宫颈腺肉瘤11例回顾性分析

Retrospective Analysis of 11 Cases of Cervical Adenosarcoma

目的探讨宫颈腺肉瘤(cervical adenosarcoma)的临床特点、诊断及治疗。方法回顾性分析2013年1月—2019年1月在福建省肿瘤医院收治宫颈腺肉瘤患者的临床资料病史特征、治疗手段及随访情况。结果共11例宫颈腺肉瘤患者,中位年龄49岁,Ⅰ期7例(63.63%),Ⅱ期2例(18.18%),Ⅲ期2例(18.18%),Ⅳ期0例。7例行HPV检测,其中1例HPV 16型阳性;8例行子宫颈细胞学检查,其中6例阳性。可伴有CA199、CA125等肿瘤标记物的异常升高,其中1例首次报道CEA异常升高。病理方面,1例伴有肉瘤成分过度生长,2例合并脉管癌栓,1例伴有宫颈高级别鳞状上皮内病变;免疫组化方面,3例ER阳性;4例PR阳性。治疗方面,8例进行了手术治疗,其中术后2例接受辅助放疗+辅助化疗4疗程,1例接受辅助化疗4疗程,1例接受内分泌治疗,4例未行术后辅助治疗。10例患者完成随访,中位随访时间65个月,1例复发,1例死亡,8例未复发。结论宫颈腺肉瘤首发症状常为宫颈息肉样肿物,易被临床医生忽视。确诊后建议首选手术治疗,预后大多良好,但须重视终身随访以排除远期复发。

Objective To investigate the clinical features,diagnosis and treatment of cervical adenosarcoma.Methods to retrospectively analyze the clinical data of patients with cervical adenosarcoma admitted to the Fujian Provincial Cancer Hospital from January 2013 to January 2019 Medical history characteristics,treatment methods and follow-up status.Results A total of 11 patients with cervical adenosarcoma,with a median age of 49 years,stageⅠ7 cases(63.63%),stageⅡ2 cases(18.18%),stageⅢ2 cases(18.18%),and stageⅣ0.7 cases were tested for HPV,of which 1 case was positive for HPV 16,8 cases of cervical cytology were examined,of which 6 cases were positive.It may be accompanied by abnormal elevation of CA199,CA125 and other tumor markers.1 case reported abnormal elevation of CEA for the first time.Pathologically,1 case was accompanied by overgrowth of sarcoma components,2 cases were accompanied by vascular tumor thrombus,and 1 case was accompanied by high-grade squamous intraepithelial lesions of the cervix.In terms of immunohistochemistry,3 cases were positive for ER and 4 cases were positive for PR.In terms of treatment,8 cases underwent surgical treatment,of which 2 cases received 4 courses of adjuvant radiotherapy+adjuvant chemotherapy,1 case received 4 courses of adjuvant chemotherapy,1 case received endocrine therapy,and 4 cases did not receive postoperative adjuvant therapy.10 patients completed the follow-up,with a median follow-up time of 65 months,1 case relapsed,1 case died,and 8 cases did not relapse.Conclusion The first symptom of cervical adenosarcoma is usually cervical polypoid mass,which is easy to be ignored by clinicians.Surgical treatment is recommended after diagnosis,and the prognosis is mostly good,but lifelong follow-up must be paid attention to to rule out long-term recurrence.