肿瘤预防与治疗2026，Vol.39Issue(4)：262-266,5.DOI:10.3969/j.issn.1674-0904.2026.04.003
不可忽视的例外:子宫颈胃型腺癌与高危型HPV DNA检测阳性的"矛盾"解析
A Not-to-Be-Ignored Exception:Analysis of the"Paradox"of Gastric-Type Endocervical Adenocarcinoma with Positive High-Risk HPV DNA Test Results
摘要
Abstract
Gastric-type endocervical adenocarcinoma(G-EAC)is the most common subtype of non-HPV-associated en-docervical adenocarcinoma.It is highly invasive and is prone to missed diagnosis and misdiagnosis.In clinical practice,some patients with G-EAC test positive for high-risk human papillomavirus(HR-HPV)DNA,which presents diagnostic challenges.Although G-EAC is essentially an HR-HPV-negative tumor,positive HR-HPV DNA results are observed in 10.9％to 23.1％of cases,a rate considerably lower than that of usual-type endocervical adenocarcinoma.The primary reasons for these positive results are assay interference or co-infection,rather than actual HPV infection within the tumor cells.Dif-ferential diagnosis should be based on the gold standard of HR-HPV RNAscope in situ hybridization,integrated with his-topathological features,immunohistochemical markers(such as MUC6,HIK1083,p16,and p53),and clinical manifesta-tions(including vaginal discharge and barrel-shaped cervical enlargement).Clinically,a positive HR-HPV DNA result should not lead to the outright exclusion of G-EAC,nor should a negative result lead to overlooking the possibility of malig-nancy.Establishing a diagnostic system centered on histomorphology,immunohistochemistry,and RNAscope testing can help reduce misdiagnosis and improve patient outcomes.关键词
子宫颈胃型腺癌/病因学/高危型 HPV/鉴别诊断/RNAscopeKey words
Gastric-type endocervical adenocarcinoma/Etiology/High risk human papillomavirus/Differential diagno-sis/RNAscope分类
医药卫生引用本文复制引用
王登凤,史敏,张国楠..不可忽视的例外:子宫颈胃型腺癌与高危型HPV DNA检测阳性的"矛盾"解析[J].肿瘤预防与治疗,2026,39(4):262-266,5.基金项目
国家医学高层次人才计划(编号:国卫人发[2024]26号) （编号:国卫人发[2024]26号）
天府青城计划天府名医项目(2021 年)(编号:川青城第910号) This study was supported by National Medical High-Level Talent Program(Guo Wei Ren Fa[2024]No.26),and Tianfu Famous Doctor Project of Tianfu Qingcheng Plan(Chuan Qing Cheng[2021]No.910). （2021 年）
