宫颈不典型腺细胞18例液基细胞学观察

Cervical atypical glandular cells in liquid-based specimens:a cytological investigation of 18 cases

目的探讨宫颈不典型腺细胞(atypical glandular cells,AGC)的临床意义及其在液基涂片中的细胞学特征及鉴别诊断。方法对成都市第一人民医院病理科2013年1月至2014年1月判读为AGC的18例液基涂片进行回顾观察并与组织学对照,分析其诊断要点。结果 18例中不典型腺细胞,非特异检出9例(50%);不典型腺细胞,子宫内膜腺起源,检出2例(11%);不典型腺细胞,倾向瘤变检出7例,(39%)。组织学检查结果包括炎症5例、CIN累腺6例、宫颈腺癌2例、子宫内膜增生3例、子宫内膜腺癌1例,输卵管腺癌1例。其中,组织学良性8例(44%),癌前病变及癌10例(56%)。结论宫颈AGC含有较多高级别的癌前病变及癌,来自鳞状上皮内病变及良性病变(如增生子宫内膜)的细胞可以呈现非典型腺细胞的特征。

Objective To explore the clinical significance of cervical atypical glandular cells（AGC） and investigate the cytological characteristics in liquid-based specimens（LBP） and differential diagnosis of AGC.Methods Biopsy data of 18 cases who were diagnosed as AGC among 10121 cases in LBP at the pathology department of Chengdu NO.1 People＇s Hospital from January,2013 to January,2014 were retrospectively reviewed.Results The subtype AGC-NOS,AGC-EM and AGC-FN were 9（50%）,2（11%） and 7（39%）,respectively.Among18 AGC,the histo-pathological results were as follows：5 cases were inflammation,6 cases were CIN involving endocervical glands,2 cases were cervical adenocarcinoma,3 cases were endometrial hyperplasia,1 case was endometrial carcinoma and 1 case was adenocarcinoma of fallopian tube.The benign lesions were 8（44%）,while the premalignt or underlying malignant lesions were 10（56%）.Conclusion AGC represents a cytological diagnosis associated with high incidence of premalignant or underlying malignant lesions.Cells derived from CIN or some benign lesions such as endometrial hyperplasia can mimic AGC.