宫颈透明细胞腺癌的研究进展

宫颈透明细胞腺癌(clear cell adenocarcinoma of the cervix,CCAC)是宫颈腺癌的一种,在宫颈恶性肿瘤中属罕见,其发生可能与高危型人乳头瘤病毒(HPV)感染无关,除己烯雌酚接触史外还有其他因素,常见于年轻女性,有生长较慢但易发生转移及深部浸润、预后较差等特点,临床多表现为阴道出血或阴道排液。细胞学检查常为阴性,早期诊断困难,诊断以组织病理形态学为主,免疫组织化学可辅助鉴别。由于发病率低,迄今尚无前瞻性病例对照研究以制定统一的治疗方案,早期患者多以手术治疗为主,晚期以放化疗为主,化疗多采用以铂类为基础的方案。手术、放疗和化疗相结合的综合治疗能改善早期患者的预后,保留生育功能的手术方式适用于特定条件者。对其临床病理特点及诊断治疗方法等进行综述。

Advances of the Study for Clear Cell Adenocarcinoma of the Cervix

Clear cell adenocarcinoma of the cervix (CCAC), tending to occur in young women,is a rare uterine cervical neoplasms. Different from common cervix cancer, CCAC may not relate with high-risk HPV infection. It has a strong association not only with a history of exposure to diethylstilbestrol (DES) in utero but also other factors, and is characterized by slower growing while early metastasis, deep infiltration and poor prognosis. Patients with CCAC commonly present with an abnormal vaginal bleeding or discharging. According to the lower frequency of abnormal cervical cytology, it is difficult to diagnose CCAC in early stage. Diagnosis is based on histologic confirmation with immunohistochemical information. Up to now there has not been a standard treatment for CCAC, most patients are treated surgically for early stage, while chemoradiation with platinum-based chemotherapy for late stage. Operation combined with radiotherapy and chemotherapy can improve the prognosis of patients with early stage. It′s feasible to have fertility-preserving treatment for specific patients. To improve the clinical management, we review its clinical characteristics and advances in both diagnosis and treatment.