本文選題：宮頸漿液性腺癌 + 臨床��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析宮頸漿液性腺癌的臨床及病理資料,對(duì)其臨床特點(diǎn)、病理特征、診斷、治療及預(yù)后進(jìn)行分析研究。方法:收集大連醫(yī)科大學(xué)附屬第一醫(yī)院及大連市婦產(chǎn)醫(yī)院1990年1月-2017年1月經(jīng)病理確診的5例宮頸漿液性腺癌臨床及病理資料進(jìn)行回顧性分析。結(jié)果:(1)5例患者中位年齡44歲(41-64歲);(2)臨床表現(xiàn):陰道不規(guī)則流血或接觸性出血(3/5),下腹不適或腰痛1例(1/5),無異常表現(xiàn)1例(1/5);(3)盆腔檢查:宮頸菜花樣腫物或贅生物(3/5)、宮頸糜爛或糜爛樣增生(2/5)。(4)根據(jù)2009年FIGO臨床分期:3例Ib1期,2例Ib2期。(5)治療:5例均接受手術(shù)治療,3例行根治性子宮切除術(shù)及雙附件切除術(shù)及盆腔淋巴結(jié)清掃術(shù),1例行全子宮及雙附件切除術(shù)及盆腔淋巴結(jié)清掃術(shù),1例患者行全子宮切除術(shù);2例行新輔助或術(shù)后化療,1例術(shù)后輔助放療。(6)浸潤(rùn)轉(zhuǎn)移:5例均為Ib期,排除1例未行淋巴結(jié)清掃,宮頸深間質(zhì)浸潤(rùn)者(宮頸1/2)占100%,淋巴脈管間隙浸潤(rùn)者(lymph-vascular space invasion,LVSI)占 100%,盆腔淋巴結(jié)移者占 100%,其中2例行腹主動(dòng)脈旁淋巴結(jié)清掃,均伴有腹主動(dòng)脈旁淋巴結(jié)轉(zhuǎn)移。(7)隨訪:3例獲得隨訪資料,2例失訪,隨訪時(shí)間5-31個(gè)月,1例2年后盆腔復(fù)發(fā),1例術(shù)后9個(gè)月因"廣泛轉(zhuǎn)移"死亡,1例無瘤生存5個(gè)月。結(jié)論:宮頸漿液性腺癌是一類具有高侵襲性的宮頸腺癌亞型,其臨床表現(xiàn)與宮頸癌相似,淋巴結(jié)轉(zhuǎn)移可能是其最早的轉(zhuǎn)移途徑。
[Abstract]:Objective: to retrospectively analyze the clinical and pathological data of cervical serous adenocarcinoma and analyze its clinical features, pathological features, diagnosis, treatment and prognosis. Methods: the clinical and pathological data of 5 cases of cervical serous adenocarcinoma diagnosed from January 1990 to January 2017 in the first affiliated Hospital of Dalian Medical University and Dalian Maternity Hospital were retrospectively analyzed. Results the median age of 5 patients was 44 years old and 41-64 years old.) Clinical manifestations: irregular vaginal bleeding or contact hemorrhage (3 / 5), lower abdomen discomfort or low back pain (1 / 5), no abnormal findings (1 / 1 / 5) pelvic examination: cervix jugular neoplasms or neoplasms 3 / 5, uterus. Cervical erosion or erosive Hyperplasia 2 / 5. 4) according to the 2009 FIGO clinical stage: 3 cases with Ib1 stage 2 cases with Ib2 stage 5 cases were treated with surgery. 3 cases underwent radical hysterectomy, 3 cases underwent double appendage hysterectomy and 1 case underwent pelvic lymph node dissection. Hysterectomy, double appendage resection and pelvic lymph node dissection were performed in 1 patient with total hysterectomy, 2 cases with neoadjuvant or postoperative chemotherapy and 1 case with postoperative adjuvant radiotherapy. One case was excluded from lymph node dissection, 100 cases had deep interstitial invasion (1 / 2 of cervix), 100 cases had lymph-vascular space invasionus (LVSI), and 100 cases had pelvic lymph node metastasis. Two cases were followed up for 5 to 31 months, 1 case with pelvic recurrence 2 months after operation, 1 case died of "extensive metastasis" 9 months after operation, 1 case survived 5 months without aneurysm. Conclusion: cervical serous adenocarcinoma is a highly invasive subtype of cervical adenocarcinoma, and its clinical manifestation is similar to that of cervical carcinoma. Lymph node metastasis may be the earliest way of metastasis.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33

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