子宫颈微偏腺癌临床病理研究.docVIP

子宫颈微偏腺癌临床病理研究摘 要 目的：子宫颈微偏腺癌是女性生殖系统极少见的肿瘤，探讨其临床及病理形态特征、诊断要点、免疫表型特征，以提高诊断的准确性。方法：现报道5例诊断为宫颈微偏腺癌，对其临床病理形态学、免疫表型特征进行观察分析，并探讨其诊断和鉴别诊断。结果：临床主要表现为阴道不规则流血及大量稀黏液性白带，宫颈肥大和糜烂。部分病例合并黑斑息肉综合征、子宫肌瘤或卵巢肿瘤。病理特征为腺体轻度增生，大小不一、形态不规则，有轻度异型性，腺体侵入宫颈壁8mm以上并有特殊间质反应。癌胚抗原有肯定的阳性反应。结论：诊断宫颈微偏腺癌应密切结合临床表现，提出宫颈腺体有无不典型增生，多取材并尽量深取组织(＞5mm)或高频电刀锥切宫颈活检，可早期及时诊断，防止漏诊。 关键词 子宫颈肿瘤 腺癌 诊断 鉴别 免疫组织化学 doi:10.3969/j.issn.1007-614x.2009.09.183 Abstract Objective:Uterine neck micr-unsymmetrical adencarcinoma is exceptional tumor of female reproductive system,We are able to elevate accuratissime of diagnosis for this disease through approaching its clinical and pathomorphologic characteristics,diacrisis highlight,immunologic manifestation feature.Methods we surveied and analyzed clinic,pathomorphologic,immunologic manifestation,diagnosis and antidiastole of five cases.ResultsIts main clinical appearances were vagina anomal bleeding,rheuma leucorrhea,cervical hypertrophy and anabrosis;some cases merged black speck polypus syndrome,hysteromyoma or tumor of the ovary;Its pathologic character was light accrementition of glandular organ with different size,anomal morphous,light heteromorphism,intruding into cervix wall over 8cm and special stromal reaction.And carcino-embryonic antigen had confirmed positive reaction.ConclusionOn diagnosing uterine neck micr-unsymmetrical adencarcinoma,we should marriage clinical manifestation.Proposing cervical gland whether or not has atypical hyperplasia，repeatedly obtaining more sample,deeply (＞5mm)getting tissue,or conically cuttingcervical biopsy by high frequency electro surgical unit,canhelp us diagnose this disease early period and promptly,also prevent missed diagnosis. Key words cervix neoplasm Adenocarcinoma Diagnosis,differential immunohistochemistry 宫颈微偏腺癌(MDAC)是女性生殖系统极为少见的肿瘤，由于分化程度很高，细胞异型性极微，常与子宫颈黏液腺上皮细胞相似，而临床表现为恶性的一种子宫颈腺癌，常被漏诊或误诊。现总结5例子宫颈MDAC临床病理特点，组织化学和免疫表型特征进行观察分析，并探讨其诊断和鉴别诊断。 资料与方法 一般资料：收集我院2003～2007年手术切除的子宫标本，复习原切片和临床病理资料。标本均经10%中性福尔马林固定、石蜡包埋、切片厚4μm，