摘要
目的:探讨原发性子宫颈淋巴上皮瘤样癌(lymphoepithelioma-like carcinoma,LELC)的临床病理学特征、诊治经验及预后。方法:回顾分析2015年01月至2019年12月我院收治的6例宫颈LELC患者的临床病理资料。结果:我院6例原发性子宫颈LELC占我院同期原发性宫颈癌病例总数的0.84%,患者平均年龄51.8岁。根据FIGO 2009年宫颈癌分期标准ⅠB1期4例,ⅡA1期1例,根据FIGO 2018年宫颈癌分期标准ⅠB3期1例。6例患者均行手术治疗且术后常规病理检查证实为宫颈LELC,其中5例术前宫颈活检考虑为LELC,1例活检考虑为非角化鳞癌。HE染色显微镜下形态相似,为浸润性低分化的合胞体样细胞增生伴丰富的淋巴浆细胞浸润。免疫组化染色(CK或CK5/6)、p16和p63阳性,Ki-67增值指数30%~90%。手术病理显示3例患者分别存在淋巴结转移,脉管癌栓和神经侵犯,所有病例随访至2023年03月均存活,无疾病复发和转移。结论:原发性宫颈LELC是一种罕见且独特的宫颈癌亚型,预后良好,HPV可能参与了该病的发生。通过显微镜下的形态学特征及免疫组化染色可以帮助识别该病。
Objective:To investigate the clinicopathological features,diagnosis and treatment experience and prognosis of lymphoepithelioma-like carcinoma(LELC)of cervix.Methods:The clinicopathologic data of 6 patients with cervical LELC admitted to our hospital from January 2015 to December 2019 were retrospectively analyzed.Results:Six cases of primary cervical LELC in our hospital accounted for 0.84%of the total number of primary cervical cancer cases in the same period.The average age was 51.8 years old.According to FIGO staging in 2009,four patients were diagnosed with stageⅠB1,one patient was diagnosed with stageⅡA1,and according to FIGO staging in 2018,one patient were diagnosed with stageⅠB3.All the 6 patients underwent surgical treatment and were confirmed to be cervical LELC by postoperative pathological examination.Five cases were considered LELC and one case was considered non-keratinized squamous cell carcinoma by cervical biopsy.Microscopic morphology of all cases was similar under HE staining,showing infiltration of poorly differentiated syninclusion-like cells with abundant lymphoplasmic infiltration.Immunohistochemical staining(CK or CK5/6),p16 and p63 were positive,and Ki-67 appreciation index was 30%~90%.Surgical pathology showed that 3 patients had lymph node metastasis,vascular cancer thrombus and nerve invasion,but all patients survived until March 2023 without recurrence or metastasis.Conclusion:Primary cervical LELC is a rare and unique subtype of cervical cancer with a good prognosis and HPV virus may participate in the development of the disease.Although biopsy diagnosis can sometimes be challenging,morphological features and immunohistochemical staining can help identify the disease.
作者
梁静
张铭
吴兰
常淑芳
LIANG Jing;ZHANG Ming;WU Lan;CHANG Shufang(Department of Gynecology and Obstetrics,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China;Department of Pathology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China;Department of Radiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)
出处
《现代肿瘤医学》
2025年第10期1764-1770,共7页
Journal of Modern Oncology
