子宫颈微偏腺癌与微腺体增生临床病理分析  

Clinicopathlogic analysis of micro - unsymmetrical adenocarcinoma and microglanular prolierfation in cervix.

作　　者：高路杨[1] 唐军栋[1] 王献华[2] 马小兵[2] 向聚才[2] 韩秀华[2] 

机构地区：[1]华北煤炭医学院冀唐学院,唐山063000 [2]华北煤炭医学院病理教研室

出　　处：《中国综合临床》2010年第5期540-543,共4页Clinical Medicine of China

摘　　要：目的探讨子宫颈微偏腺癌及子宫颈微腺体增生的临床和病理特点。方法对2例子宫颈微偏腺癌及1例子宫颈微腺体增生患者临床资料和免疫组化染色结果进行分析。结果微偏腺癌，临床表现为大量水样白带，肉眼观察子宫颈增粗，切面见大小不一、含有黏液的囊腔；而微腺体增生宫颈无明显异常。结论微偏腺癌是宫颈的恶性病变，分化好，预后差；微腺体增生是一种完全良性病变。Objective To discuss the features, such as clinical symptoms, pathologic morphologies, immunohistoehemical staining of minimal deviation adenoearcinoma and mieroglandular hyperplasia of the uterine cervix in order to improve the accuracy of pathological diagnosis. Methods s ： Histopathologie characteristics of total hysterectomies in 2 cases of minimal deviation adenoeareinoma and 1 ease of cervical mieroglandular hyperplasia based on the formalin-fixed, paraffin-embedded and hematoxylineosin stained tissue were analyzed retrospectively. Immunohistoehemieal staining was used to detect the expression of CEA,p53, PCNA,and Ki-67 in all 3 cases. Results The main clinical symptoms of minimal deviation adenocarcinoma were watery leueorrhea and enlargement of the cervix. The pathological findings of MDA included hyperplasia of the glands with cytological minimal atypia, invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes, or edema and inflammatory infiltration around the glands were also observed. The invasion presented in the deep part of the cervix as well. The patiant of MGH had a history of oval contraceptive use. Histological features of MGH included tightly packed glands in different sizes and shapes, presentation of inflammatory cells in stroma and glandular lumens, and focal epithelial cell pleomorphism and hyperchromatism but without mitosis. CEA was positive in all two MDA cases, but the tissue of MGH was negative for CEA. The expressions of the other four markers bad no difference between MDA and MGH. Conclusions For patients with watery discharge and/or hypertrophy of cervix, the deep （ 〉 5 mm ） biopsies should be performed. The immunohistoehemieal staining for CEA,p53 ,CA125 and ER has adjuvant diagnostic values. It is extremely important to recognize that MGH is an entirely benign lesion.

关 键 词：腺体病变 子宫颈偏微腺癌 子宫颈微腺体增生 

分 类 号：R737.33[医药卫生—肿瘤]