専攻発達看護学
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