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[阴道癌及其前驱病变诊断与治疗的跨学科S2k指南——组织病理学检查、诊断及报告的外科病理学建议]

[Interdisciplinary S2k guidelines on the diagnosis and treatment of vaginal carcinoma and its precursors-recommendations on surgical pathology for histopathological workup, diagnostics, and reporting].

作者信息

Horn Lars-Christian, Höhn Anne Kathrin, Hampl Monika, Mehlhorn Grit, Follmann Markus, Schnürch Hans-Georg

机构信息

Institut für Pathologie, Abteilung Mamma‑, Gynäko- & Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland.

Universitätsfrauenklinik, Heinrich-Heine-Universität, Düsseldorf, Deutschland.

出版信息

Pathologe. 2021 Feb;42(1):116-124. doi: 10.1007/s00292-020-00876-8.

Abstract

Primary vaginal carcinoma is rare. There are two pathogenetic pathways, one associated with HPV high-risk infection and another one with inactivation of p53. Vaginal Paget's disease is rare and mostly associated with vulvar disease or represents intravaginal spread of associated locoregional cancer. Diagnostic vaginal biopsies should be examined by step sections on H&E. Sentinel lymph nodes should be processed completely using ultrastaging. Morphology-based prognostic factors with good clinical evidence are tumour stage and lymph node status. Molecular markers are not currently relevant for treatment decision and prognosis.

摘要

原发性阴道癌罕见。其有两种发病机制,一种与高危型人乳头瘤病毒(HPV)感染相关,另一种与p53基因失活有关。阴道派杰氏病罕见,大多与外阴疾病相关或为相关局部区域癌症的阴道内播散。诊断性阴道活检标本应进行苏木精-伊红(H&E)染色连续切片检查。前哨淋巴结应采用超分期法进行完整处理。有充分临床证据的基于形态学的预后因素为肿瘤分期和淋巴结状态。分子标志物目前与治疗决策及预后无关。

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