宫颈腺样基底细胞癌二例报告 并文献复习

Two Cases of Adenoid Basal Cell Carcinoma of the Cervix: Case Reports and Literature Review

摘要: 宫颈腺样基底细胞癌(adenoid basal carcinoma, ABC)是一种罕见的宫颈恶性肿瘤类型，常伴高级别鳞状上皮内病变，因缺乏特异性表现临床易漏诊。本文通过报告青岛大学附属医院诊治的2例宫颈腺样基底细胞癌，病例1：55岁，阴HPV阳性就诊，锥切病理示局灶性单纯性ABC (最大径0.6 cm，浸润深度0.6 cm，P16+，P63+)，行全子宫 + 双附件 + 盆腔淋巴结清扫，术后无残留，分期IB1，随访无复发。病例2：48岁阴同房后出血就诊，术后病理示ABC合并浸润性鳞状细胞癌及高级别鳞状上皮内病变，侵及子宫肌壁1/2，淋巴结阴性(P16+，Ki-67约70%)，分期IB3，辅助放疗后出现肺转移，经综合治疗后现病情稳定。对相应临床资料及病理结果进行分析并复习相关文献，旨在提高临床及病理医师对此病的相关认识，加强该疾病诊治能力。

Abstract: Adenoid basal carcinoma (ABC) of the cervix is a rare type of malignant tumor in clinical practice, often accompanied by high-grade squamous intraepithelial lesions, and is more common in postmenopausal women. It is often associated with other types of tumors and is prone to be missed due to the lack of specific manifestations. This article reports two cases of ABC of the cervix treated at the Affiliated Hospital of Qingdao University. Case 1: A 55-year-old woman with positive HPV visited the hospital. The conization pathology showed focal simple ABC (maximum diameter 0.6 cm, infiltration depth 0.6 cm, P16+, P63+). She underwent total hysterectomy + bilateral adnexectomy + pelvic lymph node dissection. There was no residual lesion after the operation, and the stage was IB1. There was no recurrence during the follow-up. Case 2: A 48-year-old woman visited the hospital due to post-coital bleeding. The postoperative pathology showed ABC combined with invasive squamous cell carcinoma and high-grade squamous intraepithelial lesions, involving 1/2 of the uterine myometrium, with negative lymph nodes (P16+, Ki-67 about 70%). The stage was IB3. After adjuvant radiotherapy, lung metastasis occurred. After comprehensive treatment, the current condition is stable. The corresponding clinical data and pathological results were analyzed, and relevant literature was reviewed to improve the understanding of this disease among clinical and pathological physicians and enhance the ability to diagnose and treat it.