宫颈乳头状鳞状/移行细胞癌16例临床病理研究  

CLINICOPATHOLOGICAL STUDY OF PAPILLARY SQUAMO/TRANSITIONAL CELL CARCINOMA OF THE CERVIX

作　　者：吴影[1] 刘云双[2] 代海平[1] 王双珠[3] 

机构地区：[1]牡丹江医学院附属红旗医院病理科,黑龙江牡丹江157011 [2]牡丹江医学院附属红旗医院超声科,黑龙江牡丹江157011 [3]台州医院病理科,浙江台州317000

出　　处：《牡丹江医学院学报》2011年第2期21-25,共5页Journal of Mudanjiang Medical University

摘　　要：目的：探讨宫颈乳头状鳞状/移行细胞癌的临床病理特征、组织学类型及其鉴别诊断。方法：分析16例宫颈乳头状鳞状/移行细胞癌的临床和病理资料,免疫组化染色观察CK7、CK20、K i67及HPV在肿瘤细胞中的表达,并结合文献进行分析。结果：病人年龄33~77岁（平均年龄60.9岁）。主要表现为阴道异常出血。其中3人FIGOⅠ期,7人Ⅱ期,5人Ⅲ期。随访13例（12-102月）均健在,其中2例分别在初诊13月及28月后局部复发。病理检查：肉眼肿物从宫颈糜烂、溃疡至菜花样形态不等。镜下具有纤维血管轴心的乳头状结构、活跃的核分裂像和凋亡碎片。乳头状鳞癌10例,鳞状移行细胞癌5例,移行细胞癌1例。11例可见HPV感染形态学征象。16例中13例均具有下方间质浸润,其余3例过于浅表无法评估其间质浸润情况。免疫组织化学：CK7均阳性,CK20均阴性,HPV16/18阳性率62.5%（10/16）,K i67 index38.2±19.6%。结论：宫颈非腺性乳头状癌可能是显示一个形态学谱不同阶段的一组肿瘤。需与宫颈其它乳头状病变鉴别。目的：探讨宫颈乳头状鳞状/移行细胞癌的临床病理特征、组织学类型及其鉴别诊断。方法：分析16例宫颈乳头状鳞状/移行细胞癌的临床和病理资料,免疫组化染色观察CK7、CK20、Ki67及HPV在肿瘤细胞中的表达,并结合文献进行分析。结果：病人年龄33~77岁（平均年龄60.9岁）。主要表现为阴道异常出血。其中3人FIGOⅠ期,7人Ⅱ期,5人Ⅲ期。随访13例（12-102月）均健在,其中2例分别在初诊13月及28月后局部复发。病理检查：肉眼肿物从宫颈糜烂、溃疡至菜花样形态不等。镜下具有纤维血管轴心的乳头状结构、活跃的核分裂像和凋亡碎片。乳头状鳞癌10例,鳞状移行细胞癌5例,移行细胞癌1例。11例可见HPV感染形态学征象。16例中13例均具有下方间质浸润,其余3例过于浅表无法评估其间质浸润�Objective：To study the clinicopathologic features and histological types of papillary squamo/transitional cell carcinoma of the cervix as well as their differential diagnoses.Methods：Clinical and pathological data of 16 cases with papillary squamo/transitional cell carcinoma of the cervix were analyzed.Immunohistochemical staining for CK7、CK20、Ki67 and HPV was performed.Results：Patients ranged from 33 to 77 years old.Abnormal bleeding was the most common clinical presentation.3 patients were FIGO Stage Ⅰ,7 were StageⅡ,and 5 were Stage Ⅲ.13 patients with clinical follow-up ranging from 12-102 months were alive at the end of follow-up,and 2 local recurrence.Grossly,16 tumors were described as cervical erosion,ulcerated or cauliflowerlike masses.Microscopically,all tumors demonstrated papillary structures with fibrovascular cores,active mitotic figures and many cell fragments.16 cases of the papillary carcinoma were divided into four groups：papillary squamou cell carcinoma（PSCC）： 10 cases,squamotransitional cell carcinoma（STCC）： 5 cases,transitional cell carcinoma（TCC）： 1 cases.Underlying stromal invision was seen in 13 of 16 cases,in the remaining 3 cases,the spicimen was too superficial to assess invision.Immunohistochemical staining revealed that tumor cells were positive for CK7,but negative for CK20.HPV16/18 positive rate was 62.5% and Ki67 index was 38.2±19.6%.Conclusion：papillary carcinomas of the uterine cervix perhap reflect a morphologic continuum within a single clinically homogeneous entity.It is needed to be distinguished from other papillary lesions of the cervix.

关 键 词：乳头状鳞癌 移行细胞癌 鳞状/移行细胞癌 宫颈 

分 类 号：R36[医药卫生—病理学]