宫颈毛玻璃样细胞癌一例并文献复习

doi:10.12280/gjfckx.20220423

摘要/Abstract

摘要：

宫颈毛玻璃样细胞癌（glassy cell cervical carcinoma，GCCC）是一种罕见的宫颈恶性肿瘤，属于腺鳞癌的低分化亚型，国内外相关报道较少。由于其罕见性及特殊性，目前国内外尚无相应的诊疗规范。报道1例43岁的ⅡB期GCCC患者的诊治过程，该患者经同步放化疗后行腹腔镜下全子宫+双附件切除手术，术后给予了3个疗程的紫杉醇联合顺铂的辅助化疗，然而短期内出现全身多处复发转移，在更换多个化疗方案后治疗效果欠佳，最终失访。结合该病例并复习国内外相关文献，旨在提高对该病的认识和诊疗水平，为后续研究提供更多参考。

关键词: 宫颈肿瘤, 诊断, 治疗, 预后, 病例报告

Abstract:

Glassy cell cervical carcinoma (GCCC) is a very rare form of cervical carcinoma, which belongs to the low-differentiated subtype of adenosquamous carcinoma, and the related reports at home and abroad are few. Due to its rarity and particularity, there are currently no relevant guidelines for diagnosis and treatment of this disease. This article reports the diagnosis and treatment process of a 43-year-old patient with stage ⅡB GCCC who underwent laparoscopic total hysterectomy combined with bilateral adnexectomy after concurrent chemoradiotherapy, and was also given 3 courses of adjuvant chemotherapy with paclitaxel and cisplatin. However, in a short period of time, there have been multiple metastases throughout the body. The patient responded poorly to multiple chemotherapy regimens and was eventually lost. This article reviews the relevant literature both domestic and abroad, aiming to improve the understanding, diagnosis and treatment of the disease, and provide more reference for diagnosis and treatment for follow-up study of this disease.

Key words: Uterine cervical neoplasms, Diagnosis, Therapy, Prognosis, Case reports

王遥, 杨佳欣. 宫颈毛玻璃样细胞癌一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(2): 228-233.

WANG Yao, YANG Jia-xin. Glassy Cell Cervical Carcinoma：A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2023, 50(2): 228-233.

