目的 探讨宫颈毛玻璃细胞癌（glassy cell carcinoma, GCC）的诊断、临床病理特征及免疫组化特点。方法 分析3例宫颈GCC的临床特征、组织病理学诊断特点及免疫组织化学表达及HPV感染情况。对照组为宫颈基底细胞样鳞状细胞癌3例，腺癌3例，鳞状细胞癌3例及腺鳞癌3例，无肿瘤病变宫颈组织3例。结果 3例GCC患者平均33.7岁，症状为阴道流血，其中2例有明显肿块，1例无明显肿块，3例组织学特点相似，均为细胞呈巢状，小灶状分布，细胞界限清楚，肿瘤细胞呈毛玻璃样、胞质丰富、含大量嗜酸性颗粒、核膜薄、染色质细腻、核仁嗜酸性且较大。核分裂象及凋亡易见，间质有嗜酸性粒细胞、浆细胞浸润；免疫组化标记：p63、CK34 βE12、CAM5.2、MUC1均阳性，HER-2有2例阳性（2/3），Ki-67指数80%，ER、PR、CK8、CK10、Syn、S-100均阴性。治疗均采取广泛全子宫切除+盆腔淋巴结清扫+术后辅助化疗，术后无癌生存时间3～28个月。结论 宫颈GCC是腺鳞癌的特殊亚型，有独特的组织病理学特点及免疫组化表达谱，准确诊断该肿瘤对临床治疗有较大意义。
Abstract
Objective To investigate the histological diagnosis and clinicopathological features of cervical glassy cell carcinoma(GCC). Methods The clinical characteristics,histology and immunohistochemistry were analyzed in 3 cases of GCC. And 3 cases of basalcell-like squamous carcinoma, 3 cases of adenocarcinoma, and 3 cases of cervical squamous carcinoma,3 cases of non-tumor cervical tissues were analyzed as control group. Results The average age of the patients were 33.7 years (26-44). Abnormal vaginal bleeding was clinical presentation,two cases had an obvious mass in cervix, one case had no obvious mass; all of the 3 cases presented a similar histological features:the tumor consisted of tumor cell clusters with distinct cell bounders, the tumor cells had glassy appearance with thin menbrane and prominent nuclei. Mitosis and apoptosis were common. Eosinophils and plasma cells were present in the stroma. Immunohistochemistry: p63,CK34 βE12, CAM5.2, MUC1 were positive and 2 of the 3 cases were HER-2 positive while CK8,CK10,Syn, S-100,ER and PR were negative. The Ki-67 index was 80%. All the 3 cases were treated by radical hysterectomy, follwed by radiotherapy and chemotherapy,and the tumor free survival time ranged from 3 to 28 months. Conclusions GCC is a distinct variant of adenosquamous carcinoma of the cervix with special immunohistochemical profile; the diagnosis of this kind of tumor is significant for clinical treatment.
关键词
宫颈 /
毛玻璃细胞癌 /
组织病理学 /
免疫组织化学
Key words
cervix /
glassy cell carcinoma /
histopathology /
immunohistochemistry
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参考文献
［1］ Tavassoli F A, Devilee P. World Heath Organization classification of tumors［M］. Lyon:IARC Press,2003:260-289.
［2］ Takahashi Y, Sasaki H, Mogami H,et al.Adjuvant combined paclitaxel and carboplatin chemotherapy for glassy cell carcinoma of the uterine cervix: report of three cases with clinicopathological analysis［J］.J Obstet Gynaecol Res, 2011,37(12):1860-1863.
［3］ Deshpande A H, Kotwal M N, Bobhate S K.et al. Glassy cell carcinoma of the uterine cervix a rare histology. Report of three cases with a review of the literature［J］. Indian J Cancer， 2004,41(2):92-95.
［4］ Nasu K, Takai N, Narahara H.et al.Multimodal treatment for glassy cell carcinoma of the uterine cervix［J］.J Obstet Gynaecol Res， 2009,35(3):584-587.
［5］ Seamon L G, Downey G O, Harrison C R,et al. Neoadjuvant chemotherapy followed by post-partum chemoradiotherapy and chemoconsolidation for stage IIIB glassy cell cervical carcinoma during pregnancy［J］. Gynecol Oncol， 2009,114(3):540-551
［6］ Nagai T, Okubo T, Sakaguchi R,et al. Glassy cell carcinoma of the uterine cervix responsive to neoadjuvant intraarterial chemotherapy［J］. Int J Clin Oncol， 2008,13(6):541-544.
［7］ Ferrandina G, Salutari V, Petrillo M,et al. Conservatively treated glassy cell carcinoma of the cervix［J］.World J Surg Oncol， 2008, 28(6):92-102.
［8］ Garg M M, Arora V K.Clear cell adenosquamous carcinoma of the cervix: a case report with discussion of the differential diagnosis［J］. Int J Gynecol Pathol， 2012,31(3):294-296.
［9］ Takekuma M, Hirashima Y, Takahashi N,et al. A case of glassy cell carcinoma of the uterine cervix that responded to neoadjuvant chemotherapy with paclitaxel and carboplatin［J］.Anticancer Drugs， 2006,17(6):715-718.
［10］ Kuroda H, Toyozumi Y, Masuda T.Glassy cell carcinoma of the cervix: cytologic features and expression of estrogen receptor, progesterone receptor and Her2/neu protein［J］. Acta Cytol， 2006, 50(4):418-422.
［11］ Zannoni G F, Vellone V G, Carbone A.Morphological effects of radiochemotherapy on cervical carcinoma: a morphological study of 50 cases of hysterectomy specimens after neoadjuvant treatment［J］. Int J Gynecol Pathol， 2008, 27(2):274-281.
［12］ Coleman D V, Poznansky J J.Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications［J］. Cytopathology， 2006,17(3):127-136.
［13］ Wang T Y, Chen B F, Yang Y C,et al.Histologic and immunophenotypic classification of cervical carcinomas by expression of the p53 homologue p63: a study of 250 cases［J］.Hum Pathol， 2001,32(5):479-486.
［14］ Olu-Eddo A N, Ekanem V J, Umannah I,et al.A 20 year histopathological study of cancer of the cervix in Nigerians［J］. Nig Q J Hosp Med， 2011,21(2):149-153.
［15］ Kosińiska-Kaczyńska K, Mazanowska N, Bomba-Opoń D, et al. Glassy cell carcinoma of the cervix-a case report with review of the literature［J］.Ginekol Pol， 2011,82(12):936-939.
(2012-03-06
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