4例子宫颈腺样基底细胞癌的临床病理特征分析  

A clinicopathological study of 4 cases of Cervical adenoid basal carcinoma

作　　者：黄贞 王成有[1] 董滨华 廖翏[1] HUANG Zhen;WANG Chengyou;DONG Binhua;LIAO Liu(Department of Pathology,Fujian Maternity and Child Health Hospital,Fujian Province,Fuzhou350001,China;Laboratory of Gynecologic Oncology,Department of Gynecology,Fujian Maternity and Child Health Hospital,Affiliated Hospital of Fujian Medical University,Fujian Province,Fuzhou350001,China)

机构地区：[1]福建省妇幼保健院病理科,福建福州350001 [2]福建省妇儿重大疾病研究重点实验室,福建福州350001

出　　处：《中国当代医药》2021年第36期97-100,F0004,共5页China Modern Medicine

基　　金：福建省自然科学基金项目(2017J01232)。

摘　　要：目的探讨子宫颈腺样基底细胞癌(adenoid basal carcinoma,ABC)的临床病理学特征。方法回顾性选取2018年12月至2020年12月福建省妇幼保健院收治的4例ABC患者作为研究对象,分析其临床特征、病理学形态和免疫组化结果,并复习相关文献。结果4例患者年龄44~66岁,中位年龄57岁,1例因阴道接触性出血就诊,其余3例无特异性症状。3例高危型人乳头瘤病毒(HPV)检测为阳性,3例细胞学诊断为鳞状上皮内病变(2例为高级别)。2例行全子宫及双附件(伴或不伴盆腔淋巴结清扫)切除术,2例行宫颈锥形切除术。显微镜下,宫颈纤维性间质中见肿瘤细胞呈巢状、条索状浸润性生长,细胞体积小,细胞质少,形态一致,类似基底样细胞,癌巢周围细胞呈栅栏状排列。术后病理,3例伴随高级别鳞状上皮内病变(HSIL),1例合并宫颈浸润性鳞状细胞癌(SCC)。4例免疫组化P63、P40、高分子量细胞角蛋白CK(HMW)、细胞角蛋白CK5/6均为阳性,3例P16阳性,1例P53弱阳性,Ki-67增殖指数为1%~10%。4例均无复发和转移。结论子宫颈ABC好发于绝经后女性,多无明显临床症状,常伴有高危型HPV感染,多因宫颈细胞学检查异常就诊,具有特征性的病理形态和免疫组织化学特点,预后良好。Objective To investigate the clinicopathological characteristics of adenoid basal carcinoma of the cervix.Methods The clinicopathological data of 4 ABC patients diagnosed and treated in Fujian Maternity and Child Health Hospital from December 2018 to December 2020 were retrospectively analyzed,and their clinical,histopathological characteristics and immunohistochemical expression were analyzed,and related literatures were reviewed.Results Four patients were 44-66 years old with a median age of 57 years.One patient presented with vaginal contact bleeding,and the other three had no specific symptoms.Three cases of high-risk human papillomavirus were positive,three cases were cytologically diagnosed as squamous intraepithelial lesions(2 cases wre high grade).Two cases underwent total uterus and double appendage(with or without pelvic lymph node dissection)resection,and 2 cases underwent cervical cone resection.Under the microscope,tumor cells were seen in the fibrous stroma of the cervix with nest-like and cord-like infiltrating growth.The cells were small in size,less cytoplasm,and uniform in shape,similar to basal-like cells.The cells around the cancer nests were arranged in a fence.Postoperative pathology,three cases were accompanied by high grade squamous intraepithelial lesions(HSIL),and 1 case was accompanied by cervical squamous cell carcinoma.Four cases of immunohistochemistry were positive for P63,P40,high molecular weight cytokeratin CK(HMW),CK5/6,3 cases were positive for P16,one case was weakly positive for P53,and the Ki-67 proliferation index was 1%-10%.There were no recurrence or metastasis in 4 cases.Conclusion ABC usually occurs in postmenopausal women.Most of them have no obvious clinical symptoms and are often accompanied by high-risk HPV infections and abnormal cervical cytology.They have characteristic pathological morphology and immunohistochemical characteristics,and a good prognosis.

关 键 词：子宫颈 腺样基底细胞癌 临床病理特征 免疫组织化学 预后 

分 类 号：R642[医药卫生—外科学]