摘要
目的探讨具有基底细胞特征的宫颈腺样基底细胞癌(ABC)、腺样囊性癌(ACC)及基底样鳞状细胞癌(BSCC)的临床病理特征,提高临床及病理医师对该类病变的诊断及鉴别诊断水平。方法收集南方医科大学附属深圳妇幼保健院2018年4月至2022年12月收治的4例ABC、1例ACC及3例BSCC临床病理资料,复阅病理切片,结合国内外文献进行讨论总结。结果3种肿瘤均多见于绝经后女性,与高危型HPV感染有关。ABC为低级别癌,患者临床常无症状,多因宫颈筛查细胞学异常就诊,因HSIL行宫颈锥切或子宫切除后意外发现,常呈宫颈浅表浸润,临床分期多为早期。ACC及BSCC为中、高级别癌,常因绝经后阴道流血就诊,宫颈见到明显肿物,临床分期为中、晚期。3种病变可以共存,观察形态学特征并借助免疫组化染色可帮助鉴别诊断。随访8例患者均未出现复发、转移。结论宫颈ABC、ACC及BSCC少见,均是起源于储备细胞的肿瘤,在临床特征及病理形态方面有相似性,但治疗及预后不同,准确区分三者具有重要的临床意义。
Objective To investigate the clinical and pathological features of adenoid basal cell carcinoma(ABC),adenoid cystic carcinoma(ACC),and basaloid squamous cell carcinoma(BSCC)with basaloid charac⁃teristics and improve the diagnostic and differential diagnostic ability of clinicians and pathologists for these lesions.Methods A retrospective study was conducted on the clinical and pathological data of 4 cases of ABC,1 case of ACC,and 3 cases of BSCC diagnosed and treated at Shenzhen Maternal and Child Health Hospital,Southern Medical University from April 2018 to December 2022.Pathological slides were reviewed and relevant literature was analyzed and summarized.Results All three types of tumors were common in postmenopausal women and were associated with high-risk HPV infection.ABC was a low-grade cancer and patients were often clinically asymp⁃tomatic.It was usually detected incidentally during cervical screening due to cytological abnormalities,or after cervical cone biopsy or hysterectomy for HSIL.It presented as superficial cervical infiltration and clinical staging was often early.ACC and BSCC were intermediate to high-grade cancers and they often presented with postmenopausal vaginal bleeding.A visible mass was observed on the cervix.The clinical staging was intermediate to advanced.The three types of lesions could coexist.Careful observation of the morphological characteristics and immunohistochemical staining could help with differential diagnosis.None of the 8 patients experienced recurrence or metastasis during follow-up.Conclusion Cervical ABC,ACC and BSCC are rare and they originate from reserve cells.They share the similarities in clinical and pathological morphology,but differ in treatment and prognosis.So,accurate differen⁃tiation among them has important clinical significance.
作者
张雁瑞
黄新翼
史健
杨怡晖
刘丽敏
胡海燕
ZHANG Yanrui;HUANG Xinyi;SHI Jian;YANG Yihui;LIU Limin;HU Haiyan(Department of Pathology,Shenzhen Maternity and Child Health Care Hospital,Southern Medical University,Shenzhen 518028,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2024年第2期163-168,共6页
The Journal of Practical Medicine
基金
广东省深圳市科创委科研项目(编号:JCYJ 20220530155006014)。
关键词
宫颈癌
基底细胞
腺样基底细胞癌
腺样囊性癌
基底样鳞状细胞癌
cervical carcinoma
basaloid
adenoid basal cell carcinoma
adenoid cystic carcinoma
basaloid squamous cell carcinoma
