| 摘要: |
| 目的 分析宫颈透明细胞癌（Clear cell adenocarcinoma，CCAC）患者的临床与病理特征，以期为该罕见肿瘤的临床诊疗提供参考。方法 对甘肃省妇幼保健院2020年至2023年诊治的9例CCAC患者的临床表现、组织学特征、免疫组化表型、治疗及预后进行回顾性分析。采用Kaplan-Meier法计算生存率。结果 9例患者中位年龄64岁。其中绝经后阴道出血6例，接触性出血2例，子宫次全切除后阴道出血1例。人乳头瘤病毒（Human papilloma virus，HPV）检测阴性者8例（8/9）；国际妇产科联盟分期：IB2期4例，IIA1期1例，IIA2期2例，IIIC1p期1例，IIIC2r期1例。免疫表型：p16阳性（8/9），PAX8阳性（5/5），Napsin A阳性（5/8），HNF1-β阳性（5/5）。中位随访时间25个月，总生存率为55.6%，肿瘤特异性生存率为66.7%。结论 本研究提示CCAC好发于中老年人群，且CCAC与HPV感染无显著关联。其临床特征缺乏特异性，目前尚无有效的CCAC筛查方法，需开展更深入的研究以改善CCAC的防治及预后。 |
| 关键词: 透明细胞癌 诊断特征 免疫组化 诊疗 |
| DOI： |
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| 基金项目:甘肃省联合科研基金一般项目(编号：No. 24JRRA935)；甘肃省自然科学基金(编号：No. 22JR11RA179) |
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| Analysis of Clinicopathologic Features and Prognostic Factors in 9 Cases of Cervical Clear Cell Adenocarcinoma WAN Tao, WEI Ying, ZHANG Ya-qing, et al. Department of Gynecologic Oncology II, Gansu Provincial Maternity and Child-care Hospital/Gansu Provincial Central Hospital, Lanzhou 730070, China. |
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Wan tao
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Gansu Provincial Maternity and Child-care Hospital/Gansu Provincial Central Hospital
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| Abstract: |
| Objective To analyze the clinical and pathological characteristics of patients with clear cell adenocarcinoma (CCAC) in order to provide guidance for the clinical diagnosis and treatment of this rare tumor. Methods A retrospective analysis was conducted on the clinical manifestations, histological features, immunohistochemical phenotypes, treatment, and prognosis of 9 patients with CCAC diagnosed and treated at the Gansu Provincial Maternal and Child Health Hospital from 2020 to 2023. The Kaplan-Meier method was used to calculate survival rates. Results The median age of the 9 patients was 64 years. Among them, 6 presented with postmenopausal vaginal bleeding, 2 with contact bleeding, and 1 with vaginal bleeding following subtotal hysterectomy. Eight patients tested negative for HPV (8/9); according to the International Federation of Gynecology and Obstetrics (FIGO) staging system, 4 were stage IB2, 1 was stage IIA1, 2 were stage IIA2, 1 was stage IIIC1p, and 1 was stage IIIC2r. Immunophenotype: p16-positive (8/9), PAX8-positive (5/5), Napsin A-positive (5/8), and HNF1-β-positive (5/5). The median follow-up duration was 25 months, with an overall survival rate of 55.6% and a tumor-specific survival rate of 66.7%. Conclusion This study indicates that CCAC is more common in middle-aged and older adults, and that there is no significant association between CCAC and HPV infection. Its clinical features lack specificity, and there are currently no effective screening methods for CCAC; further research is urgently needed to improve the prevention, treatment, and prognosis of CCAC. |
| Key words: Clear cell adenocarcinoma Diagnostic trait Immunohistochemistry Diagnosis and treatment |
