The Definition and Diagnosis of Malign Lesions of the Cervix Uteri

Abstract

Givan et al. (1966, 1969) have divided epithelial abnormalities of the cervix into bland and malign lesions. Bland lesions include squamous hyperplasia, reserve cell proliferation and squamous metaplasia. The malign lesions include dysplasia, carcinoma in situ and microcarcinoma but not frankly invasive carcinoma which is truly malignant. It is this malign group which will be defined and discussed in this chapter. In order that the natural history and malignant potential of these conditions may be assessed objectively, it is necessary to define them in clear morphological terms without prejudice to their possible biological significance. The attempt to identify morphological entities and relate them to their biological potential is not simply an academic exercise. Failure to recognize potentially malignant epithelium may lead to women with early carcinoma of the cervix slipping through the therapeutic net at a curable stage of the disease; whereas too ready diagnosis of carcinoma in situ may cause women in the child-bearing period to lose their uteri unnecessarily. Moreover, precise diagnostic concepts are a necessary preliminary for the comparison of studies by various authors.