宫颈腺样基底细胞癌6例临床病理分析OACSTPCD

Objective:Cervical adenoid basal carcinoma(CABC)is a rare cervical tumor with low malignant potential and a good prognosis,but it is often misdiagnosed clinically.This study aims to improve understanding of this tumor by exploring its clinicopathological features,immunophenotype,diagnosis,differentiation,and prognosis. Methods:Clinicopathological data of 6 cases of CABC were collected for light microscopy observation and immunohistochemical staining.Related literature was also reviewed. Results:The 6 cases were all postmenopausal women,aged 62 to 73 years.Four cases had no obvious clinical symptoms and were diagnosed due to abnormal cervical cytology;1 case presented with postmenopausal vaginal bleeding,and 1 case with malignant tumor of the vulva.Human papillomavirus(HPV)testing was positive in 3 cases,with 1 case showing positive on retesting,and the results were positive.All 6 cases underwent total hysterectomy with double appendages resection.Grossly,no obvious masses were found in the cervix,but various degrees of cervical erosion were observed.Microscopically,the tumor consisted of small,round basaloid cells arranging solid or cribriform nests,infiltrating the superficial stroma of the cervix with depth of 2 to 6 mm.The stroma reaction around the nests was not obvious,with mucinous degeneration seen around nests in 1 case.The peripheral cells of the tumor nests were arranged in a fence shape,with some nests showing glandular or cribriform differentiation in the center.The tumor cells were small,uniform in shape,closely packed,with round or oval nuclei,sparse cytoplasm,occasional mitotic figures,and squamous cell differentiation in some nests of 2 cases.Five cases were associated with high-grade squamous intraepithelial lesion(HSIL)involving glands,and 1 case was associated with squamous cell carcinoma.Immunophenotypically,P16 was diffusely positive,while cytokeratin(CK)5/6,P63,and P40 were positive.CD117 testing in 3 cases was negative.Ki-67 expression showed heterogeneity,with higher positive rates in squamous differentiation areas and lower positive rates in basal cell-like areas and glandular structures,ranging from 5%to 20%.All 6 cases were followed up for 5 months to 7 years,with no recurrence or metastasis. Conclusion:CABC is a rarely low-grade malignant cervical tumor with a good prognosis and rare metastasis.The overall prognosis of the tumor depends on the other tumor types involved.