原发性子宫颈透明细胞腺癌32例临床病理分析

Primary clear cell adenocarcinoma of the uterine cervix:a clinicopathological analysis of 32 patients

目的探讨原发性子宫颈透明细胞腺癌(PCCAC)的临床病理特征及预后。方法收集2013年1月至2023年1月山东大学齐鲁医院收治的PCCAC患者32例,分析其临床病理特点,通过log-rank检验探索患者生存的相关影响因素。结果32例患者中位年龄48岁,均接受子宫切除术+盆腔淋巴结切除术,其中5例保留单侧/双侧卵巢。中位随访时间45个月(1~116个月),1例失访,3例因疾病复发转移引起多器官功能衰竭死亡,1例术后复发经综合治疗预后良好,其余患者随访过程中未见复发和转移。log-rank检验提示,年龄>50岁、已绝经、内生型/颈管型以及宫体受累与较差的预后相关(P<0.05)。结论年龄>50岁、已绝经、内生型/颈管型以及宫体受累可能是影响PCCAC患者生存的预后因素,保留卵巢与否似并不影响患者预后。

Objective To investigate the clinical and pathological features and prognosis of primary clear cell adenocarcinoma of the uterine cervix(PCCAC).Methods Thirty-two patients diagnosed with PCCAC and treated at Qilu Hospital of Shandong University from January 2013 to January 2023 were collected,their clinical and pathological characteristics were analyzed,and the Log-rank test was performed to explore factors associated with patient survival.Results The median age of the thirty-two patients was 48 years.All patients underwent hysterectomy and pelvic lymphadenectomy,and the unilateral or bilateral ovaries were preserved in 5 cases.The median follow-up was 45 months(ranging,1-116 months),1 case was lost to followup,3 patients died of multiple organ dysfunction syndrome due to recurrence and metastasis,and 1 patient recurred but the prognosis was good after comprehensive treatment;no recurrence or metastasis was found in the follow-up of the remaining patients.Log-rank test showed that age>50 years,menopause,endogenous or cervical canal type and corpus uteri invasion were associated with worse prognosis(P<0.05).Conclusion Age>50 years,menopause,endogenous or cervical canal type and corpus uteri invasion may be prognostic factors for survival of PCCAC patients.Ovarian preservation does not seem to affect the prognosis of patients.