对19例宫颈胃型腺癌病例的临床分析

Clinical analysis of 19 cases of cervical gastric adenocarcinoma

目的:探讨宫颈胃型腺癌的临床表现、病理特点、诊治及预后情况。方法:回顾性分析2016年1月至2020年12月山东大学齐鲁医院妇产科收治的宫颈胃型腺癌患者的临床、病理及随访资料。结果:患者的临床症状主要表现为不规则阴道流血、接触性出血和阴道流液;其中ⅠA期1例,ⅠB期11例,ⅢC1期5例,Ⅳ期2例。2例行新辅助化疗+术后同步放化疗,11例术后行同步放化疗,4例行术后化疗,2例未行化疗;17人完成随访,其中13人随访0.5~5年无瘤生存至今,1例术后1年发现卵巢、腹膜转移,行肿瘤减灭术+化疗存活至今,3例随访3~6个月因本病死亡。结论:宫颈胃型腺癌临床少见,临床表现缺乏特异性,易误诊、漏诊。其侵袭性强,易复发转移,提高诊断水平是改善预后的关键。

Objective:To investigate the clinical manifestations,pathological features,diagnosis,treatment and prognosis of cervical gastric adenocarcinoma.Methods:The clinical,pathological and follow-up data of patients with cervical and gastric adenocarcinoma admitted to the Department of Obstetrics and Gynecology of Shandong University Qilu Hospital from January 2016 to December 2020 were retrospectively analyzed.Results:The main clinical symptoms of the patients were irregular vaginal bleeding,contact bleeding and vaginal fluid.There were 1 case of stageⅠA,11 cases of stageⅠB,5 cases of stageⅢC1 and 2 cases of stageⅣ.2 patients received neoadjuvant chemotherapy+postoperative concurrent chemoradiotherapy,11 patients received postoperative concurrent chemoradiotherapy,4 patients received postoperative chemotherapy,2 patients did not receive chemotherapy;17 patients were followed up and 13 of them were free of tumor for 0.5 to 5 years.One patient was found to have ovarian and peritoneal metastases 1 year after surgery and survived after tumor reduction and chemotherapy.Three patients died of this disease after 3 to 6 months of follow-up.Conclusion:Cervical gastric adenocarcinoma is rare in clinic,the clinical manifestations lack specificity,easy misdiagnosis,missed diagnosis.It is highly invasive and easy to relapse and metast asize.Improving the diagnostic level is the key to improve the prognosis.