| 10例宫颈原位腺癌临床病理特征分析 |
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| 引用本文： | 杨宁宁1,' target='_blank'>2,陈洪春1,' target='_blank'>2,黄雨晨1,' target='_blank'>2,闫文天1,' target='_blank'>2,冯振中2,' target='_blank'>3. 10例宫颈原位腺癌临床病理特征分析[J]. 现代肿瘤医学, 2022, 0(8): 1459-1462. DOI: 10.3969/j.issn.1672-4992.2022.08.023 |
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| 作者姓名： | 杨宁宁1 ' target='_blank'>2 陈洪春1 ' target='_blank'>2 黄雨晨1 ' target='_blank'>2 闫文天1 ' target='_blank'>2 冯振中2 ' target='_blank'>3 |
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| 作者单位： | 1.蚌埠医学院第一附属医院病理科，安徽 蚌埠 233000;2.蚌埠医学院病理学教研室，安徽 蚌埠 233000;3.安徽医科大学第二附属医院病理科，安徽 合肥 230601 |
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| 基金项目： | 安徽省自然科学基金项目（编号:1908085MH275）;蚌埠医学院自然科学类项目(编号:BYKY1710) |
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| 摘 要： | 目的:探讨宫颈原位腺癌（adenocarcinoma in situ,AIS）的临床病理特征和诊断要点。方法:回顾性分析某医院病理科存档的10例宫颈原位腺癌患者的临床及病理资料，并复习相关文献。结果:年龄31~51岁，平均年龄44岁。7例表现为腰痛、异常的阴道流血及排液，3例无明显的临床症状，因HPV检测阳性而行宫颈活检确诊。9例为宫颈内膜型，1例为复层产黏液性上皮内病变（SMILE）；5例为单纯宫颈原位腺癌，5例伴有高级别鳞状上皮内病变（HSIL）。镜下观察，单纯性AIS腺体仍保持原有的结构特征，但细胞异型性明显，细胞核拥挤、深染、重叠，核分裂象多见，可见凋亡小体。SMILE肿瘤细胞由复层上皮细胞构成，可见富含黏液细胞或具有产黏液趋势，巢团状排列。10例细胞不同程度阳性表达p16、CEA，Ki67增殖指数均>20%；术后1例进展为浸润性腺癌，2例失访，余均无病生存。结论:宫颈原位腺癌缺乏典型的临床表现且病变位置较深，具有相对特征的形态学改变和免疫表型，需要充分的病理取材和临床密切随访。
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| 关 键 词： | 宫颈原位腺癌 复层产黏液性上皮内病变 临床病理特征 免疫组化 |
Clinicopathological characteristics of 10 cases of cervical adenocarcinoma in situ |
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| YANG Ningning1,' target='_blank'>2,CHEN Hongchun1,' target='_blank'>2,HUANG Yuchen1,' target='_blank'>2,YAN Wentian1,' target='_blank'>2,FENG Zhenzhong2,' target='_blank'>3. Clinicopathological characteristics of 10 cases of cervical adenocarcinoma in situ[J]. Journal of Modern Oncology, 2022, 0(8): 1459-1462. DOI: 10.3969/j.issn.1672-4992.2022.08.023 |
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| Authors: | YANG Ningning1 ' target='_blank'>2 CHEN Hongchun1 ' target='_blank'>2 HUANG Yuchen1 ' target='_blank'>2 YAN Wentian1 ' target='_blank'>2 FENG Zhenzhong2 ' target='_blank'>3 |
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| Affiliation: | 1.Department of Pathology,the First Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233000,China;2.Department of Pathology,Bengbu Medical College,Anhui Bengbu 233000,China;3.Department of Pathology,the Second Hospital of Anhui Medical University,Anhui Hefei 230601,China. |
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| Abstract: | Objective:To investigate the clinicopathological features and diagnostic points of cervical adenocarcinoma in situ(AIS).Methods:The clinical and pathological data of 10 cases of cervical adenocarcinoma in situ filed in the department of pathology of one hospital were analyzed retrospectively,and the related literature was reviewed.Results:The age ranged from 31 to 51 years,with an average age of 44 years.7 cases showed lumbago,abnormal vaginal bleeding and drainage.3 cases had no obvious clinical symptoms,and were diagnosed by cervical biopsy because of positive HPV test.9 cases were endocervical type,and 1 case was stratified mucin-producing intraepithelial lesion(SMILE).5 cases were simple cervical adenocarcinoma in situ,and 5 cases were accompanied by high-grade squamous intraepithelial lesion(HSIL).Microscopically,the simple AIS gland still maintains its original structural features,but its cell atypia is obvious,with crowded,deeply stained and overlapped nuclei,and mitosis is common,with apoptotic bodies visible.SMILE tumor cells are composed of multiple layers of epithelial cells,which are rich in mucus cells or tend to produce mucus,arranged in nests.p16 and CEA were positively expressed in 10 cases,and Ki67 proliferation index was all over 20%.After operation,1 case progressed to invasive adenocarcinoma,2 cases lost follow-up,and the rest survived without disease.Conclusion:Cervical adenocarcinoma in situ lacks typical clinical manifestations,has deep pathological changes and immunophenotype,and needs adequate pathological materials and close clinical follow-up. |
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| Keywords: | cervical adenocarcinoma in situ stratified mucin-producing intraepithelial lesion clinicopathological features immunohistochemical |
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