Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.
Clin Radiol. 2024 Oct;79(10):e1189-e1195. doi: 10.1016/j.crad.2024.04.016. Epub 2024 May 10.
This study identified the distinct magnetic resonance imaging findings of cervical gastric-type adenocarcinoma (GAS) that can help differentiate it from squamous cell carcinoma (SCC) and usual-type endocervical adenocarcinoma (UEA) and reveal the radiologic-pathologic correlation.
All consecutive patients with cervical GAS treated at our hospital from November 2009 to August 2021 were included. The SCC and UEA cases were considered controls. Tumor location, tumor shape, presence and size of cysts, presence of uterine fluid, and apparent diffusion coefficient (ADC) were evaluated.
Overall, 18 GAS, 55 SCC, and 23 UEA cases were evaluated. The tumor was located in the entire cervix in 13/18 GAS cases, whereas it was predominantly located in the lower cervix in 38/55 SCC cases and 14/23 UEA cases. Most GAS cases exhibited a diffuse infiltration growth pattern (17/18), whereas most SCC and UEA cases exhibited a mass-forming pattern (39/55 and 20/23, respectively). Moreover, the percentages of cases presenting microcysts or macrocysts and undergoing uterine fluid collection were significantly higher in the GAS group (14/18 and 13/18) than in the SCC and UEA groups. ADC was significantly higher in the GAS group than in the SCC group (1.092 × 10 vs. 0.819 × 10 mm/s).
This study revealed that GAS is characterized by tumor presence in the entire cervix, infiltrative growth pattern, intrauterine fluid collection, and frequent microcyst or macrocyst formation. Moreover, ADC was significantly higher in the GAS group than in the SCC group.
本研究旨在确定宫颈胃型腺癌（GAS）的独特磁共振成像表现，以帮助其与鳞状细胞癌（SCC）和普通型宫颈内膜腺癌（UEA）相鉴别，并揭示影像学-病理学相关性。
本研究纳入了 2009 年 11 月至 2021 年 8 月期间在我院接受治疗的所有连续宫颈 GAS 患者。将 SCC 和 UEA 病例作为对照组。评估了肿瘤位置、肿瘤形状、囊肿存在和大小、子宫积液以及表观扩散系数（ADC）。
共有 18 例 GAS、55 例 SCC 和 23 例 UEA 病例进行了评估。在 18 例 GAS 中，肿瘤位于整个宫颈的有 13 例，而在 38 例 SCC 和 14 例 UEA 中，肿瘤主要位于宫颈下段。大多数 GAS 病例表现为弥漫性浸润生长模式（17/18），而大多数 SCC 和 UEA 病例表现为肿块形成模式（39/55 和 20/23）。此外，微囊或大囊形成以及子宫积液收集的病例百分比在 GAS 组（14/18 和 13/18）显著高于 SCC 和 UEA 组。GAS 组的 ADC 值明显高于 SCC 组（1.092×10 vs. 0.819×10 mm/s）。
本研究表明，GAS 的特征为肿瘤存在于整个宫颈、浸润性生长模式、子宫内积液和频繁的微囊或大囊形成。此外，GAS 组的 ADC 值明显高于 SCC 组。
