13例宫颈微偏腺癌(MDA)的临床诊治分析

 目的 探讨子宫颈微偏腺癌(minimal deviation adenocarcinoma,MDA)的临床病理特点、诊断治疗方案及预后。方法 回顾性分析我院1994年9月至2012年6月收集的13例MDA患者的临床资料和随访记录。结果 5例表现为阴道排液增多,4例以同房后出血为主诉,4例有不规则阴道流血。6例术前经宫颈活检或锥切后明确诊断,其余7例则为其他肿瘤手术后诊断(1例子宫内膜腺癌,5例宫颈液腺癌,1例因子宫肌瘤行全子宫切除后确诊)。13例均接受广泛全子宫切除术。4例术前介入化疗加术后化疗,7例术后化疗。术后随访8个月～11年,除3例失访外,其余10例均存活至今。结论 MDA临床极少见,容易误诊,及早手术、必要的辅助治疗和密切随访可能改善预后。

Clinical diagnosis and treatment of 13 cases of cervical minimal deviation adenocarcinoma(MDA)

Objective To investigate the clinical and pathological characteristics,diagnosis,treatment and prognosis of cervical minimal deviation adenocarcinoma (MDA).Methods Retrospective analysis clinical data and follow-up records of 13 cases of MDA who were diagnosed and managed in our hospital from Sep.,1994 to Jun.,2012.Results The main symptoms were water-like leucorrhea in vaginal discharge (38.5%),bleeding after intercourse (36.4%) and irregular vaginal bleeding (36.4%).Six cases were diagnosed by the biopsy or cornization,and the other 7 cases were confirmed after operation for other tumors (1 case of endometrial adenocarcinoma,5 cases of cervical mucus adenocarcinoma,1 case of uterine leiomyoma).All the 13 cases received radical hysterectomy.Four cases received pre and postoperative chemotherapy,Seven cases underwent postoperative chemotherapy.All patients survive during 8 months to 11 years of follow up,except for 3 cases were lost.Conclusions MDA is an extremely rare disease and was often misdiagnosed.Early diagnosis and operation with adjuvant therapy may improve the prognosis.