Imachi M, Tsukamoto N, Amagase H, Shigematsu T, Amada S, Nakano H
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1993 Jun 1;71(11):3472-7. doi: 10.1002/1097-0142(19930601)71:11<3472::aid-cncr2820711103>3.0.co;2-v.
Metastatic adenocarcinoma to the uterine cervix from gastric cancer is rare, and the clinicopathologic features of this metastasis are unclear.
A clinicopathologic review of 16 patients with metastatic adenocarcinoma to the uterine cervix from gastric cancer was performed.
The ages of the patients ranged from 29 to 57 years, and 81.3% of the patients were premenopausal. Nine of the patients had undergone gastrectomy previously. In 11 patients the histologic type of the gastric cancer was poorly differentiated adenocarcinoma and, in 5 patients, signet ring cell carcinoma. The cervical metastasis was diagnosed 11-121 months (mean, 57.5 months) after the diagnosis of the gastric cancer in 10 of the patients. In six patients, the cervical metastasis was discovered synchronously or before the diagnosis of the gastric cancer. The colposcopic findings were normal in 57.1%, but 56.3% had abnormal cervical smears. In all patients, tumor cells were present in the dilated lymphatics of the cervix. Metastases to the uterine body and bilateral ovaries were common, and half of the patients had metastases to the paraaortic lymph nodes. Extirpation of the cervix was performed in six patients. The prognosis was poor, regardless of the treatment method.
The route of metastasis to the cervix is surmised to be retrograde lymphatic, and this extension is often slow. Periodic gynecologic examinations should be performed indefinitely for premenopausal female patients with advanced gastric cancer.
胃癌转移至子宫颈的腺癌罕见，这种转移的临床病理特征尚不清楚。
对16例胃癌转移至子宫颈的腺癌患者进行临床病理回顾。
患者年龄29至57岁，81.3%的患者处于绝经前。9例患者曾接受过胃切除术。11例患者的胃癌组织学类型为低分化腺癌，5例为印戒细胞癌。10例患者在胃癌诊断后11 - 121个月（平均57.5个月）被诊断为宫颈转移。6例患者宫颈转移与胃癌诊断同步或在胃癌诊断之前被发现。阴道镜检查结果正常的占57.1%，但宫颈涂片异常的占56.3%。所有患者宫颈扩张淋巴管内均有肿瘤细胞。子宫体和双侧卵巢转移常见，半数患者有腹主动脉旁淋巴结转移。6例患者接受了宫颈切除术。无论治疗方法如何预后均差。
推测转移至宫颈的途径为逆行淋巴转移，且这种扩散通常缓慢。对于绝经前晚期胃癌女性患者应长期定期进行妇科检查。
