Li Hai-Mei, Lei Rui-Xue, Yang Hai-Jun
Department of Pathology, Anyang Tumor Hospital, The Affiliated Anyang Tumor Hospital of Henan University of Science and Technology Anyang 455000, Henan, China.
Int J Clin Exp Pathol. 2025 Jun 15;18(6):258-266. doi: 10.62347/AEHS8635. eCollection 2025.
This study investigated the clinical and pathological characteristics of gastric-type endocervical adenocarcinoma (G-EAC) to advance the early diagnosis and treatment of this disease.
The diagnosis, treatment, follow-up, pathological morphology, immunohistochemical characteristics and other data of 15 patients of G-EAC visiting our hospital from December 2016 to March 2024 were retrospectively analyzed, and the relevant literature was discussed.
The mean age of participants was 45.13 years. There were four cases with vaginal discharge, eight cases with spontaneous vaginal contact bleeding, one case where hysterosalpingography (HSG) demonstrated uterine cavity fluid accumulation, and two cases of abdominal pain and swelling with pelvic mass (one with fever) as the initial symptom. There were two participants with Peutz-Jeghers syndrome (PJS). Histologically speaking, G-EAC exhibited various morphologic characteristics, including well-differentiated glands and unusual glands dispersed randomly within the cervical stroma and lacking lobular structures. Neutrophil infiltration and glandular abscess formation were commonly observed. Immunohistochemical analysis showed no expression of ER, PR, or NapsinA, but varying degrees of CK7, MUC6, MUC5AC, CEA, HNF1β, and PAX-8 expression. During the follow-up, which lasted from 1 to 88 months, 2 participants died after 6 months and 10 months respectively. Moreover, 5 participants exhibited distant metastasis, and the remaining 8 participants were healthy and disease free.
G-EAC is an uncommon subtype of cervical adenocarcinoma that frequently manifests as an advanced-stage cancer with vague clinical symptoms, making biopsy-based diagnosis challenging. Since conventional treatments demonstrated limited efficacy, clinicians and pathologists should pay particular attention to this entity.
本研究旨在探讨胃型宫颈内膜腺癌（G-EAC）的临床及病理特征，以推动该病的早期诊断与治疗。
回顾性分析2016年12月至2024年3月期间在我院就诊的15例G-EAC患者的诊断、治疗、随访、病理形态、免疫组化特征等资料，并对相关文献进行讨论。
参与者的平均年龄为45.13岁。4例有阴道分泌物，8例有自发性阴道接触性出血，1例子宫输卵管造影（HSG）显示宫腔积液，2例以腹痛、腹胀伴盆腔包块（1例伴发热）为首发症状。有2名参与者患有黑斑息肉综合征（PJS）。从组织学上讲，G-EAC表现出多种形态特征，包括高分化腺体以及随机散在于宫颈间质内且缺乏小叶结构的异常腺体。常见中性粒细胞浸润和腺脓肿形成。免疫组化分析显示ER、PR或NapsinA无表达，但CK7、MUC6、MUC5AC、CEA、HNF1β和PAX-8有不同程度表达。在为期1至88个月的随访中，2名参与者分别在6个月和10个月后死亡。此外，5名参与者出现远处转移，其余8名参与者健康且无疾病。
G-EAC是宫颈腺癌的一种罕见亚型，常表现为晚期癌症，临床症状不明确，基于活检的诊断具有挑战性。由于传统治疗疗效有限，临床医生和病理学家应特别关注这一实体。
