Department of Surgery, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Rev Bras Ginecol Obstet. 2020 May;42(5):266-271. doi: 10.1055/s-0040-1709191. Epub 2020 May 29.
To observe if the histopathological result of a conization performed after cervical adenocarcinoma in situ diagnosis is compatible with the histopathological analysis of a subsequent hysterectomy.
The present descriptive and observational research consisted of the analysis of the medical records of 42 patients who were diagnosed with in situ adenocarcinoma postconization. The analysis consisted of whether there was compatibility between the histopathological reports of conization and hysterectomy and if there was an association between adenocarcinoma in situ and another neoplasia (squamous disease). Interpretation of any immunohistochemistry reports obtained was also performed. In addition, clinical and epidemiological data were also analyzed.
A total of 42 conizations were performed, 33 (79%) were cold knife conizations and 9 (21%) were loop electrosurgical excision procedures (LEEPs). Of the patients analyzed, 5 (10%) chose not to undergo subsequent hysterectomy to preserve fertility or were < 25 years old. Out of the 37 patients with adenocarcinoma in situ who underwent subsequent hysterectomy, 6 (16%) presented with residual disease. This finding proved incompatible with the finding of the conizations, which had ruled out invasive cancer.
The prevalence of adenocarcinoma in situ increased in the past years. There is still a large part of the medical literature that advocates the use of conservative treatment for this disease, even though it is common knowledge that it is a multifocal disease. However, the majority of studies advocate that hysterectomy should remain the preferred treatment for women who have already completed their reproductive purpose.
观察宫颈原位腺癌诊断后行锥切术的组织病理学结果是否与随后行子宫切除术的组织病理学分析一致。
本描述性和观察性研究分析了 42 例经锥切术诊断为原位腺癌后患者的病历。分析内容包括锥切术和子宫切除术的组织病理学报告是否存在一致性，以及原位腺癌与另一种肿瘤（鳞状疾病）是否存在关联。还对获得的任何免疫组织化学报告进行了解读。此外，还分析了临床和流行病学数据。
共进行了 42 例锥切术，其中 33 例（79%）为冷刀锥切术，9 例（21%）为环形电切术（LEEP）。在分析的患者中，有 5 例（10%）因保留生育能力或年龄<25 岁而选择不进行随后的子宫切除术。在 37 例随后行子宫切除术的原位腺癌患者中，有 6 例（16%）有残留疾病。这一发现与锥切术的结果不一致，后者排除了浸润性癌。
近年来，原位腺癌的患病率有所增加。尽管人们普遍认为这是一种多灶性疾病，但仍有很大一部分医学文献主张对这种疾病采用保守治疗。然而，大多数研究主张对于已经完成生育目的的女性，子宫切除术仍然是首选治疗方法。
