本文選題：子宮頸腫瘤 + 腺樣基底細(xì)胞癌��； 參考：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2017年01期

【摘要】：目的探討子宮頸腺樣基底細(xì)胞癌的臨床病理特征、診斷、鑒別診斷及預(yù)后特點(diǎn),以提高對(duì)該病的認(rèn)識(shí)及避免過(guò)度治療。方法對(duì)4例子宮頸腺樣基底細(xì)胞癌的臨床及病理資料進(jìn)行回顧性分析,運(yùn)用常規(guī)HE、免疫組化EnVision法染色及原位雜交技術(shù)進(jìn)行檢測(cè),并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 4例子宮頸腺樣基底細(xì)胞癌患者年齡53~67歲,平均61.5歲,4例患者均行全子宮+雙側(cè)附件切除術(shù)。鏡下見(jiàn)癌組織由形態(tài)單一、分化良好的基底樣小細(xì)胞組成,排列成小巢狀或條索狀。癌巢周邊見(jiàn)柵欄狀排列的細(xì)胞核,部分癌巢中央形成囊性腔隙,也可見(jiàn)腺樣或鱗狀分化。4例患者均伴子宮頸上皮內(nèi)病變(cervical intraepithelial neoplasia,CIN)。免疫表型:腫瘤細(xì)胞CK5/6、CK8/18、CK19、p16、p40、p53、BCL-2和p63均陽(yáng)性,ER、CK7、CEA、CD117和S-100均陰性。原位雜交檢測(cè):HPV16/18陽(yáng)性。4例患者隨訪19~62個(gè)月,均未見(jiàn)復(fù)發(fā)及轉(zhuǎn)移。結(jié)論子宮頸腺樣基底細(xì)胞癌屬于罕見(jiàn)但預(yù)后較好的腫瘤,因預(yù)后不同,需與腺樣囊性癌、基底樣鱗狀細(xì)胞癌、神經(jīng)內(nèi)分泌癌及腺鱗癌鑒別。治療可選擇全子宮切除術(shù)或?qū)m頸錐切術(shù),不推薦放、化療。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis, differential diagnosis and prognosis of adenoid basal cell carcinoma of the cervix. Methods the clinical and pathological data of 4 cases of adenoid basal cell carcinoma of the cervix were analyzed retrospectively. The clinical and pathological data were examined by routine hehe immunohistochemical EnVision staining and in situ hybridization. Results the age of 4 patients with adenoid basal cell carcinoma of the cervix was 53 ~ 67 years old, with an average of 61.5 years old. All 4 patients underwent bilateral hysterectomy. Microscopically, the cancerous tissue was composed of single, well-differentiated basal small cells, arranged in nests or stripes. Palisade nuclei were seen around the tumor nests, and cystic lacunae were formed in the center of some of the nests. Adenoid or squamous differentiation was also seen in 4 patients with cervical intraepithelial lesions (cervical intraepithelial neoplasia). Immunophenotypes: tumor cells CK5 / 6 / CK8 / 18 + CK19p16 / p40 p53nBCL-2 and p63 were both positive for ERT CK7 CEA CD117 and S-100 negative. In situ hybridization analysis showed that there was no recurrence or metastasis in 4 cases of HPV16 / 18 positive after 19 ~ 62 months follow-up. Conclusion Adenoid basal cell carcinoma of the cervix is a rare tumor with good prognosis. Because of its different prognosis, it should be distinguished from adenoid cystic carcinoma, basal squamous cell carcinoma, neuroendocrine carcinoma and adenosquamous carcinoma. Total hysterectomy or cervix conization can be selected for treatment. Radiotherapy and chemotherapy are not recommended.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院病理科;
【基金】：湖北省自然基金(2015CFB654)
【分類號(hào)】：R737.33

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