何雪梅

    [摘要] 目的 探讨宫颈原位腺癌(AIS)的临床诊断及治疗方式。 方法 选取2018年9月至2021年3月江苏省徐州市妇幼保健院收治的31例宫颈原位腺癌患者，分析其临床表现、诊断方法、治疗方式及病理情况。结果 患者平均年龄(41.48±7.60)岁。25例患者无异常症状;细胞学异常者13例;高危型HPV阳性者28例;阴道镜图像5例评估为AIS。多点活检病理发现AIS 11例，锥切术后病理发现20例。6例因生育要求仅行锥切术，25例进一步行全子宫切除术，1例病理升级为浸润性腺癌。结论 宫颈原位腺癌临床症状极少见，联合细胞学、HPV检测及阴道镜检查可提高诊断的敏感度，确诊依靠病理。完成生育后尽早行全子宫切除术，以降低宫颈腺癌的发生率。

    [关键词] 宫颈原位腺癌;宫颈细胞学;HPV;阴道镜;宫颈活检;宫颈锥切

    [中图分类号] R737.33? ? ? ? ? [文献标识码] B? ? ? ? ? [文章编号] 1673-9701(2022)12-0054-03

    [Abstract] Objective To investigate the clinical diagnosis and treatment of adenocarcinoma in situ (AIS) of cervix. Methods A total of 31 patients with adenocarcinoma in situ of cervix who were admitted to Xuzhou Maternal and Child Health Care Hospital in Jiangsu Province from September 2018 to March 2021 were selected to analyze their clinical manifestations， diagnostic methods， treatment methods and pathological conditions. Results The mean age of the patients was (41.48±7.60) years， and 25 patients had no abnormal symptoms. Cytological abnormalities were observed in 13 patients. A total of 28 patients were high-risk HPV positive. Colposcopic images in 5 patients were assessed as AIS. The number of patients who were diagnosed as AIS is 11 by multi-point biopsy and 20 by athological examination after conization. Conization was performed only in 6 patients due to fertility requirements; total hysterectomy was performed in 25 patients; invasive adenocarcinoma was developed in 1 patient. Conclusion Clinical symptoms of adenocarcinoma in situ of cervix are rare. The cytology ......