宫颈管内膜型宫颈原位腺癌临床病理特征分析  

Analysis of clinicopathological features of endocervical adenocarcinoma in situ of the uterine cervix

作　　者：顾文贤 程羽青 高蔚 华芬 周晓莉 王更芳 GU Wen-xian;CHENG Yu-qing;GAO Wei(Department of Pathology,Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou 213003,China)

机构地区：[1]南京医科大学附属常州第二人民医院病理科,213003

出　　处：《中国现代药物应用》2022年第22期95-98,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析宫颈管内膜型宫颈原位腺癌(AIS)的临床病理特点。方法回顾性分析18例宫颈管内膜型原位腺癌患者的临床病理资料,并结合文献进行讨论。结果18例患者在组织活检前均行宫颈液基细胞学检查,2例报告为不能明确意义的非典型腺细胞,细胞学形态表现为细胞排列拥挤重叠、不规则,核浆比增大,细胞核拉长增大,细胞核深染伴染色质颗粒状,核膜不规则。其余患者中有2例为高级别鳞状上皮细胞内病变,2例为低级别鳞状上皮细胞内病变,3例为不除外高级别鳞状上皮细胞内病变的非典型鳞状上皮细胞,4例为不能明确意义的非典型鳞状上皮细胞,5例患者细胞学检查阴性。宫颈锥切标本和全子宫切除标本宫颈巨检均未见有占位病变。18例宫颈管内膜型AIS的P16免疫组化染色均在腺癌细胞核、细胞质中呈现均一的弥漫性强阳性表达;Ki67均在腺癌细胞核中呈弥漫强阳性表达,周围非肿瘤宫颈腺上皮呈阴性或散在个别细胞阳性表达。结论宫颈管内膜型宫颈AIS是临床较为少见的宫颈肿瘤,进行免疫组化检测有助于鉴别诊断。Objective To analyze the clinicopathological features of endocervical adenocarcinoma in situ of the uterine cervix.Methods The clinicopathological data of 18 patients with endometrial adenocarcinoma in situ(AIS)of the uterine cervix were retrospectively analyzed and discussed with review of relevant literature.Results All 18 patients underwent cervical liquid-based cytology examination before biopsy.2 cases were reported as atypical glandular cells of undefined significance,with cytological morphology showing crowded,overlapping and irregular cell arrangements,increased nucleoplasmic ratio,elongated and enlarged nuclei,darkly stained nuclei with granular chromatin,and irregular nuclear membranes.In the remaining cases,2 cases were high-grade squamous intraepithelial lesions,2 cases were low-grade squamous intraepithelial lesions,3 cases were atypical squamous epithelial cells without excluding high-grade squamous intraepithelial lesions,4 cases were atypical squamous epithelial cells without clear significance,and 5 cases had negative cytology.Cervical conization specimens and total hysterectomy specimens were not found to have space-occupying lesions.Immunohistochemical staining for P16 in all 18 cases of endocervical ductal AIS showed uniform diffuse strong positive expression in the nucleus and cytoplasm of adenocarcinoma cells;Ki67 showed diffuse strong positive expression in the nucleus of adenocarcinoma cells and negative or scattered positive expression in the surrounding non-tumor cervical glandular epithelium of individual cells.Conclusion Endocervical AIS of the uterine cervix is a relatively rare cervical tumor,and immunohistochemical testing is useful for differential diagnosis.

关 键 词：宫颈 原位腺癌 鉴别诊断 内膜型 

分 类 号：R737.33[医药卫生—肿瘤]