子宫颈黏液腺癌21例病理诊断分析

目的 对子宫颈黏液腺癌病理诊断过程的分析旨在为早期诊断、减少漏诊总结经验.方法 回顾性分析21例子宫颈黏液腺癌的病理诊断过程;采用LABC法免疫组化检测CEA及Ki-67的表达.结果 21例子宫颈黏液腺癌诊断中,漏诊3例(14.3%),其中1例为TCT漏诊,2例为子宫颈活检漏诊;4例(19.0%)子宫颈活检诊断为子宫颈原位腺癌、浸润不能除外,后经LEEP术确诊为子宫颈浸润性黏液腺癌;1例(4.8%)子宫颈活检诊断为慢性子宫颈炎,经LEEP术确诊为子宫颈浸润性黏液腺癌;12例(57.1%)直接由子宫颈活检确诊为子宫颈黏液腺癌;1例(4.8%)经诊刮诊断为腺癌,无法确定组织学类型,术后确诊为子宫颈黏液腺癌.免疫组化染色显示,其中10例CEA表达阳性(47.6%),Ki-67表达均升高(>20%).结论 从细胞学及组织形态学上,掌握子宫颈黏液腺癌的诊断要点,可以减少漏诊,及早做出正确的诊断,为患者赢得宝贵的手术时间.

Cervical mucinous adenocarcinoma:a pathologic analysis of twenty-one cases

Purpose To improve the early correct diagnosis and avoid misdiagnosis of cervical mucinous adenocarcinoma.Methods Twenty-one cases of cervical mucinous adenocarcinoma were reviewed and analyzed retrospectively.The expression of CEA and Ki-67 was detected in the tumor by immunohistochemical staining (LABC method).Results Of the twenty-one cases, three cases (14.3%) were missed out, in which one was missed out by TCT and the others by biopsy; four cases (19.0%) were diagnosed by biopsy as adenocarcinoma in situ with invasion not be excluded, and then further confirmed as invasive adenocarcinoma by LEEP; one case (4.8%) was diagnosed as cervicitis at first and was further detected as adenocarcinoma by LEEP; twelve cases (57.1%) were directly diagnosed as adenocarcinoma by biopsy; one case (4.8%) was diagnosed as adenocarcinoma with unknown origin, and then as cervical adenocarcinoma after hysterectomy. Immunohistochemically, ten cases were CEA positive (47.6%) and the expression of Ki-67 was increased (>20%).Conclusions Understanding of the cytologic and histologic features of adenocarcinoma in cervix might improve its early detection and correct diagnosis, so that timely treatment is guaranteed for patients.