title: Progression of 189 women diagnosed with uterine cervical dysplasia based on abnormal results in mass screening.
abstract: During the five-year period from January 1997 to December 2001, cytological abnormalities in the uterine cervix were confirmed in 189 women (class IIIa: 172, class IIIb: 9, class IV: 7, and class V: 1) who underwent cytology screening of the uterine cervix at the Tokai University Health Evaluation and Promotion Center. Biopsy samples from the uterine cervix showed that the 172 women categorized into class IIIa based on cytology included 28 with no atypical lesions, 53 with mild dysplasia, 24 with moderate dysplasia, 3 with severe dysplasia; and the 9 women in class IIIb included 2 with mild dysplasia, 5 with moderate dysplasia, 1 with carcinoma in situ, and 1 with invasive carcinoma. The conformity rates between the cytology data and the biopsy samples were 71.3% and 11.1% in class IIIa and class IIIb, respectively. A three-year followup survey of the class IIIa and class IIIb subjects confirmed progression (PRO) in 8 (4.7%), continuous (CON) symptoms in 48 (27.9%), and regression (REG) in 116 (67.4%) in class IIIa, and PRO, CON and REG in 3 (33.3%), 4 (44.4%), and 2 (22.2%), respectively, in class IIIb; the percentage of subjects in the CON+REG group was significantly higher than in the PRO group (p = 0.0052). Twelve subjects underwent resection because uterine carcinoma was suspected in the punch biopsy; these subjects have remained under observation and have now made a complete recovery. Our results suggest that patients with uterine abnormal cells should undergo regular cytology and colposcopy for detection of high-risk patients and to allow treatment at an early stage.
authors.affiliation: Department of Obstetrics and Gynecology, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa 259-1143, Japan. mura-to@is.icc.u-tokai.ac.jp
authors.forename: Toshinari
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yoshitake
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Iida
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamashita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirasawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Masaru
authors.initials: M
authors.lastname: Murakami
authors.forename: Naruaki
authors.initials: N
authors.lastname: Matsui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kajiwara
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuda
authors.forename: R Yoshiyuki
authors.initials: RY
authors.lastname: Osamura
authors.forename: Mikio
authors.initials: M
authors.lastname: Mikami
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003127:Colposcopy; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008403:Mass Screening; D008875:Middle Aged; D012720:Severity of Illness Index; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D014626:Vaginal Smears; D055815:Young Adult