图/表 5

图1 PET/CT图

图2 术后病理图（HE染色×40）注：细胞呈巢状生长，胞质磨玻璃样，伴炎性细胞浸润。

图3 术后放化疗前盆腔MRI图

图4 放化疗后盆腔MRI图注：提示宫颈占位较前变小。

图5 手术标本注：术中剖视子宫见宫颈管及子宫内膜均光滑未见明显异常，双侧附件未见明显异常。

参考文献 23

[1]	Guitarte C, Alagkiozidis I, Mize B, et al. Glassy cell carcinoma of the cervix: a systematic review and meta-analysis[J]. Gynecol Oncol, 2014, 133(2):186-191. doi: 10.1016/j.ygyno.2014.01.048. doi: 10.1016/j.ygyno.2014.01.048 pmid: 24503463
[2]	Cherry CP, Glucksmann A. Incidence, histology, and response to radiation of mixed carcinomas (adenoacanthomas) of the uterine cervix[J]. Cancer, 1956, 9(5):971-979. doi: 10.1002/1097-0142(195609/10)9:5<971::aid-cncr2820090518>3.0.co;2-t. doi: 10.1002/1097-0142(195609/10)9:5<971::aid-cncr2820090518>3.0.co;2-t pmid: 13364884
[3]	Boustani J, Achkar S, Bertaut A, et al. Glassy cell carcinoma of the uterine cervix: 20-year experience from a comprehensive cancer center[J]. Cancer Radiother, 2021, 25(3):207-212. doi: 10.1016/j.canrad.2020.07.007. doi: 10.1016/j.canrad.2020.07.007 pmid: 33408051
[4]	Zolciak-Siwinska A, Jonska-Gmyrek J. Glassy cell carcinoma of the cervix: a literature review[J]. Eur J Obstet Gynecol Reprod Biol, 2014, 179:232-235. doi: 10.1016/j.ejogrb.2014.03.035. doi: 10.1016/j.ejogrb.2014.03.035 pmid: 24792540
[5]	Gray HJ, Garcia R, Tamimi HK, et al. Glassy cell carcinoma of the cervix revisited[J]. Gynecol Oncol, 2002, 85(2):274-277. doi: 10.1006/gyno.2001.6523. doi: 10.1006/gyno.2001.6523 pmid: 11972387
[6]	Yoon N, Kim JY, Kim HS. Clinical outcomes of advanced-stage glassy cell carcinoma of the uterine cervix: a need for reappraisal[J]. Oncotarget, 2016, 7(48):78448-78454. doi: 10.18632/oncotarget.12905. doi: 10.18632/oncotarget.12905 pmid: 27793022
[7]	Seamon LG, Downey GO, Harrison CR, et al. Neoadjuvant chemotherapy followed by post-partum chemoradiotherapy and chemoconsolidation for stage IIIB glassy cell cervical carcinoma during pregnancy[J]. Gynecol Oncol, 2009, 114(3):540-541. doi: 10.1016/j.ygyno.2009.05.025. doi: 10.1016/j.ygyno.2009.05.025 pmid: 19523669
[8]	付静, 梁莉. 宫颈毛玻璃细胞癌4例临床病理分析[J]. 诊断病理学杂志, 2015, 22(7):414-417. doi: 10.3969/j.issn.1007-8096.2015.07.009. doi: 10.3969/j.issn.1007-8096.2015.07.009
[9]	Hopkins MP, Morley GW. Glassy cell adenocarcinoma of the uterine cervix[J]. Am J Obstet Gynecol, 2004, 190(1):67-70. doi: 10.1016/s0002-9378(03)00928-1. doi: 10.1016/s0002-9378(03)00928-1 pmid: 14749637
[10]	Kim SK, Shim HS, Lee KG, et al. Glassy cell carcinoma predominantly commits to a squamous lineage and is strongly associated with high-risk type human papillomavirus infection[J]. Int J Gynecol Pathol, 2009, 28(4):389-395. doi: 10.1097/PGP.0b013e31819343a5. doi: 10.1097/PGP.0b013e31819343a5
[11]	Kato N, Katayama Y, Kaimori M, et al. Glassy cell carcinoma of the uterine cervix: histochemical, immunohistochemical, and molecular genetic observations[J]. Int J Gynecol Pathol, 2002, 21(2):134-140. doi: 10.1097/00004347-200204000-00005. doi: 10.1097/00004347-200204000-00005 pmid: 11917222
[12]	Hirai Y, Kawamata Y, Takeshima N, et al. Conventional and array-based comparative genomic hybridization analyses of novel cell lines harboring HPV18 from glassy cell carcinoma of the uterine cervix[J]. Int J Oncol, 2004, 24(4):977-986. pmid: 15010838
[13]	Jung YY, Nahm JH, Kim HS. Cytomorphological characteristics of glassy cell carcinoma of the uterine cervix: histopathological correlation and human papillomavirus genotyping[J]. Oncotarget, 2016, 7(45):74152-74161. doi: 10.18632/oncotarget.12361. doi: 10.18632/oncotarget.12361 pmid: 27708230
[14]	赵春华, 许天敏. 宫颈毛玻璃样细胞癌的研究进展[J]. 中国实验诊断学, 2018, 22(2):359-362. doi: 10.3969/j.issn.1007-4287.2018.02.059. doi: 10.3969/j.issn.1007-4287.2018.02.059
[15]	Chung JH, Koh JS, Lee SS, et al. Glassy cell carcinoma of the uterine cervix. Cytologic features and expression of estrogen and progesterone receptors[J]. Acta Cytol, 2000, 44(4):551-556. doi: 10.1159/000328529. doi: 10.1159/000328529 pmid: 10934948
[16]	王晴, 赵淑华. 残端宫颈毛玻璃样细胞癌1例并文献复习[J]. 中国计划生育和妇产科, 2021, 13(6):95-96. doi: 10.3969/j.issn.1674-4020.2021.06.22. doi: 10.3969/j.issn.1674-4020.2021.06.22
[17]	朱慧庭, 李淑霞. 宫颈毛玻璃细胞癌五例临床病理分析[J]. 中华病理学杂志, 2011, 40(8):523-527. doi: 10.3760/cma.j.issn.0529-5807.2011.08.006. doi: 10.3760/cma.j.issn.0529-5807.2011.08.006
[18]	Littman P, Clement PB, Henriksen B, et al. Glassy cell carcinoma of the cervix[J]. Cancer, 1976, 37(5):2238-2246. doi: 10.1002/1097-0142(197605)37:5<2238::aid-cncr2820370513>3.0.co;2-d. doi: 10.1002/1097-0142(197605)37:5<2238::aid-cncr2820370513>3.0.co;2-d pmid: 1260713
[19]	Wang Q, Hu Y, He Y, et al. Glassy cell carcinoma of cervix: an analysis for 20 cases and literatures review[J]. Transl Cancer Res, 2020, 9(4):2357-2362. doi: 10.21037/tcr.2020.03.35. doi: 10.21037/tcr.2020.03.35 pmid: 35117596
[20]	Plante M, Renaud MC, François H, et al. Vaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature[J]. Gynecol Oncol, 2004, 94(3):614-623. doi: 10.1016/j.ygyno.2004.05.032. doi: 10.1016/j.ygyno.2004.05.032 pmid: 15350349
[21]	Ferrandina G, Salutari V, Petrillo M, et al. Conservatively treated glassy cell carcinoma of the cervix[J]. World J Surg Oncol, 2008, 6:92. doi: 10.1186/1477-7819-6-92. doi: 10.1186/1477-7819-6-92 pmid: 18755015
[22]	Fagotti A, Gagliardi ML, Moruzzi C, et al. Excisional cone as fertility-sparing treatment in early-stage cervical cancer[J]. Fertil Steril, 2011, 95(3):1109-1112. doi: 10.1016/j.fertnstert.2010.11.010. doi: 10.1016/j.fertnstert.2010.11.010 pmid: 21122837
[23]	Blake EA, Ross MS, Ross ME, et al. Immunohistochemical analysis of glassy cell carcinoma of the cervix reveals robust lymphocyte infiltrate and the expression of targetable inhibitory immune checkpoints[J]. Arch Gynecol Obstet, 2022, 305(2):439-447. doi: 10.1007/s00404-021-06164-x. doi: 10.1007/s00404-021-06164-x