中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2011年
8期
523-527
,共5页
宫颈肿瘤%病理学,临床%细胞学%免疫组织化学
宮頸腫瘤%病理學,臨床%細胞學%免疫組織化學
궁경종류%병이학,림상%세포학%면역조직화학
Cervix neoplasms%Pathology,clinical%Cytology%Immunohistochemistry
目的 探讨宫颈毛玻璃细胞癌的临床病理特征、免疫组织化学特点、诊断和预后.方法 回顾性分析了5例宫颈毛玻璃细胞癌的临床特征、脱落细胞学和组织病理学诊断要点及免疫组织化学特点.对照组为非特殊类型宫颈腺鳞癌10例、腺癌10例、鳞状细胞癌20例(角化型和非角化型各10例),非肿瘤性宫颈5例.结果 5例宫颈毛玻璃细胞癌患者平均年龄34.4岁(31～41岁),症状有阴道流血或流水样白带,其中合并中期妊娠1例,服用避孕药史7年1例,临床检查均可见宫颈明显肿块.两例典型病例的形态学特点显示:细胞呈簇状、小片状分布,细胞界限清楚,肿瘤细胞呈典型毛玻璃样特点,胞质丰富,内含大量嗜酸性颗粒,核膜薄,核染色质相对细腻,核仁嗜酸性,较大且突出,核分裂象和凋亡易见,间质中可见大量嗜酸性粒细胞和浆细胞浸润.与其他宫颈癌相比,毛玻璃细胞癌Ki-67阳性指数高(≥70%),既表达鳞癌的标志物p63和CK34βE12,又表达腺癌的标志物CAM5.2、MUC1、MUC2和癌胚抗原.治疗均采取广泛全子宫切除术+盆腔淋巴结清扫术+术后辅助放疗或化疗,术后无瘤生存时间25 d～33个月.结论 宫颈毛玻璃细胞癌是腺鳞癌的特殊亚型,细胞学和组织学方面具有独特的形态特点,表达腺上皮及鳞状上皮标志物,增殖活性高.
目的 探討宮頸毛玻璃細胞癌的臨床病理特徵、免疫組織化學特點、診斷和預後.方法 迴顧性分析瞭5例宮頸毛玻璃細胞癌的臨床特徵、脫落細胞學和組織病理學診斷要點及免疫組織化學特點.對照組為非特殊類型宮頸腺鱗癌10例、腺癌10例、鱗狀細胞癌20例(角化型和非角化型各10例),非腫瘤性宮頸5例.結果 5例宮頸毛玻璃細胞癌患者平均年齡34.4歲(31～41歲),癥狀有陰道流血或流水樣白帶,其中閤併中期妊娠1例,服用避孕藥史7年1例,臨床檢查均可見宮頸明顯腫塊.兩例典型病例的形態學特點顯示:細胞呈簇狀、小片狀分佈,細胞界限清楚,腫瘤細胞呈典型毛玻璃樣特點,胞質豐富,內含大量嗜痠性顆粒,覈膜薄,覈染色質相對細膩,覈仁嗜痠性,較大且突齣,覈分裂象和凋亡易見,間質中可見大量嗜痠性粒細胞和漿細胞浸潤.與其他宮頸癌相比,毛玻璃細胞癌Ki-67暘性指數高(≥70%),既錶達鱗癌的標誌物p63和CK34βE12,又錶達腺癌的標誌物CAM5.2、MUC1、MUC2和癌胚抗原.治療均採取廣汎全子宮切除術+盆腔淋巴結清掃術+術後輔助放療或化療,術後無瘤生存時間25 d～33箇月.結論 宮頸毛玻璃細胞癌是腺鱗癌的特殊亞型,細胞學和組織學方麵具有獨特的形態特點,錶達腺上皮及鱗狀上皮標誌物,增殖活性高.
목적 탐토궁경모파리세포암적림상병리특정、면역조직화학특점、진단화예후.방법 회고성분석료5례궁경모파리세포암적림상특정、탈락세포학화조직병이학진단요점급면역조직화학특점.대조조위비특수류형궁경선린암10례、선암10례、린상세포암20례(각화형화비각화형각10례),비종류성궁경5례.결과 5례궁경모파리세포암환자평균년령34.4세(31～41세),증상유음도류혈혹류수양백대,기중합병중기임신1례,복용피잉약사7년1례,림상검사균가견궁경명현종괴.량례전형병례적형태학특점현시:세포정족상、소편상분포,세포계한청초,종류세포정전형모파리양특점,포질봉부,내함대량기산성과립,핵막박,핵염색질상대세니,핵인기산성,교대차돌출,핵분렬상화조망역견,간질중가견대량기산성립세포화장세포침윤.여기타궁경암상비,모파리세포암Ki-67양성지수고(≥70%),기표체린암적표지물p63화CK34βE12,우표체선암적표지물CAM5.2、MUC1、MUC2화암배항원.치료균채취엄범전자궁절제술+분강림파결청소술+술후보조방료혹화료,술후무류생존시간25 d～33개월.결론 궁경모파리세포암시선린암적특수아형,세포학화조직학방면구유독특적형태특점,표체선상피급린상상피표지물,증식활성고.
Objective To investigate the clinicopathological characteristics, histological diagnosis,immunohistochemistry and prognosis of cervical glassy cell carcinoma ( GCC ) . Methods The clinical characteristics, cytology, histology and immunohistochemistry were analyzed in 5 cases of GCC. Results The average age of the five patients was 34. 4 years ( 31 - 41 years ). Abnormal vaginal bleeding and/or watery discharge were clinical presentations. One case was complicated with pregnancy and another one had a seven-year history of using contraceptives. All patients had an obvious mass in the cervix. Characteristic morphological features of GCC were present in 2 cases. Morphologically, the tumors consisted of clusters of tumor cells with distinct cell bounders, a large amount of eosinophilic granules in the cytoplasm imparting ground glass appearance, and thin nuclear membrane and prominent nucleoli. Nuclear enlargement and multinucleation were frequently noted. Mitosis and apoptosis were common. Numerous eosinophils and plasma cells were present in the stroma. Immunohistochemically, GCC expressed markers for both squamous cell carcinoma (p63 and CK34βE12) and adenocarcinoma ( CAM5. 2, MUCI, MUC2 and CEA). Ki-67 proliferation index was high( ≥70% ). All the five patients were treated with radical hysterectomy, followed by radiation and chemotherapy. The tumor-free survival time ranged from 25 days to 33 months.Conclusions GCC is a distinct variant of adenosquamous carcinoma of the cervix with high proliferation index and expression of markers of both squamous cell carcinoma and adenocarcinoma. The tumor has characteristic cytological and histological features.
