宫颈微偏腺癌16例影像及预后分析

Imaging and prognostic analysis of 16 cases of minimal deviation adenocarcinoma of cervix

目的:探讨宫颈微偏腺癌(MDA)的临床影像特征及预后并分析诊治方法。方法:对我院2006年1月-2012年6月经手术病理证实的16例MDA的完整的临床及随访资料进行回顾性分析。结果:影像学检查:16例术前均行盆腔超声检查,其中8例提示宫颈囊性改变;8例术前行盆腔增强CT检查提示宫颈管增大,其中5例呈多囊蜂窝样改变,增强后可见强化;7例术前行盆腔增强MRI检查均见子宫颈增大,其中6例见子宫颈间质多发、不规则的囊性病灶,静脉注射钆(Gd)后囊肿明显强化。11例获随访,最长存活72个月,最短2.5个月,中位总生存时间为28个月;总的1年、5年生存率分别为81.8%(9/11)和27.3%(3/11),其预后较差。结论:MDA临床上容易误诊,对临床症状可疑病例应高度重视;MRI能最详尽的显示本病特征,是影像学检查的首选,治疗应以根治性手术为主的综合治疗为宜。

Objective: To explore clinical and imaging features,diagnosis and treatment method of minimal deviation adenocarcinoma of cervix( MDA). Methods: The medical records,imaging results and prognosis of 16 patients with MDA were retrospeaiveiy reviewed. Results: Imaging examination results: 16 cases of preoperative patients were performed with pelvic ultrasound examination,of which 8 cases of prompt cervical cystic change,8 cases of preoperative line pelvic enhancement CT examination of the cervical pipe increases,5 cases of polycystic honeycomb- like change,enhanced visible strengthened. 7 cases of preoperative line pelvic enhanced MRI all had cervical increase,among them 6 patients had cervical interstitial multiple,irregular cystic stove,intravenous gadolinium( Gd) after cyst obvious reinforcement. 11 patients had been followed up till death. The median survival time was 2 8 months( range 2. 5 to 72 months). The overall 1 year and 5 years survival rates were 81. 8%( 9 /11) and 27. 3%( 3 /11) respectively. Conclusion: MDA was easily misdiagnosed clinically. For clinical symptoms suspected cases should pay attention,MRI can display the characteristics of the disease,the most detailed imaging examination is the first choice.Radical surgery and adjuvant chemoradietion might be the proper treatment choice.