宫颈绒毛状腺癌临床病理分析

Villoglandular Carcinoma of Cervix:A Clinicopathological Analysis

目的探讨宫颈绒毛状腺癌的临床病理学特征、诊断及鉴别诊断。方法 2010年4月6日收治1例34岁宫颈绒毛状腺癌患者,观察分析宫颈绒毛状腺癌的临床病理学特征、诊断及鉴别诊断。结果肿物大体呈菜花状生长,肿瘤组织形态相似于结直肠的管状绒毛状腺瘤,由绒毛腺管状的分支乳头构成,乳头表面被覆细胞形态温和,呈假复层或复层柱状排列,核分裂像少见。免疫表型:肿瘤细胞癌胚抗原、CK7和CA125阳性表达,雌激素受体、孕激素受体、P16、p53和波形蛋白均阴性表达。患者随访时间48个月,未见复发和转移。结论宫颈绒毛状腺癌罕见,预后较好,其诊断主要依赖组织病理学,需与伴有乳头状生长特点的其他良性肿瘤和恶性肿瘤鉴别。

Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of villoglandular carcinoma of the uterine cervix. Methods The clinical data of a 34-year-old patient diagnosed with villoglandular carcinoma of cervix on April 6, 2010 was retrospectively analyzed. Surgical excision samples were analyzed by means of hematoxylin-eosin and immunohistochemical staining. Results The gross appearance of the tumor mass showed cauliflower-like pattern of growth. Histologically, it was similar to colorectal villoglandular adenoma, and was composed of branching papillae shaped like villous glandular tube structure, and the surface was coated with pseudostratified or stratified columnar cells which showed mild atypia and uncommon mitotic figures. Immunohistochemically, tumor cells were positive for carcinoma embryonic antigen, CK7 and CA125, and negative for estrogen receptor, progesterone receptor, P16, p53 and vimentin. This patient was subjected to a follow-up of 48 months, and was alive without recurrence or metastasis. Conclusions Vflloglandular carcinoma of the uterine cervix is rare and has a favorable prognosis. The diagnosis of villoglandular carcinoma depends on pathological morphology, and meanwhile, it is necessary to distinguish villoglandular carcinoma from other benign and malignant tumors which exhibited papillary growth pattern.