Fignon A, Mayelo V, Wurst C, Magnin G, Tariel D, Descamps P, Renjard L, Body G, Lansac J
Département de Gynécologie-Obstétrique, Reproduction Humaine et Médecine Foetale, CHRU Bretonneau, Tours.
J Gynecol Obstet Biol Reprod (Paris). 1995;24(4):369-73.
We report diagnosis and treatment problems encountered in 4 cases of adenocarcinoma in situ (AIS) of the uterine cervix. The patients' ages ranged from 24 to 45 years. In 2 cases, Pap smears revealed strips of cells showing crowded nuclei and pseudostratification of AIS. In 3 cases, the diagnosis of AIS was confirmed from a colposcopically directed biopsy and, in the last case, from a surgical cone biopsy. In 3 cases, AIS was found to be associated with cervical squamous intraepithelial neoplasia. In all cases, it was difficult to rule out an early invasive adenocarcinoma. Three patients underwent total abdominal hysterectomy. The topographic data of lesions, notably the presence of endocervical AIS in hysterectomy specimen realised 4 years after conization, and a review of literature lead us to propose hysterectomy as a basic treatment. If conization is chosen, it should be cylindrical with adequate diameter and height.
我们报告了4例子宫颈原位腺癌(AIS)诊断和治疗中遇到的问题。患者年龄在24至45岁之间。2例患者的巴氏涂片显示细胞条带,细胞核拥挤,呈AIS假复层排列。3例患者经阴道镜引导活检确诊为AIS,最后1例经手术锥形活检确诊。3例患者发现AIS与宫颈鳞状上皮内瘤变相关。在所有病例中,很难排除早期浸润性腺癌。3例患者接受了全腹子宫切除术。病变的地形学数据,特别是锥切术后4年子宫切除标本中宫颈管内AIS的存在,以及文献回顾使我们建议将子宫切除术作为基本治疗方法。如果选择锥切术,应采用直径和高度合适的圆柱形。