子宫颈胃型腺癌7例临床病理学分析

Gastric-type adenocarcinoma of uterine cervix: a clinicopathological analysis of seven cases

目的探讨子宫颈胃型腺癌(GAC)的临床特征、组织学特点、免疫组化表型、诊断及鉴别诊断。方法回顾性分析7例GAC的临床病理特点,并复习相关文献。结果7例患者发病年龄34~66岁,平均年龄44岁。临床均表现为阴道接触性出血和/或不规则流血。组织学上GAC形态多样,多为高至中分化腺癌,细胞边界清楚,常见少量杯状细胞。免疫组化:肿瘤细胞不同程度MUC-6、CDX2、CEA、CK7和PAX8(+),而ER、PR、p16、p53常(-)。患者随访6~64个月,1例死亡,5例未出现复发,1例失访。结论胃型宫颈腺癌是宫颈腺癌的一种少见亚型,好发于中年女性,临床表现缺乏特异性,组织学形态多样,免疫组化有助于诊断和鉴别诊断。

Objective To investigate the clinicopathological features,histological characteristics,immunohistochemical phenotype of gastric-type adenocarcinoma(GAC)of the uterine cervix,with emphasis on diagnosis and differential diagnosis.Methods The clinicopathological manifestations of 7 endocervical GAC patients were analyzed,the literatures were also reviewed.Results The age of 7 patients ranged from 34 to 66 years,with an average age of 44 years.Clinically,all the 7 patients showed vaginal contact bleeding and/or irregular bleeding.Histologically,endocervical GAC was highly to moderately differentiated adenocarcinomas with clear cell boundaries and a small number of goblet cells.Immunohistochemical staining showed positive reactivity to MUC-6,CDX2,CEA,CK7,PAX8,but negative for ER,PR,p16 and p53.During follow-up from 6 to 64 months,1 patient died,5 patients did not recur and 1 patient was lost.Conclusion GAC is a rare subtype of cervical adenocarcinoma.It is predominant in middle-aged women.Its clinical manifestations are lack of specificity,and its histological morphology is diverse.Immunohistochemistry is helpful in the diagnosis and differential diagnosis of GAC.