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SECTION Ⅰ CANCER OF THE ECTOCERVIX 3

1．DIAGNOSTIC METHODS 5

Introduction 5

Cytology 7

Karyology 11

Schiller Test 12

Colposcopy 12

Colpomicroscopy 13

2．THE NORMAL AND PATHOLOGICAL APPEARANCES OF THE ECTOCERVIX GIVEN BY THE DIFFERENT METHODS 16

Introduction 16

Normal Pictures 16

Nonmalignant Patterns 23

Erosion and Ectropion 23

Squamous Metaplasia 26

Colpitis 29

Vaginal Trichomoniasis 31

Polyp 35

The Ectocervix During the Menopause 38

The Ectocervix During Pregnancy 40

Vaginal Prolapse 43

Precancerous and Cancerous Conditions 44

Leukoplakia 44

Base of Leukoplakia 48

Mosaic Leukoplakia 50

Papillary Base 55

Erosio Vera (True Ulcer) 58

Red Zone 59

Iodine-negative，Sharply-demarcated Zones 61

Carcinoma 63

Remarks on Carcinoma In Situ 70

Remarks on Invasive Carcinoma and Its Recurrences 77

3．MORPHOLOGICAL DETERMINATION OF THE RADIOCURABILITY OF CARCINOMA OF THE ECTOCERVIX 80

Introduction 80

Radiation Lesions of the Various Tissues 81

Radiation Lesions of the Chromosomes 82

Radiation Cell Changes on the Cancerous and Normal Ectocervix 86

Radiation Cell Changes on Endocervical Glandular Epithelium 89

Lesions of the Bladder，Ovaries and Pelvic Lymph Nodes，caused by Radiotherapy of Carcinoma of the Ectocervix 91

Tests of Radiocurability 95

Changes Produced by High Voltage and Isotope Therapies 102

4．HISTOCHEMICAL INVESTIGATIONS 107

Introduction 107

Carbohydrates 107

Nucleic Acids 112

Enzymes 114

Amount of Beta-glucuronidase in the Vaginal Fluid 116

Techniques 120

5．HISTOPHYSICAL INVESTIGATIONS 121

Introduction 121

Histophotometric Technique 121

Ultraviolet Spectrophotometry 122

Ultraviolet Microspectrography 123

Phase Contrast Microscopy 124

Interference Microscopy 126

Fluorescence Microscopy 128

The Cytoanalyzer 132

6．HORMONAL INVESTIGATIONS 134

Introduction 134

Estrogens 134

Progesterone 137

Androgens 138

Cytological Determination of the Hormonal State With Particular Reference of Physiological，Radiation-induced and Surgical (by Oophorectomy，Adrenalectomy and Hypophysectomy) Menopause 139

Cytohormonal Diagnosis of Ovarian Dysfunctions 143

Modifications Induced by Hormones on the Vaginal Epithelium 145

Correlations Between Vaginal Cytology and the Level of Urinary Estrogens 148

7．CONSIDERATIONS ON ENDOCRINE SURGERY 149

Introduction 149

Ovario-adrenalectomy 150

Surgical Hypophysectomy 154

Isotopic Hypophysectomy 156

Behavior of Urinary Steriods After Endocrine Surgery 156

Persistence of Hormonal Activity After Endocrine Surgery 158

SECTION Ⅱ CANCER OF THE ENDOCERVIX AND ENDOMETRIUM 161

8．CANCER OF THE ENDOCERVIX 163

Introduction 163

Histology of the Endocervix 163

The Cyclic Changes of the Cervical Mucus 164

Cytology of the Cervical Canal 165

Phase Contrast Microscopy of Endocervical Cells 165

Non-neoplastic Pictures of the Endocervix 166

Neoplastic Pictures of the Endocervix 168

9．CANCER OF THE ENDOMETRIUM 173

Introduction 173

Histology of the Normal Endometrium 174

Exfoliative Cytology of the Normal and Pathological Endometrium 176

Phase Contrast Microscopy of the Endometrial Cells 181

Histochemistry of the Normal and Abnormal Endometrium and of Adenocarcinoma of the Endometrium 181

Non-neoplastic Histological Pictures of the Endometrium 183

Histological Pattern of Carcinomatous Endometrium 189

10．CYTOLOGIC DIAGNOSIS OF METASTASES FROM CARCINOMA OF THE ECTOCERVIX AND ENDOMETRIUM 194

Introduction 194

Pulmonary Cytodiagnosis 194

Urologic Cytodiagnosis 196

Cytology of Pleural and Peritoneal Effusions 197

Detection of Neoplastic Cells in the Peripheral Blood 200

SECTION Ⅲ ELECTRON MICROSCOPY ON CELLS OF THE PORTIO AND ENDOMETRIUM 205

11．CELLULAR ULTRASTRUCTURE 207

Introduction 207

Cellular Ultrastructure and the Functional Significance of the Various Cell Constituents 208

Differences Between Normal and Malignant Cells Under the Electron Microscopy 220

Technique of Electron Microscopy 223

12．ELECTRON MICROSCOPY ON CELLS OF THE ECTOCERVIX 228

Introduction 228

Normal Ectocervix 228

Carcinoma of the Ectocervix 233

Electron Microscopy of Carcinoma of the Ectocervix after Irradiation 241

13．ELECTRON MICROSCOPY ON CELLS OF THE ENDOMETRIUM 254

Introduction 254

Normal Endometrium 254

Carcinoma of the Endometrium 256

Modifications Induced by Synthetic Progestogens on Endometrium 257

Conclusions 258

14．REMARKS ON ULTRASTRUCTURAL-BIOCHEMICAL CHANGES IN NEOPLASTIC CELLS AND THEIR IMPLICATIONS FOR CARCINOGENESIS，DIFFERENTIATED AND UNDIFFERENTIATED NEOPLASMS，AND VARIOUS DEGREES OF MORPHOLOGICAL ATYPIA IN NEOPLASTIC CELLS 306

SECTION Ⅳ THE SENILE CERVIX AND ENDOMETRIUM EXAMINED WITH THE LIGHT AND ELECTRON MICROSCOPES 309

15．THE SENILE CERVIX AND ENDOMETRIUM 311

Introduction 311

Light Microscope Examination of Senile Cells 311

The Senile Ectocervix Examined by Means of the Electron Microscope 314

The Senile Endometrium Examined by Means of the Electron Microscope 321

The Nuclei of the Senile Ectocervix and Endometrium 326

Discussion 326

Conclusions and Prospects for Future Research in the Study of the Senile Cells．Role of Senility in the Carcinogenesis 329

SECTION Ⅴ FINAL CONSIDERATIONS AND SYNOPSIS OF THE ORIGINAL CONTRIBUTIONS 333

16．FINAL CONSIDERATIONS 335

Synopsis of the Original Contributions 341

BIBLIOGRAPHY 344

Miscellanea 344

Vaginal Cytology 345

Colposcopy 348

Pathology of the Ectocervix 349

Pregnancy 351

Radiation-induced Changes in Various Tissues 352

Histochemistry 353

Histophysics 353

Hormonal Evaluation 354

Endocrine Therapy of Cancer 355

Pathology of the Endocervix 356

Pathology of the Endometrium 356

Cytodiagnosis of Metastases from Uterine Cancer and Detection of Tumoral Cells in Circulating Blood 358

Functional Biochemistry of Cell Structures 359

Electron Microscopy 360

Senile Changes in Cells 362

Authors Index 365

Analytical Index 369