摘要
目的探讨宫颈腺样囊性癌的临床和病理组织学特点。方法对2例宫颈腺样囊性癌进行回顾性分析,复阅临床资料及病理切片,统计相关的免疫组化结果,分析其临床病理学特征,随诊其预后,并查阅相关文献总结。结果 2例腺样囊性癌,其中1例为单纯的腺样囊性癌,1例为腺样囊性癌伴肉瘤。宫颈腺样囊性癌多发生于中老年女性,患者发病年龄24~99岁,但常以绝经后女性多见。临床多以阴道异常出血就诊,阴道镜检查时常可看到明确肿块。组织学上肿瘤细胞呈圆形岛状或巢状生长,大部分区域肿瘤细胞呈筛状排列,由一层或两层肿瘤细胞形成小导管结构,有些筛孔内含有嗜酸性分泌物,细胞巢周围常有栅栏状结构。可与其他类型病变混合存在,如鳞状细胞癌、高级别鳞状上皮内病变或肉瘤等。临床HPV检查多呈阳性,可有p16阳性。随访,1例术后8个月出现肺部转移,现化疗中;另1例随诊1个月,目前无复发、转移。结论宫颈腺样囊性癌是来源于宫颈储备细胞的肿瘤,多与高危型HPV感染有关,p16多呈阳性。具有高度侵袭性,治疗与普通型宫颈鳞状细胞癌相似,根据临床分期采取手术切除加放化疗,预后较差。
Objective To explore the clinical and histopathological features of cervical adenoid cystic carcinoma,and to improve the understanding of pathologists on cervical adenoid cystic carcinoma.Methods A retrospective analysis was conducted in 2 cases of cervical adenoid cystic carcinoma,with detailed review of clinical data and pathological sections.The relevant immunohistochemical results were analyzed,and then the clinical pathological features identified with the statistical analyses,follow-up and review of the literature.Results Two cases of adenoid cystic carcinoma were analyzed:1 typical adenoid cystic carcinoma and the other case with sarcoma.Cervical adenoid cystic carcinoma occured mostly in middle-aged and elderly women.The age of onset was between 24 and 99 years but it was often seen in postmenopausal women.Most cases presented with vaginal bleeding,colposcopy often showed a clear mass.Histologically,the tumor cells grew in a circular island or nest pattern.Most of the tumor cells showed a sieve arrangement.One or two layers of tumor cells formed a small duct structure,and some of the mesh holes contained eosinophilic secretions.There were often fence-like structures around.The tumor might be mixed with other types of lesions,such as squamous cell carcinoma,high-grade squamous intraepithelial lesions or sarcomas.Clinical HPV examination was mostly positive,and there may be positive expression of P16.Telephone follow-up ended in February 2019:one patient had pulmonary metastases 8 months after surgery and then in chemotherapy.Another case was followed up for 1 month,and there was no recurrence or metastasis.Conclusion Cervical adenoid cystic carcinoma is a tumor derived from cervical reserve cells,which is associated with high-risk HPV infection,and P16 is mostly positive.It is highly invasive,and the treatment is similar to common cervical squamous cell carcinoma.According to the clinical stage,surgical resection and radiotherapy are adopted,and the prognosis is poor.
作者
马亚琪
王利群
封琳
刘鹏
刘爱军
MA Ya-qi;WANG Li-qun;FENG Lin;LIU Peng;LIU Ai-jun(Department of Pathology,First Medical Center of China PLA General Hospital,Beijinɡ100853,China)
出处
《诊断病理学杂志》
2019年第10期633-637,共5页
Chinese Journal of Diagnostic Pathology