子宫颈腺样基底细胞癌4例临床病理观察

发布时间：2018-04-25 05:04

本文选题：子宫颈肿瘤 + 腺样基底细胞癌　；参考：《临床与实验病理学杂志》2017年01期

【摘要】：目的探讨子宫颈腺样基底细胞癌的临床病理特征、诊断、鉴别诊断及预后特点,以提高对该病的认识及避免过度治疗。方法对4例子宫颈腺样基底细胞癌的临床及病理资料进行回顾性分析,运用常规HE、免疫组化EnVision法染色及原位杂交技术进行检测,并复习相关文献。结果 4例子宫颈腺样基底细胞癌患者年龄53~67岁,平均61.5岁,4例患者均行全子宫+双侧附件切除术。镜下见癌组织由形态单一、分化良好的基底样小细胞组成,排列成小巢状或条索状。癌巢周边见栅栏状排列的细胞核,部分癌巢中央形成囊性腔隙,也可见腺样或鳞状分化。4例患者均伴子宫颈上皮内病变(cervical intraepithelial neoplasia,CIN)。免疫表型:肿瘤细胞CK5/6、CK8/18、CK19、p16、p40、p53、BCL-2和p63均阳性,ER、CK7、CEA、CD117和S-100均阴性。原位杂交检测:HPV16/18阳性。4例患者随访19~62个月,均未见复发及转移。结论子宫颈腺样基底细胞癌属于罕见但预后较好的肿瘤,因预后不同,需与腺样囊性癌、基底样鳞状细胞癌、神经内分泌癌及腺鳞癌鉴别。治疗可选择全子宫切除术或宫颈锥切术,不推荐放、化疗。
[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.
【作者单位】：华中科技大学同济医学院附属协和医院病理科;
【基金】：湖北省自然基金(2015CFB654)
【分类号】：R737.33

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