Microinvasive adenocarcinoma of the cervix
Microinvasive adenocarcinoma of the cervix
复制标题
DOI：
10.1111/j.1479-828x.1999.tb03123.x
复制
发表时间：
1999-11-01
影响因子：
1.7
通讯作者：
Ward, BG
中科院分区：
文献类型：
--
作者：
Nicklin, JL;Perrin, LC;Ward, BG
我们评估了宫颈微创腺癌（MIAC）患者的治疗，特别是确定保守手术的位置，并确定MIAC的FIGO分类是否有效，是否等同于适用于微创鳞状癌的分类。1986年1月至1998年10月对昆士兰妇科癌症中心的数据库进行了审查。检索所有记录为MIAC的患者的记录。根据1995年FIGO分类，微浸润被定义为浸润深度不大于5mm，水平尺寸不大于7mm。30例MIAC患者接受治疗，绝大多数（29例）无症状，在常规巴氏涂片时发现疾病。并发鳞状上皮内瘤变的发生率为43%，多灶性病变发生率为17%，淋巴血管阳性发生率为7%。18例采用根治性手术治疗，13例采用保守性手术治疗。随访3-116个月无复发。在接受根治性手术治疗的18例患者中，没有发现参数或淋巴结转移有隐匿性显微镜疾病。总共切除了27个卵巢，所有卵巢均无疾病。在这项小型研究中，MIAC的行为方式与鳞状等同物相似。本研究结果为宫颈浸润性腺瘤的FIGO分类提供了一定的依据。有一些支持保守手术在治疗这种疾病中的作用，但没有足够的全球经验来提出明确的建议。
We evaluated the management of patients with microinvasive adenocarcinoma of the cervix (MIAC), in particular, to determine the place of conservative surgery, and determine if the FIGO classification for MIAC is valid and equivalent to the classification as it applies to microinvasive squamous cancer. A review was undertaken of the database of the Queensland Centre for Gynaecological Cancer (QCGC) from January, 1986 to October, 1998. The records of all patients recorded as having MIAC were retrieved. Microinvasion was defined according to the 1995 FIGO classification as a depth of invasion of no greater than 5 mm and a horizontal dimension of no greater than 7 mm. 30 patients were found to have been treated for MIAC, The vast majority (29) were asymptomatic, disease being discovered at the time of routine Papanicolaou smear. There was a 43% incidence of coexisting squamous intraepithelial neoplasia, Multifocal disease was found in 17% of patients and lymph-vascular positivity in 7%. Eighteen patients were treated with radical surgery and 13 with conservative surgery. There were no recurrences over a follow-up interval of 3-116 months. Of the 18 patients treated with radical surgery, none was found to have occult microscopic disease in the parametria or nodal metastases. A total of 27 ovaries were removed, all of which were free of disease. In this small study, MIAC appears to behave in a manner similar to the squamous equivalent. The results provide some justification for the FIGO classification of a microinvasive glandular neoplasm of the cervix. There is some support for a role for conservative surgery in managing this condition, but there is insufficient worldwide experience to make definitive recommendations.