[Cytophotometric studies of epithelial dysplasia in the uterine cervix]

Proliferative activity in dysplasia, carcinoma in situ and microinvasive carcinoma of the uterine cervix

Proliferative activity of various human uterine cervical lesions obtained by conization was examined by measuring the proportion of mitotic cells including abnormal mitosis and the nuclear DNA content by a microspectrophotometer. Twelve ratios of mitotic cells calculated in the present study showed a step-wise increase from normal squamous cell epithelium through various grades of dysplasia to carcinoma in situ (CIS). The great difference between moderate and severe dysplasia was observed. All ratios in CIS with bulky outgrowth (CIS(b)) were the highest. The nuclear DNA content in various lesions also indicated the great difference between moderate and severe dysplasias in the DNA histograms. Severe dysplasia had a wider distributed DNA histogram without distinct modes similar to those in CIS and the non-invasive areas of the microinvasive carcinoma. These results may suggest that severe dysplasia but not slight or moderate dysplasia is a direct precursor lesion for uterine cervical epidermoid carcinoma.

Diagnosis and grading of malignancy in squamous epithelial lesions of the larynx with DNA cytophotometry

For diagnostic purposes 14 histologically benign, 15 dysplastic, and 16 malignant squamous epithelial lesions were subjected to DNA cytophotometry. Results were computed according to an algorithm for DNA diagnosis and grading of malignancy. In cases of unequivocally malignant or benign lesions all DNA diagnoses agreed with the histologic diagnoses. In one case the allegedly faulty DNA diagnosis of cancer was proven to be correct on clinical follow-up. Within the group of histologically mild to moderate dysplasias the algorithm identified four cases as malignant that were proved to be malignant either in the follow-up or at another site of the same lesion. With the aid of the DNA malignancy grade two groups of patients with squamous epithelial carcinomas of the larynx could be discerned with a highly significant difference according to their survival times.

Cytophotometric determinations of DNA, histone, arginine, lysine, and their concentrations in eu- and heterochromatin of the cell nucleus of dysplasias, carcinoma in situ, and carcinoma of the human cervix uteri

In the cell nuclei of dysplasias, carcinoma in situ, and carcinoma the amount of DNA, histone, arginine, lysine, and their condensed areas were determined by cytophotometry. Moreover their concentrations in the euchromatic and heterochromatic areas of the nuclei were measured. Statistical analysis showed that the quantitative relations between parameters did not change during carcinogenesis. The significantly increased amount of lysine underlines the role of the lysine-rich histones in producing denser coiling of the chromatin fibril in heterochromatin.

[Diagnosis of stromal hyperplasia of the endometrium (author's transl)]

In three cases of endometrial stromal hyperplasia, nuclear DNA-content was determined by Feulgen microspectrophotometry. In two cases DNA-content exhibited the diploid pattern. In the third case values ranged from diploid to tetraploid, also showing an additional peak for hypotetraploid values. The two cases with diploid DNA patterns are considered to have less malignant potential. This corresponds well to clinical follow-up examinations performed three and nine years later, where no progression to malignant growth was established. The pronounced proliferative tendency observed in the third case would make progression to malignancy appear highly probable.

[The problem of the ploidy reduction in carcinogenesis of the uterine cervix: numerical chromosome anomalies in carcinoma in situ (author's transl)]

The authors report on cytogenetic studies of the uterine cervix in 11 carcinoma in situ. In six cases with intact epithelium the cells were no longer normal and five cases showed beginning stroma invasion. The numerical chromosome anomalies observed indicate the presence of ploidy reduction. In accord with cytogenetic findings in precancerous conditions and in carcinoma of the uterine cervix published in the literature, the ploidy reduction may be regarded as a probable causal principle for malignancy at the uterine cervix.

The nuclear DNA content of lobular neoplasia of the mammary gland

Twelve cases of lobular neoplasia and three cases of invasive lobular carcinoma of the breast were examined by Feulgen microspectrophotometry. Two different ranges of nuclear DNA values were observed. Eight cases of lobular neoplasia fell within the diploid range and the four remaining cases within the diploid to tetraploid range, while the three cases of invasive lobular carcinoma showed a DNA distribution between the diploid and tetraploid range. Cytophotometrically, lobular neoplasia with diploid DNA values can be considered to represent a precancerous condition, whereas lobular neoplasia with diploid to tetraploid values are regarded as a more advanced stage of an non infiltrating carcinoma still confined to the performed spaces.

[Cytofotometrically Determined DNA-pattern of premalignant cases of dysplasia of the cervix uteri. Contribution to the problem of morphologic definition and clinical sigificance of these lesions (author's transl)]

24 cases of probably benign and precancerous epithelial lesions of the cervix uteri were analysed cytofotometrically. The specimens were stained after the method of Feulgen. Benign epithelial changes for instance metaplasia, regenerating epithelium, atrophic and parakeratotic epithelium, basal cell hyperplasia and cervix epithelium irritated by inflammation, had normal diploid DNA-pattern. On the contrary premalignant dysplasia of all stages show an aneuploid DNA-content in every case. The cases of dysplasia had no diploid mode, an atypical proliferation with polyploidisation of an atypical way, DNA-stemlines and a broad scattering of DNA-values. Carcinoma in situ had a similar DNA-content. These data confirm the hypothesis premalignant dyplasia is a reality between normal cervical epithelium and carcinoma in situ. For now only severe grades of dysplasia have been treated by operation (i. e. conisation, hystectomy) not the low grade cases of dysplasia. With regard to DNA-histograms of dysplasia of all grades this seems to be unjustified.