Zaino R J
Department of Pathology, M.S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Mod Pathol. 2000 Mar;13(3):261-74. doi: 10.1038/modpathol.3880047.
During the past 20 years, pathologists have more carefully examined and more precisely classified glandular lesions of the endocervix, largely reflecting increased concerns about the diagnosis and pathogenesis of adenocarcinoma of the cervix. This review of glandular lesions of the cervix focuses on the following six issues surrounding the histologic diagnosis of the more common types of adenocarcinoma of the endocervix and their mimics: (1) the classification and recognition of preinvasive glandular lesions, (2) the distinction of invasive from preinvasive adenocarcinoma, (3) the definition and significance of microinvasive adenocarcinoma, (4) the epidemiology and pathogenesis of adenocarcinoma, (5) the identification and behavior of the more common subtypes of invasive adenocarcinoma, and (6) the recognition of benign lesions that mimic adenocarcinoma It is the author's opinion that most in situ and invasive adenocarcinomas of the cervix can be recognized and distinguished from benign mimics. In contrast, glandular dysplasia and microinvasive adenocarcinoma of the cervix are currently ill-defined and irreproducible terms that should not be used for diagnostic purposes. Although only brief descriptions of the biologic behavior of the various lesions and their therapy are included in this review, certain variants of endocervical adenocarcinoma have distinctive behaviors and should be classified appropriately to provide prognostication and help to guide therapy.
在过去20年里，病理学家对子宫颈腺性病变进行了更仔细的检查和更精确的分类，这在很大程度上反映出人们对子宫颈腺癌的诊断和发病机制越来越关注。本子宫颈腺性病变综述聚焦于围绕子宫颈内膜常见类型腺癌及其模仿病变的组织学诊断的以下六个问题：（1）浸润前腺性病变的分类与识别；（2）浸润性腺癌与浸润前腺癌的区分；（3）微浸润性腺癌的定义与意义；（4）腺癌的流行病学与发病机制；（5）浸润性腺癌更常见亚型的识别与行为表现；（6）模仿腺癌的良性病变的识别。作者认为，大多数子宫颈原位腺癌和浸润性腺癌能够被识别，并与良性病变区分开来。相比之下，子宫颈腺发育异常和微浸润性腺癌目前定义不明确且无法重复，不应将其用于诊断目的。尽管本综述仅对各种病变的生物学行为及其治疗方法进行了简要描述，但子宫颈内膜腺癌的某些变体具有独特的行为表现，应进行适当分类以提供预后信息并指导治疗。
