BACKGROUND Minimal deviation adenocarcinoma is a rare malignancy with a high rate of misdiagnosis and high aggressiveness,and its diagnosis relies on histopathology.Surgical resection is the preferred and most effecti...BACKGROUND Minimal deviation adenocarcinoma is a rare malignancy with a high rate of misdiagnosis and high aggressiveness,and its diagnosis relies on histopathology.Surgical resection is the preferred and most effective treatment,but the outcomes are often unsatisfactory.CASE SUMMARY A 60-year-old perimenopausal woman was admitted to the hospital and found to have elevated CA19-9 on physical examination without abdominal pain or vaginal bleeding.Clinical examination and positron emission tomography/computed tomography examination were unremarkable,magnetic resonance imaging examination was suggestive of dominant cervical lesions,and methylation examination was suggestive of malignant lesions.Tissue samples were taken from the suspected cervical lesion,and the final pathologic diagnosis was minimal deviation adenocarcinoma.Based on the pathologic diagnosis of suspected minimal deviation adenocarcinoma,radical abdominal total hysterectomy,bilateral oophorectomy,and pelvic and para-aortic lymph node dissection were performed.The final histological report confirmed minimal deviation adenocarcinoma of the cervix,stage IB2,with lymph node metastasis.Minimal deviation adenocarcinoma is a tumor with aggressive clinical behavior.CONCLUSION Patients with minimal deviation adenocarcinoma have a lower survival rate than patients with conventional human papillomavirus-related cervical adenocarcinoma.A precise preoperative pathologic diagnosis may reduce the mortality rate due to missed optimal treatment with multiple surgical interventions.To date,there is no therapeutic consensus;therefore,each case must be treated individually.展开更多
背景与目的:宫颈微偏腺癌(minimal deviation adenocarcinoma of cervix,MDA)是一种罕见疾病,误诊率较高,尚无规范的治疗方法。本研究旨在分析总结MDA的临床病理特点,以提高对该病的认识。方法:回顾性分析中山大学附属第二医院1991年1月...背景与目的:宫颈微偏腺癌(minimal deviation adenocarcinoma of cervix,MDA)是一种罕见疾病,误诊率较高,尚无规范的治疗方法。本研究旨在分析总结MDA的临床病理特点,以提高对该病的认识。方法:回顾性分析中山大学附属第二医院1991年1月至2006年12月诊治的5例MDA患者的临床病理资料。结果:5例患者的中位年龄47岁(38～59岁)。主要临床表现为大量稀薄粘液性白带、阴道不规则出血等。MDA在组织学上表现为腺体分化好,镜下难与宫颈内膜的正常腺体相区别,但浸润深度超过正常宫颈腺体的深度。免疫组化示2例患者癌胚抗原(CEA)和P53阳性。4例患者接受手术治疗,其中手术+放疗1例,手术+化疗+放疗3例;1例不能手术的患者接受了姑息性放疗。随访6～88个月,无失访病例,2例无瘤生存的患者中有1例无瘤生存时间超过5年,3例死于肿瘤复发转移。结论:MDA的诊断主要依靠临床表现和腺体浸润深度超过正常宫颈腺体深度的病理特点,以手术为主的综合治疗可能是治疗MDA的较好方法。展开更多
目的:探讨不同肿瘤标记物的表达在宫颈微偏腺癌(minimal deviation adenocarcinoma,MDA)与普通宫颈腺癌(adenocarcinoma of the uterine cervix,AUC)鉴别诊断中的意义。方法:收集2001年7月至2013年6月间于中国医科大学附属盛京医院、沈...目的:探讨不同肿瘤标记物的表达在宫颈微偏腺癌(minimal deviation adenocarcinoma,MDA)与普通宫颈腺癌(adenocarcinoma of the uterine cervix,AUC)鉴别诊断中的意义。方法:收集2001年7月至2013年6月间于中国医科大学附属盛京医院、沈阳市妇婴医院、辽宁省肿瘤医院妇科病房进行手术治疗的19例MDA、同期的50例普通AUC(分化程度:高分化16例,中分化20例,低分化14例)病理标本,采用免疫组化的方法检测Ki67、SMA、p53、PCNA、Vimentin、CEA、ER、CA125和PR的表达。结果:MDA中p53和大于50%细胞核染Ki67(Ki67/50+)的阳性率分别是84%和68%,明显高于普通AUC(分别是38%和18%,P<0.01),MDA中CA 125的阳性率为21%,明显低于普通AUC中的58%(P<0.01)。CEA、PR、Vimentin、ER、PCNA和SMA在两组比较中没有差异(P>0.05)。所有标记物的表达在普通AUC的高、中、低分化组别中没有明显差异(P>0.05)。结论:p53和Ki67/50+的阳性表达及CA125的阴性表达有助于MDA与普通AUC的鉴别,从而有利于MDA的早期诊断及治疗。展开更多
