子宫颈微偏腺癌临床特点及误诊分析  

The clinical characteristics and misdiagnosis analysis of minimal deviation adenocarcinoma of the cervix

作　　者：方慧彬[1] 冯燕[2] 

机构地区：[1]浙江大学医学院附属第二医院滨江院区妇科,浙江杭州310000 [2]浙江大学医学院附属妇产科医院妇科肿瘤科,浙江杭州310006

出　　处：《中国计划生育和妇产科》2013年第6期58-61,64,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨子宫颈微偏腺癌（minimal deviation adenoearcinoma of the cervix，MDAC）的临床特点及高误诊率原因。方法回顾性分析浙江大学医学院附属妇产科医院1999～2012年收治的9例病理确诊为MDAC患者的临床特点。结果最常见临床症状为阴道分泌物增多。子宫颈分泌物检查未提示高危型人乳头状瘤病毒（High-risk type human papillomavirus，HR-HPV）感染，子宫颈细胞学检查少有阳性发现，影像学检查可见子宫颈增粗、多囊性改变。子宫颈活组织检查阳性率低。子宫颈大块组织切除作病理检查可提高确诊率。结论MDAC是一种极为特殊的子宫颈腺癌类型，临床症状及体征不明显，诊断较困难，易出现漏诊，重复子宫颈深部活组织检查或子宫颈锥切病理组织学检查可提高诊断准确率。Objective To investigate the clinical characteristics and the reason of high misdiagnosis of the minimal deviation adenocarcinoma of the cervix （MDAC）. Methods The retrospective analysis was carried out to evaluate the clinical and pathological data of 9 patients with MDA treated in Women＇s Hospital, Zhejiang University School of Medicine, during year 1999 to 2012. Results The commonly chief complaint was increased vaginal discharge. The result of cytological exam always came out negative, no evidence of infection of the high risk - human papillomavirus （HR - HPV） . Imaging examinations showed enlarge of the cervical with polycystic lesions. The positive rate of cervical biopsy was low. Large tissue of cervix for pathological examination could improve the diagnosis rate. Conclusion MDAC is a very special type of cervical adenocarcinoma, the clinical symptoms and signs are inconspicuous, clinical diagnosis is very difficult, it is easy to be misdiagnosised, repeat cervical biopsy or cervical conization is helpful for the diagnosis.

关 键 词：子宫颈 微偏腺癌 临床特点 误诊 

分 类 号：R737.33[医药卫生—肿瘤]