【摘要】 目的探讨宫颈内膜腺体叶状增生(LEGH)的临床病理特征、诊治方法及预后。方法回顾性分析2013年2月至2016年9月复旦大学附属妇产科医院收治的13例LEGH患者的临床资料和随访记录。结果 LEGH最常见的症状是阴道排液(11/13,84.6%),其他少见症状包括性交后出血和宫颈肿块;液基细胞学筛查(TCT)细胞异常阳性率23.1%(3/13)。1例通过宫颈活检得以确诊(1/11,7.7%),7例通过宫颈锥切得以确诊(7/8,87.5%),余5例因合并其他疾病行子宫切除术后意外发现(5/13,38.5%)。8例经活检或锥切术确诊的患者中,6例进一步行全子宫切除,其中2例术后病理提示合并宫颈胃型黏液腺癌。11例切除子宫的患者中,7例(63.6%)合并原位腺癌或浸润黏液腺癌。术后随访2~43个月,除1例失访外,余病例均无复发。结论 LEGH临床少见,不易与宫颈胃型黏液腺癌鉴别,常伴随宫颈原位腺癌或浸润性腺癌,容易漏诊误诊,宫颈锥切术是较好的诊断方法。更多还原

【Abstract】 Objective To investigate the clinical and pathological characteristics,diagnosis,treatment and prognosis of lobular endocervical glandular hyperplasia(LEGH).Methods Clinical data and follow-up records of 13 patients who were diagnosed and treated from February 2013 to September 2016 in Obstetrics and Gynecology Hospital of Fudan University were reviewed retrospectively.Results Watery vaginal discharge was a common manifestation of LEGH(11/13,84.6%),irregular vaginal bleeding(2/13,15.4%)and cervical masses(2/13,15.4%)were also founded.Abnormal cytology rate by TCT and diagnostic rate by biopsy were low(23.1% and 7.7%,respectively).Eight cases were diagnosed by the cervical biopsy or conization,and the other 5 cases were confirmed accidently after hysterectomy for other diseases.For the 8 cases diagnosed by biopsy or conization,2 cases were followed without additional surgery while 6 cases received hysterectomy,among which 2 cases underwent additional radical surgery because of cervical carcinoma coexisting LEGH.Final pathologic reports revealed 69.2% of the cases were atypical LEGH(ALEGH)and 63.6% of cases coexisted with adenocarcinoma in situ or gastric mucinous adenocarcinoma.The patients were followed up for 2 to 43 months without recurrence,except that 1 case was lost.Conclusion LEGH is a rare disease and often coexsits with cervical carcinoma in situ(AIS)or invasive adenocarcinoma,which is likely to be misdiagnosed or missed in diagnosis.Cervical conization is a better way to diagnose.更多还原