During the past 8 years 1501 colposcopies were performed paying a special attention to cervical glands for diagnosis of cervical intraepithelial neoplasia (CIN) and carcinoma. Normal openings could exclude these diseases at the error rate of only 5.1%, while atypical openings could identify them at the high confidence rate of 96.3%. False positive evaluations were mostly attributable to a marked degree of squamous metaplasia in the glands. The absence of gland openings in the main portion of the lesions amounted to 88.6% in invasive carcinomas but to only 12.4% in CIN. Adenoma malignum was a highly characteristic exception.

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The minimum thickness of cervical fibromuscular stroma remaining uninvolved with invasive cervical carcinoma was examined in relation to pelvic node metastases and 5-year cancer death rate, using specimens from Stage IB, IIA, and IIB patients who underwent radical hysterectomy and pelvic lym-phadenectomy. The nodal metastasis and 5-year cancer death rates were 7% and 8%, respectively, in patients with the uninvolved fibromuscular stroma thickness above 3 mm, and 37% and 26%, respectively , in patients with the thickness below 3 mm. The thickness of cancer-unaffected cervical fibro-muscular stroma seemed to be closely related to and to be a more useful parameter of the biological behavior of invasive cervical carcinoma than the depth of the cancer invasion. A threshold value of the minimum thickness of the tissue as a barrier against extrauterine spread of cervical cancer could not be identified in this study.

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