关键词: 宫颈肿瘤, 腺癌, 淋巴转移, 回顾性研究, 预后

Abstract: Objective：To discuss the clinical features，treatment and prognosis of villoglandular adenocarcinoma of the uterine cervix(VGA). Methods: We retrospectively reviewed data on age distribution, clinical features, human papillomavirus(HPV) and TCT results, treatment and prognosis of the 36 patients with VGA, who had been treated and followed up from January 2013 to April 2018 in the First Affiliated Hospital of Zhengzhou University. Results: In the same period of 323 cases of cervical adenocarcinoma, VGA accounted for 11.15% (36/323). The average age of the 36 patients with VGA is 44.61±7.93 years (range 25-67 years). The most common clinical symptoms were cervical contract (33.3%) and irregular vaginal bleeding (33.3%). International Federation of Gynecology and Obstetrics (FIGO) stage ⅠB1 disease was found in 26 patients, ⅠB2 in 5, ⅡA1 in 3, ⅡB in 2. HPV was performed in 26 patients before treatment. 21 patients were positive (80.77%), and 5 patients were negative for HPV (19.23%). 35 patients were treated with radical hysterectomy with pelvic lymphadenectomy，6 young ⅠB patients retained ovary during operation;1 patient received concurrent chemoradiation therapy. Followed up 4 to 59 months, 2 patients died of recurrence, and the remaining 34 survived without tumor recurrence (includes 6 patients with ovarian retention). Conclusions: The incidence of VGA is very low. Its occurrence is closely related to high-risk HPV infection. Most patients are found in the early clinical stage. The degree of tumor differentiation is relatively good, and the depth of invasion is shallow. Ovarian metastasis, lymphatic vessel infiltration and lymph node metastasis are rare, the prognosis is better. Young patients who stay in early stage may consider retaining the ovaries after excluding high risk factors of ovarian metastasis.

Key words: Uterine cervical neoplasms, Adenocarcinoma, Lymphatic metastasis, Retrospective studies, Prognosis