子宫颈黏液腺癌21例病理诊断分析  

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

作　　者：车祺[1] 周先荣[1] 朱慧庭[1] 王丽[1] 曲玉清[1] 宁燕[1] 

机构地区：[1]复旦大学附属妇产科医院病理科,上海200011

出　　处：《临床与实验病理学杂志》2009年第6期580-583,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：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。】 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.

关 键 词：子宫颈肿瘤 黏液腺癌 病理诊断 漏诊 子宫颈活检 

分 类 号：R737.33[医药卫生—肿瘤]