宫颈微偏腺癌临床及病理特征-附8例分析

Clinical and pathologic characteristics of minimal deviationadenocarcinoma of the cervix:analysis of 8 cases

目的 探讨宫颈微偏腺癌的临床特征、诊断、治疗及预后。方法 回顾性分析了我院 1982年～ 1992年治疗的 8例宫颈微偏腺癌患者的临床和病理资料。结果 本组病例占同期宫颈腺癌的 3 9% ,8例患者平均年龄 4 6 8岁 ,临床症状 :稀粘液性白带增多 1例 ,不规则阴道出血 4例 ,以上两种症状兼有 3例。临床分期 ,Ⅰ期 2例 ,Ⅱ期 2例 ,Ⅲ期 4例。本组病例均经病理确诊 ,其中 4例行手术 +放疗 +化疗 ,1例患者手术 +放疗。 3例放疗 +化疗。随访 ,3例无瘤生存 6～ 12年 ,5例存活 11～ 39个月。结论 宫颈微偏腺癌扩散早 ,预后差 ,早期发现及综合治疗可改善其预后 ,在临床及病理诊断上应与重度宫颈炎症及腺体增生鉴别。

Objective To study the clinical characteristics,diagnosis,treatment and prognostic factors of the minima deviation adenocarcinoma of the cervix.Methods During 1982～1994,a total of 8 patients with minimal deviation adenocarinoma of the cervix were retrospectively analyzed.Results This group was 3.9% of cervical adenocarcinoma in the same period.The average age was 46.8 years.Two of the cases were at stage Ⅰ,2 stage Ⅱ and 4 stage Ⅲ.Four patients presented irregular vaginal bleeding,one increased vaginal discharge and three both of the symptoms.All patients were diagnosed by pathologic examination.Four patients were subjected to operation with adjuvant radiotherapy and chemotherapy,one operation with adjuvant radiotherapy,and three radiotherapy and chemotherapy.After 11 months to 12 years follow-up,three patients were tumor-free survival for 6～12 years.Five patients died in 11～39 months.Conclusions The minimal deviation adenocarcinoma of cervix is prone to metastasis in early stage with poor prognosis.Early diagnosis and combinative treatment may improve prognosis.