Zhu Xiaqin, Wu Ming, Tan Xianjie, Yu Qi
Department of Obstetrics & Gynecology, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Obstetrics & Gynecology, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China. Email:
Zhonghua Yi Xue Za Zhi. 2015 Feb 17;95(7):519-22.
To explore the clinicopathologic features, managements and outcomes of villoglandular adenocarcinoma (VA) of uterine cervix.
From June 2009 to January 2014, a total of 16 cases of VA were reviewed retrospectively.
Their mean age was 41.4 (30-56) years. The major symptoms were post-coital hemorrhage or abnormal vaginal hemorrhage (10/16). And the International Federation of Gynecology and Obstetrics (FIGO) stages were Ia1 (n = 1),Ib1 (n = 12),Ib2 (n = 2) and IIa1 (n = 1).One patient of Ia1 stage underwent laparoscopic total hysterectomy and bilateral salpingo-oophorectomy (BSO) after conization; one patient of Ib1 stage total abdominal hysterectomy and BSO after radiotherapy and concurrent chemotherapy while another one of Ib1 stage radical vaginal trachelectomy; one pregnancy-associated patient of Ib1 stage was diagnosed at 12 weeks' gestation and underwent cesarean radical hysterectomy plus pelvic lymphadenectomy after four courses of chemotherapy. Aand the remainder underwent radical hysterectomy plus pelvic lymphadenectomy.None of 14 cases with a known status of lymph node status had positive nodes. And 1/13 cases undergoing ovariectomy had pathologically confirmed cervical cancer metastasis of ovarian surface and the remainder and another patient of ovarian biopsy had negative results for lymph nodes. The median follow-up period was 23.3 (5-60) months. All patients survived and there was one recurrent case of vaginal stump mass at 8 months after initial surgery. The overall and disease-free 5-year survival was 100% and 94% (15/16) respectively.
VA mainly affects younger women and prognosis is generally fair with a lower rate of ovarian metastasis compared to common forms of cervical cancer. Due to a limited sample size and clinical data are studied retrospectively, multi-center prospective studies are warranted for a better understand of this disease.
探讨宫颈绒毛腺管状腺癌(VA)的临床病理特征、治疗方法及预后。
回顾性分析2009年6月至2014年1月间收治的16例VA患者的临床资料。
患者平均年龄41.4岁(30 - 56岁)。主要症状为性交后出血或阴道不规则出血(10/16)。国际妇产科联盟(FIGO)分期为Ia1期(n = 1)、Ib1期(n = 12)、Ib2期(n = 2)和IIa1期(n = 1)。1例Ia1期患者锥切术后行腹腔镜全子宫切除术及双侧输卵管卵巢切除术(BSO);1例Ib1期患者放疗及同步化疗后行全腹子宫切除术及BSO,另1例Ib1期患者行根治性阴道宫颈切除术;1例妊娠合并Ib1期患者孕12周时诊断,化疗4疗程后行剖宫产根治性子宫切除术及盆腔淋巴结清扫术。其余患者均行根治性子宫切除术及盆腔淋巴结清扫术。14例已知淋巴结状态的患者中无一例淋巴结阳性。13例行卵巢切除术的患者中1例病理证实卵巢表面有宫颈癌转移,其余及另1例卵巢活检患者淋巴结结果为阴性。中位随访时间为23.3个月(5 - 60个月)。所有患者均存活,1例患者术后8个月阴道残端肿物复发。总体5年生存率和无病生存率分别为100%和94%(15/16)。
VA主要影响年轻女性,与常见宫颈癌相比,卵巢转移率较低,总体预后较好。由于样本量有限且为回顾性研究临床资料,需要多中心前瞻性研究以更好地了解该疾病。