Histological Cell Type and DNA Value in the Prognosis of Squamous Cell Cancer of Uterine Cervix

Abstract

Based on the evaluation of 362 cases of squamous cell carcinoma of the uterine cervix, the distribution of the tumours in relation to their modified Broders' grade, histological cell type as proposed by Wentz and Reagan, and the clinical stage of disease was evaluated. The morphological characteristics of the 3 cell types—large cell non-keratinizing, keratinizing, and small cell cancers—were described. The 5 year survival in relation to Broders' grade, cell type, extent and DNA values of the malignant cells were evaluated and compared. Broders' grading system was not useful in predicting the biological behaviour of cervical squamous cancer. The histological cell type and extent of the tumour were important factors in prognosis. The 5 year survival for large cell cancer was 51·8%, keratinizing cancer 34·7% and small cell cancer 10·0%. The 5 year survival was 63·3% for stage I neoplasms, 52·9% for stage II neoplasms, 30·7% for stage III neoplasms and 15·0% for stage IV neoplasms. When the DNA values of neoplastic cells were considered in relation to cell type and extent of disease, the biological behaviour of cervical squamous cell cancers was determined more accurately. The 5 year survival of women with cervical cancer in which the DNA values of the neoplastic cells exceeded 155 was more favourable than those with DNA values of less than 155. This difference in 5 year survival was evident for comparable cell type and clinical stage of disease.