文摘BACKGROUND Minimal deviation adenocarcinoma is a rare malignancy with a high rate of misdiagnosis and high aggressiveness,and its diagnosis relies on histopathology.Surgical resection is the preferred and most effective treatment,but the outcomes are often unsatisfactory.CASE SUMMARY A 60-year-old perimenopausal woman was admitted to the hospital and found to have elevated CA19-9 on physical examination without abdominal pain or vaginal bleeding.Clinical examination and positron emission tomography/computed tomography examination were unremarkable,magnetic resonance imaging examination was suggestive of dominant cervical lesions,and methylation examination was suggestive of malignant lesions.Tissue samples were taken from the suspected cervical lesion,and the final pathologic diagnosis was minimal deviation adenocarcinoma.Based on the pathologic diagnosis of suspected minimal deviation adenocarcinoma,radical abdominal total hysterectomy,bilateral oophorectomy,and pelvic and para-aortic lymph node dissection were performed.The final histological report confirmed minimal deviation adenocarcinoma of the cervix,stage IB2,with lymph node metastasis.Minimal deviation adenocarcinoma is a tumor with aggressive clinical behavior.CONCLUSION Patients with minimal deviation adenocarcinoma have a lower survival rate than patients with conventional human papillomavirus-related cervical adenocarcinoma.A precise preoperative pathologic diagnosis may reduce the mortality rate due to missed optimal treatment with multiple surgical interventions.To date,there is no therapeutic consensus;therefore,each case must be treated individually.
文摘背景与目的:宫颈微偏腺癌(minimal deviation adenocarcinoma of cervix,MDA)是一种罕见疾病,误诊率较高,尚无规范的治疗方法。本研究旨在分析总结MDA的临床病理特点,以提高对该病的认识。方法:回顾性分析中山大学附属第二医院1991年1月至2006年12月诊治的5例MDA患者的临床病理资料。结果:5例患者的中位年龄47岁(38～59岁)。主要临床表现为大量稀薄粘液性白带、阴道不规则出血等。MDA在组织学上表现为腺体分化好,镜下难与宫颈内膜的正常腺体相区别,但浸润深度超过正常宫颈腺体的深度。免疫组化示2例患者癌胚抗原(CEA)和P53阳性。4例患者接受手术治疗,其中手术+放疗1例,手术+化疗+放疗3例;1例不能手术的患者接受了姑息性放疗。随访6～88个月,无失访病例,2例无瘤生存的患者中有1例无瘤生存时间超过5年,3例死于肿瘤复发转移。结论:MDA的诊断主要依靠临床表现和腺体浸润深度超过正常宫颈腺体深度的病理特点,以手术为主的综合治疗可能是治疗MDA的较好方法。
文摘目的:探讨不同肿瘤标记物的表达在宫颈微偏腺癌(minimal deviation adenocarcinoma,MDA)与普通宫颈腺癌(adenocarcinoma of the uterine cervix,AUC)鉴别诊断中的意义。方法:收集2001年7月至2013年6月间于中国医科大学附属盛京医院、沈阳市妇婴医院、辽宁省肿瘤医院妇科病房进行手术治疗的19例MDA、同期的50例普通AUC(分化程度:高分化16例,中分化20例,低分化14例)病理标本,采用免疫组化的方法检测Ki67、SMA、p53、PCNA、Vimentin、CEA、ER、CA125和PR的表达。结果:MDA中p53和大于50%细胞核染Ki67(Ki67/50+)的阳性率分别是84%和68%,明显高于普通AUC(分别是38%和18%,P<0.01),MDA中CA 125的阳性率为21%,明显低于普通AUC中的58%(P<0.01)。CEA、PR、Vimentin、ER、PCNA和SMA在两组比较中没有差异(P>0.05)。所有标记物的表达在普通AUC的高、中、低分化组别中没有明显差异(P>0.05)。结论:p53和Ki67/50+的阳性表达及CA125的阴性表达有助于MDA与普通AUC的鉴别,从而有利于MDA的早期诊断及治疗。
