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Cytogenetische Untersuchungen an Praecancerosen und Carcinomen der Cervix uteri

III. Literaturübersicht. Diskussion der bisher mitgeteilten Befunde

Cytogenetic studies of preinvasive lesions and invasive carcinomas of the cervix uteri

III. Survey and interpretation of the results reported in the literature

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Summary

Cytogenetic studies were performed of 54 preinvasive carcinomas and invasive squamous cervix carcinomas altogether. The chromosome number could be determined in 9 dysplasias, 25 carcinomas in situ, 4 carcinomas in situ with microinvasion and 16 invasive squamous carcinomas (at least clinical stage I b). It was shown that carcinomas in situ, carcinomas in situ with microinvasion and invasive squamous carcinomas could not be differentiated from each other in principle as groups with regard to numerical chromosome deviations. The only remarkable finding was that cells in the peritriploid region occur more frequently in invasive carcinomas. The dysplasia group showed in general less numerical chromosome deviations than the other three groups. Chromosome gains seldom occured in this group, chromosome losses appeared to be more frequent, whereas chromosome gains predominate in carcinomas in situ, carcinomas in situ with microinvasion and invasive squamous carcinomas.

An analysis of karyotypes was possible in 17 preinvasive lesions (3 dysplasias, 14 carcinomas in situ) and 15 invasive lesions (3 carcinomas in situ with microinvasion, 12 invasive squamous carcinomas — at least clinical stage I b). Deviations of the chromosome distribution in their groups were generally found. Chromosome gains could he chiefly demonstrated in the C group and chromosome losses in the B, D and G chromosome groups. Structural abnormalities – particularly proved by the appearance of marker chromosomes — were frequent. The deviations were more frequent and more distinct in invasive squamous carcinomas than in preinvasive lesions. The question of whether the dysplasia subgroup would be different in further studies of karyotypes with more cases and could be differentiated like the numerical deviations cannot yet be answered. Because of the small numbers, only preinvasive and invasive deviations could be comparatively studied as groups.

Results reported in the literature and the recent genetic concepts of cervical carcinogenesis are discussed.

Zusammenfassung

Es wurden cytogenetische Untersuchungen an insgesamt 54 Krebsvorstadien und Carcinomen der Cervix uteri durchgeführt. Die Bestimmung der Chromosomenzahlen war bei 9 Dysplasien, 25 Carcinomata in situ, 4 Mikrocarcinomen und 16 Plattenepithelcarcinomen (mindestens Stadium I b) möglich. Dabei ergab sich, daß sich die Carcinomata in situ, die Mikrocarcinome und die Plattenepithelcarcinome als Gruppen aufgrund numerischer Chromosomenanomalien nicht prinzipiell voneinander unterscheiden lassen. Auffällig ist lediglich ein etwas häufigeres Vorkommen von Zellen im peritriploiden Bereich bei invasiven Carcinomen. Die Gruppe der Dysplasien zeigt generell geringere numerische Chromosomenanomalien als die drei anderen Gruppen; Chromosomengewinne sind in dieser Gruppe selten, Chromosomenverluste scheinen häufiger vorzukommen, während bei den Carcinomata in situ, den Mikrocarcinomen und Carcinomen der Cervix uteri Chromosomengewinne überwiegen.

Eine Analyse der Karyotypen war in 17 Krebsvorstadien (3 Dysplasien, 14 Carcinomata in situ) und 15 invasiven Carcinomen (3 Mikrocarcinome, 12 Carcinome — mindestens Stadium I b) möglich. Dabei fanden sich ganz allgemein Störungen in der Verteilung der Chromosomen auf ihre Gruppen: In der C-Gruppe ließen sich überwiegend Chromosomeingewinne, in den Gruppen der B-, D- und G-Chromosomen überwiegend Verluste nachweisen. Strukturelle Anomalien — besonders dokumentiert durch das Auftreten von Markerchromosomen — sind häufig. Die Abweichungen von der Norm sind bei den invasiven Carcinomen häufiger und ausgeprägter als bei den Praecancerosen. Ob sich die Untergruppe der Dysplasien aufgrund von Analysen der Karyotypen bei größeren Fallzahlen anders verhält und abgrenzen läßt, wie dies bei den numerischen Anomalien möglich erscheint, muß vorerst offen bleiben. Wegen der kleinen Zahlen konnten als Gruppen nur praeinvasive und invasive Epithelveränderungen der Cervix uteri miteinander verglichen werden.

Die bisher in der Literatur mitgeteilten Befunde und die heutigen Vorstellungen über die Carcinogenese an der Cervix uteri aus cytogenetischer Sicht werden diskutiert.

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  1. Geburtshilflich-gynäkologische Abteilung des Stadtkrankenhauses Rüsselsheim, Rüsselsheim

    F. Dehnhard, H. Breinl, J. Schüssler & V. Wehler

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  1. F. Dehnhard
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Herrn Prof. Dr. K. Knörr zum 60. Geburtstag gewidmet.

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Dehnhard, F., Breinl, H., Schüssler, J. et al. Cytogenetische Untersuchungen an Praecancerosen und Carcinomen der Cervix uteri. Arch. Gynak. 220, 161–177 (1975). https://doi.org/10.1007/BF00667119

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