摘要
目的探讨宫颈胃型腺癌的临床及影像学特征。方法回顾性收集2014年1月至2021年6月期间我院经病理证实的15例宫颈胃型腺癌的临床及影像学资料,分析病变的临床及影像学表现。结果15例患者中有3例伴有阴道异常排液或分泌物增多史,4例伴有接触性阴道出血或阴道异常出血史,2例表现为阴道异常流液伴接触性出血,3例患者表现为下腹痛,1例患者表现为腹胀。15例患者均表现为长T_(2)信号肿块,内见多发小囊状更长T_(2)信号,10例患者伴有卵巢囊性灶(66.67%),在此10例患者中进行手术者5例,证实为卵巢转移者2例,卵巢系膜囊肿1例。病灶均于DWI(b=800)呈明显高信号,测得ADC平均值范围为1.14~2.12×10^(-3)mm^(2)/s。结论宫颈胃型腺癌为非HPV相关型宫颈癌,其临床及影像学表现与病理相关。宫颈胃型腺癌临床症状常不典型,病理易漏诊,可伴有非特异性的CA19-9升高。MRI对判断病灶的大小及邻近结构受累情况具有重要诊断价值,但对于宫旁浸润范围及淋巴结转移的评价可能小于实际受累情况,且由于病灶侵袭性强,易早期转移,故术中应注意尽量切除病灶。
Objective To investigate the clinical and imaging features of gastric type adenocarcinoma of the uterine cervix.Methods The clinical and imaging data of 15 patients with pathologically confirmed gastric type adenocarcinoma of the uterine cervix in Fujian Cancer Hospital from January 2014 to June 2021 were retrospectively collected,and the clinical and imaging features were analyzed.Results Among the 15 patients,3 patients had a history of increased leucorrhea or watery leucorrhea,4 patients had a history of vaginal contact bleeding or abnormal vaginal bleeding,and 2 patients had a history of abnormal watery leucorrhea and contact bleeding.Three patients presented with lower abdominal pain and one patient presented with abdominal distention.All the 15 patients presented with cervical mass with long T_(2) signal and multiple small cystic longer T_(2) signal.10 patients had ovarian cystic foci(66.67%).Among these 10 patients,5 patients underwent surgery,2 patients were confirmed to have ovarian metastasis,and 1 patient was confirmed to have ovarian cyst.All lesions showed significantly high signal on DWI(B=800),and the average range of ADC measured was 1.14~2.12×10^(-3)mm^(2)/s.Conclusion Gastric type adenocarcinoma of the uterine cervix is a non-HPV-associated(NHPVA)cervical cancer,and its clinical and imaging features are related to pathology.The clinical symptoms of gastric type adenocarcinoma are often atypical and easily missed pathologically,accompanied by non-specific elevation of CA19-9.MRI is of great diagnostic value in judging the size of the lesion and the involvement of adjacent structures,but the evaluation of the paracervical invasion and lymph node metastasis may be smaller than the actual involvement,and as the lesion is highly invasive and prone to early metastasis,attention should be paid to removing the lesion as much as possible during the operation.
作者
林琳
何庄贞
陈兴发
魏伟
刘萌
许强
郑德春
LIN Lin;HE Zhuang-zhen;CHEN Xing-fa;WEI Wei;LIU Meng;XU Qiang;ZHENG De-chun(Department of Radiology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou350014,China)
出处
《罕少疾病杂志》
2022年第9期59-61,共3页
Journal of Rare and Uncommon Diseases
关键词
宫颈胃型腺癌
非HPV相关
影像学特征
MRI
Gastric Type Adenocarcinoma of the Uterine Cervix
NHPVA
Imaging Features,MRI
作者简介
第一作者/通讯作者:林琳,女,主治医师,主要研究方向:CT和MRI诊断。E-mail:794568593@qq.com。
