宫颈微小偏离性腺癌临床病理分析  

The Clinical and Pathological Analysis of Minimal Deviation Adenocarcinoma

作　　者：侯卫华[1] 胡学信[1] 刘英杰[2] 段尚林[1] 王建业[1] 李从洋[1] 赵晓旭[1] 于兵兵[1] 

机构地区：[1]中国人民解放军第152医院病理科,河南平顶山467000 [2]中国人民解放军第152医院肿瘤科,河南平顶山467000

出　　处：《肿瘤基础与临床》2007年第1期37-38,共2页journal of basic and clinical oncology

摘　　要：目的探讨宫颈微小偏离性腺癌(MDA)的临床、病理特征。方法对2例宫颈微小偏离性腺癌临床资料进行分析,组织化学及免疫组化(S-P法)检测CEA、CK7、CK8、K i-67、P53,并结合文献进行复习。结果MDA多见于中老年人,病程6个月至3年不等,预后较差。临床表现主要为白带增多或阴道流水样液,可伴阴道不规则出血。妇检:宫颈肥大,表面糜烂或颗粒状,质硬;宫颈管扩张,可呈桶状。术前临床及病理易误诊为慢性宫颈炎。镜下:MDA分化程度高,瘤组织形态和正常颈管腺体差异微小,腺体结构呈奇异性分支和成角浸润,少见背靠背现象;瘤细胞异型性小,可见个别胞核轻中度增大或核上移,核分裂像无或极少见。浸润深度达宫颈壁的2/3(或7 mm以上),间质可见血管及神经侵犯。可向上侵犯宫腔及淋巴结转移。腺周间质可见不同程度的组织反应及炎细胞浸润。组织化学PAS阳性。免疫组化CEA、CK7、CK8、K i-67瘤细胞阳性P53蛋白阴性。结论MDA是一种较为少见的特殊类型的子宫颈腺癌。Objective To explore the clinical and pathologic features of minimal deviation adenocarcinoma. Methods Analysis of the clinical materials of 2 cases with minimal deviation adenocarcinoma, tests of CEA, CK7, Ki-67, P53 and review of the related documents. Resuits . Minimal deviation adenocarcinoma was common in the middle of life or aged people, the natural course ranged from 6 mouths to 3 years, prognosis was worse. The gynecologic examination： cervical hypertrophy, erosion or granola could be seen in the cervix surface. Texture was hard. Cervical canals were broadened and barrel-shaped. It may be misdiagnosed as chronic cervicitis preoperatively. Under microscope, MDA was highly differentiated, morphous of tumor was similar to that of normal cervical gland. The infiltrated depth may reach 2 thirds of cervical wall（or more than 7mm） , Uterine cavity and lymph nodes may be involved upwards. Histochemistry found the PAS was positive. Immunohistochemistry showed that CEA, CK7, CK8, Ki-67 were all positive, P53 was negative. Conclusions MDA is a special kind and rare adenocarcinoma of the uterine cervix.

关 键 词：宫颈肿瘤 腺癌 微小偏离性腺癌 恶性腺瘤 

分 类 号：R737.33[医药卫生—肿瘤]