宫颈微偏腺癌10例临床病理分析  

Minimal deviation adenocarcinoma of cervix:a clinicopathologic analysis of 10 cases

作　　者：李胜水[1] 范嫏娣[2] 于翠珍[1] 王风革[1] 

机构地区：[1]沧州市中西医结合医院,河北沧州061001 [2]天津市病理会诊中心,天津300121

出　　处：《诊断病理学杂志》2007年第1期16-19,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的通过10例宫颈微偏腺癌（MI）A）临床病理分析，进一步探讨MDA的临床症状、病理形态及免疫组化特征。方法对10例宫颈MI）A的病理活检和，或全子宫切除标本进行巨检、光镜观察，其中7例行免疫组化染色测定CEA、p16、p53、Ki-67、CA125、ER、PR、HPV16／18等免疫表型。结果10例患者平均年龄49．5岁，临床症状以宫颈水样溢液为主，伴，不伴接触性出血，体征多数为宫颈肥大和，或宫颈糜烂。术前病理活检确诊6例，术后随访2。60个月，其中2例分别于5个月和7个月时死亡；2例转移，2例健在，余4例失访。结论宫颈MDA的早期确诊率极低，应警惕宫颈水样溢液和，或宫颈肥大者，应争取宫颈深部（〉5mm）活检，必要时施行高频电刀宫颈锥形切除术。CEA、p53（＋）及CA125、ER（-）具有辅助诊断价值。Objective To discuss the features, such as clinical symptoms, pathologic morphologies, immunohistochemical staining, of minimal deviation adenocarcinoma of the cervix （MDA） in order to obtain the early diagnosis. Methods Gross, microscopic changes of biopsies and total hysterectomies were analyzed in 10 cases of cervical MDA and immunohistochemical staining was used to detect the expression of CEA, p53, P16, Ki-67, CA125, ER, PR and HPV16/18 in 7 cases . Results The average age was 45.9 years for the 10 patients. The main symptoms included the watery discharge of cervix, with or without the irregular hemorrhage of uterus. Most patients had the signs of cervical hypertrophy and/or erosion. Of the 10 cases, definite were obtained in 6 cases, accounting for 60% ; from preoperative pathologic biopsies. Of all the cases, six were followed-up for 2 - 60 months postoperatively. Of them, two cases died for 5 and 7 months, metastatic diseases occurred in 2 cases, and disease-free survivals were found in 2. The follow-up was lost for the other 4. Conclusion The early diagnosis rate of the cervical MDA is very low, to which we must pay more attention. For patients with watery discharge and/or hypertrophy of cervix, the deep （ 〉 5 mm） biopsies should be performed. When necessary, electric knife conization should be performed. The immunohistochemical staining for CEA, p53, CA125 and ER has adjuvant diagnostic values.

关 键 词：宫颈 微偏腺癌 癌胚抗原 

分 类 号：R737.33[医药卫生—肿瘤]