宫颈非典型腺细胞液基细胞学诊断的临床意义探讨  

Clinical significance of the atypical glandular cells of cytologic diagnosis in liquid-based cytology smear

作　　者：常柏峰 赵琳琳[1] 周彬[1] 潘秦镜[1] 曹箭[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院肿瘤研究所病理细胞室,北京100021

出　　处：《诊断病理学杂志》2016年第2期89-92,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨细胞病理学宫颈非典型腺细胞(AGC)诊断的临床意义。方法对细胞学诊断141例AGC进行随访,与有组织病理学诊断的117例进行对照总结。结果宫颈细胞学诊断26345例中,细胞学异常诊断2966例(11.3%),其中腺细胞异常诊断335例(1.27%),AGC诊断141例(0.54%)。141例AGC中117例有随访病理结果,10例病理诊断良性,8例为鳞状上皮病变,97例腺上皮病变(3例宫内膜非典型增生、94例为宫内膜/卵巢/宫颈腺癌),2例宫内膜肉瘤。9例癌前病变<50岁者6例(66.7%),98例恶性肿瘤≥50岁者70例(71.4%),两组差异显著(P<0.05)。85例腺癌患者中,早期宫内膜癌占82.9%(58/70),晚期卵巢腺癌占73.3%(11/15)。结论细胞学AGC诊断在随诊病理结果中多数为宫内膜腺癌或卵巢腺癌,少数为鳞状上皮内病变或鳞癌;<50岁者更多见于上皮内病变,≥50岁者有更高的恶性肿瘤风险。Objective To explore the significance of the cytologic diagnosis of atypical glandular cells （AGC）. Methods 141 smears reported as AGC were follow-up, 117 cases have the diagnosis of histology. These cases were all from Cancer Hospital Chinese Academy of Medical Sciences from January 2011 to July 2014. Results Of 26,345 smears, 2966 （ 11.3% ） reported abnormality, 335 （1.27%） reported abnormal glandular cells, 141 （0. 54% ） reported A GC. And 117 cases have histologic follow-up, 10 benign changes, 8 squamous intraepithelial lesions, 97 glandular lesions including 3 atypical endometrial hyperplasia, 94 endometrial / ovarian / cervical adenoearcinoma, 2 endometrial sarcoma. Among 9 precancerous lesions,6 patients （ 66. 7 % ） were 〈 50 years old ; among 98 malignant, 70 patients （ 71.4 % ） were ≥ 50 years old, the two groups were different （ P = 0. 048 ）. Among 85 adenocarcinoma, early endometrial carcinoma accounted for 82. 9% （58/70）, advanced ovarian cancer accounted for 73.3% （11/15）. Conclusion Most of the patients of AGC in Cancer Hospital, outcome of follow-up histology were endometrial or ovarian adenocarcinoma, a few of the patients were squamous intraepithelial lesions or cervical squamous cell carcinoma. Most of intraepithelial lesion were 〈 50 years old, ≥ 50 years old have a higher risk for malignant tumor.

关 键 词：宫颈细胞学 AGC 宫内膜病变 液基细胞学 

分 类 号：R737.33[医药卫生—肿瘤]