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与小叶型宫颈管内腺体增生相关的子宫颈癌。

Uterine cervical carcinomas associated with lobular endocervical glandular hyperplasia.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.

出版信息

Histopathology. 2011 Jul;59(1):55-62. doi: 10.1111/j.1365-2559.2011.03886.x.

Abstract

AIMS

To investigate the clinicopathological features of cervical uterine carcinoma associated with lobular endocervical glandular hyperplasia (LEGH).

METHODS AND RESULTS

Subjects comprised 12 patients with cervical carcinoma associated with LEGH. Carcinoma included nine invasive adenocarcinomas, two adenocarcinoma in-situ (AIS) and one microinvasive squamous cell carcinoma (SCC). Baseline characteristics, cervical cytology, human papilloma virus (HPV) status, immunohistochemistry, surgical procedures and clinical outcomes were investigated. There was a pair of adenocarcinoma cases in a mother and daughter unrelated to Peutz-Jeghers syndrome. In all patients, atypical cells were seen on cervical cytology (adenocarcinoma cells in 11 cases and SCC cells in one). All the 12 patients were positive for mucin antigen 6 (MUC6) in the LEGH component, while seven patients were positive for gastric mucin (HIK1083). HPV was detected only in the SCC component. One patient with adenocarcinoma stage Ib died of disease 4 years after radical hysterectomy. The others are currently alive 2-16 years postoperatively.

CONCLUSIONS

The diagnosis of adenocarcinoma with LEGH is not always difficult. The prognosis of adenocarcinoma associated with LEGH may be better than previously expected. Adenocarcinoma with a LEGH component does not always develop into a highly aggressive minimal deviation adenocarcinoma.

摘要

目的

研究与宫颈子宫内膜型腺管增生(LEGH)相关的宫颈子宫体癌的临床病理特征。

方法与结果

研究对象包括 12 例与 LEGH 相关的宫颈癌患者。癌包括 9 例浸润性腺癌、2 例原位腺癌(AIS)和 1 例微浸润鳞状细胞癌(SCC)。调查了基线特征、宫颈细胞学、人乳头瘤病毒(HPV)状态、免疫组织化学、手术程序和临床结果。有一对母女与 Peutz-Jeghers 综合征无关的腺癌病例。在所有患者中,宫颈细胞学检查均可见异型细胞(11 例腺癌细胞和 1 例 SCC 细胞)。所有 12 例 LEGH 成分中的 MUC6 阳性,7 例 HIK1083 阳性。仅在 SCC 成分中检测到 HPV。1 例 Ib 期腺癌患者在根治性子宫切除术后 4 年内死于疾病。其他患者目前术后 2-16 年仍存活。

结论

LEGH 相关腺癌的诊断并不总是困难的。与 LEGH 相关的腺癌的预后可能比预期的要好。具有 LEGH 成分的腺癌并不总是发展为高度侵袭性的微小偏差腺癌。

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