宫颈乳头状鳞状细胞癌18例临床病理分析

Clinical and pathological analysis of 18 cases of cervical papillary squamous cell carcinoma

目的提高对宫颈乳头状鳞状细胞癌(papillary squamous cell carcinoma,PSCC)的认识,为该病的诊断及治疗策略的选择提供依据。方法收集2015年1月至2021年12月唐山市工人医院18例术前宫颈活检诊断为PSCC患者的临床病理及随访资料,分析术前活检、液基细胞、人乳头瘤病毒(human papilloma virus,HPV)感染与术后病理以及预后的相关性。结果术前活检与术后病理一致率为50%(9/18)。9例术后诊断为PSCC患者中,有4例患者液基细胞呈现出PSCC特征,HPV感染率为44.4%(4/9),国际妇产科联盟分期为ⅠA1~ⅠB1期,所有患者均未出现淋巴结转移、复发及死亡。结论宫颈术前活检对PSCC的诊断具有一定局限性,需要术后病理明确诊断,PSCC患者HPV感染率较低、分期较早、预后较好,部分患者可以选择比根治性手术创伤性更小的手术方法。

Objective To improve the understanding of cervical papillary squamous cell carcinoma(PSCC),and to provide evidence for the diagnosis and treatment of PSCC.Methods The clinicopathological and follow-up data of 18 patients diagnosed PSCC by preoperative cervical biopsy in Tangshan Gongren hospital were collected,the correlation of preoperative biopsy,liquid-based cells,and human papilloma virus(HPV)with postoperative pathology and prognosis was analyzed.Results The concordance rate between preoperative biopsy and postoperative pathology was 50%(9/18).4 patients showed the characteristic features of PSCC in their liquid-based cells of the 9 patients who were diagnosed as PSCC postoperatively(4/9),the HPV infection rate was 44.4%(4/9),the International Federation of Gynecology and Obstetrics stage were ⅠA1-ⅠB1,no lymph node metastasis,recurrence or death occurred in all patients.Conclusions Cervical biopsy before operation has certain limitations in the diagnosis of PSCC,which requires a clear diagnosis by postoperative pathology.The HPV infection rate is lower,the stage is earlier and the prognosis is better in PSCC.Some patients can choose a less invasive surgical method than radical surgery.