上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

子宫颈黏液腺癌35例临床病理分析

朱梅娟，陈 婕，刘瑞旭   

  1. 上海市嘉定区妇幼保健医院病理科， 上海 201822
  • 出版日期:2014-01-28 发布日期:2014-01-29
  • 作者简介:朱梅娟（1967—）， 女， 主治医师， 学士; 电子信箱: abcdef1313@163.com。

Clinicopathologic analysis of 35 cases of cervical mucinous adenocarcinoma

ZHU Mei-juan, CHEN Jie, LIU Rui-xu   

  1. Department of Pathology, Jiading Maternal and Child Health Hospital, Shanghai 201800, China
  • Online:2014-01-28 Published:2014-01-29

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摘要：

目的 探讨宫颈黏液腺癌的临床病理特点，为其诊断、治疗及预后判断提供参考。方法 回顾性分析35例宫颈黏液腺癌患者的临床病理资料与病理诊断过程，采用免疫组织化学SP法检测人乳头瘤病毒（HPV）及癌胚抗原（CEA）的表达。结果 35例宫颈黏液腺癌患者中，32例为宫颈管型，2例为微小偏离型，1例为绒毛腺型。宫颈细胞学检查阳性率为42.9%（15/35）。漏诊4例，其中1例宫颈涂片漏诊，1例宫颈活检漏诊，2例宫颈活检正常，宫颈活检见异形腺细胞，经宫颈锥切确诊为宫颈浸润性黏液腺癌。免疫组织化学染色结果显示，35例病例中，26例（74.3%）CEA表达阳性，14例（40.0%）HPV表达阳性，其中8例伴有鳞状上皮病变。结论 宫颈细胞学检查对宫颈黏液腺癌的诊断有一定意义；宫颈黏液腺癌早期容易漏诊，宫颈组织大块切除活检、诊断性锥切有助于诊断。

关键词: 宫颈黏液腺癌, 病理诊断, 临床特征, 漏诊

Abstract:

Objective To analyze the clinicopathologic features of cervical mucinous adenocarcinoma in order to provide reference for its diagnosis, treatment, and prognosis. Methods The clinical and pathological manifestations of 35 patients with cervical mucinous adenocarcinoma were retrospectively analyzed. The expressions of human papilloma virus and carcino-embryonic antigen were detected by using SP immunohistochemical method. Results Among 35 cases, 32 were endocervical type, 2, minimal deviation; and 2, villoglandular. The positive rate of cervical cytology was 42.9% (15/35). Missed diagnosis was found in 4 cases. One case was missed in cervical smears; 1, cervical biopsy diagnosis; and 2, abnormal gland cells in cervical biopsy. The 2 with abnormal gland cells were diagnosed as cervical invasive adenocarcinoma by loopelectrosurgical excision procedure. Immunohistochemical staining results showed that 26 had positive expressions of carcinoembryonic antigen （26/35, 74.3%）, and 14 had positive expressions of human papilloma virus (14/35, 40.0%). Among the 14 patients, 8 had squamous intraepithelial lesions. Conclusion Cervical cytological test is effective in the diagnosis of cervical mucinous adenocarcinoma. Early stage cervical mucinous adenocarcinoma is difficult to be detected. Cervical excisional biopsy and endocervical curettage are beneficial to its diagnosis.

Key words: cervical mucinous adenocarcinoma, pathological diagnosis, clinical characteristics, missed diagnosis