Predicting the effect of irradiation on cervical cancer by colposcopy

Serial changes in cervical cancer lesions treated with irradiation were examined by colposcopy and biopsy specimens in 30 patients. Cervical lesions were classified by three morphological characteristics of tumor surface. In 11 patients (Group A), papillary and exophytic lesions became whitish with the addition of acetic acid before and during irradiation, showing marked destruction and shrinkage of cancer tissues. In 13 patients (Group B), endophytic lesions did not have many atypical vessels. In addition to whitish cervical lesions similar to those in Group A, atypical vessels became narrow and cancer tissues disappeared later than those in Group A. In the remaining 6 patients (Group C), endophytic lesions were characterized by atypical vessels, including dilatated and ruptured vessels. Neither whitish lesion change nor tumor surface before and during irradiation was observed, suggesting unfavorable effects of irradiation. The effect of irradiation based on the method of Ohboshi and Shimosato, cell density, tumor area, and DNA patterns were worse in Group C than Groups A and B. These results indicated that morphological growth of tumor, whitish change of lesions with acetic acid, and the quantity of atypical vessels, which are obtained by using colposcopy, would become indicators for evaluating the early effect of irradiation. (N.K.)