11例宫颈胃型黏液性癌的临床病理分析
作者: |
1朱亚宁,
1张连美,
1周武碧,
2张媛媛
1 南京医科大学附属淮安第一医院病理科,江苏 淮安 223300 2 南京医科大学附属淮安第一医院儿科,江苏 淮安 223300 |
通讯: |
朱亚宁
Email: hayyzyn@njmu.edu.cn |
DOI: | 10.3978/j.issn.2095-6959.2019.06.005 |
摘要
目的:探讨宫颈胃型黏液性癌(gastr ic-t y pe muc inous carc inoma,GA S)的临床病理学特征。 方法:对11例宫颈GAS进行回顾性分析,对其临床表现、病理学形态、免疫组织化学等进行观察。结果:患者年龄37~69(平均42.4)岁。大多有白带增多或水样白带史,其中1例伴有阴道流血,无一例伴有高危型HPV感染。肉眼观病灶多位于子宫颈和宫颈管,大多数肿瘤向上累及子宫肌层,宫颈外口光滑或糜烂。镜下见结构简单、单管状,胃型分化的腺体,杂乱的分布于宫颈间质中。免疫组织化学显示11例P16均阴性,MUC6阳性或局部阳性,6例p53呈错义模式表达,1例无义模式表达,4例为野生型模式表达。结论:宫颈GAS是一种特殊类型的、与HPV感染无关的高侵袭性宫颈腺癌,它的发生可能与p53基因突变有关。
关键词:
宫颈肿瘤;胃型黏液性癌;病理学
Gastric-type mucinous carcinoma of cervix: A clinicopathologic analysis of 11 cases
CorrespondingAuthor: ZHU Yaning Email: hayyzyn@njmu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2019.06.005
Abstract
Objective: To investigate the clinicopathological features of gastric-type mucinous carcinoma (GAS) of the cervix. Methods: A retrospective analysis was performed in 11 cases with GAS of the cervix by comparing clinical manifestations, pathological morphology and immunohistochemical changes. Results: The mean age of patients was 42.4 years (37 to 69 years). Most of them had a history of increased leucorrhea or watery leucorrhea, including one with vaginal bleeding and none with high-risk HPV infection. The gross lesions were mostly located in the cervix and cervical canal, most of which upward involving the uterine myometrium with a smooth or erosion cervical orifice. Microscopically, simple tubular glands exhibiting gastric differentiation were found in the cervical stroma. Immunohistochemistry showed that P16 was negative in 11 cases, MUC6 was positive or locally positive, p53 indication missense mutation in 6 cases, nonsense mutation in 1 case and wild type in 4 cases. Conclusion: GAS of the cervix is a special type of highly invasive cervical adenocarcinoma, which is unrelated to HPV infection and may be related to the mutation of p53 gene.
Keywords:
cervical neoplasms; gastric-type mucinous carcinoma; pathology