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Gastric-Type Adenocarcinoma of the Uterine Cervix

医学 参数 子宫颈 淋巴血管侵犯 磁共振成像 腺癌 阶段(地层学) 比例危险模型 切除缘 放射科 病理 妇科 胃肠病学 肿瘤科 泌尿科 内科学 癌症 宫颈癌 外科 宫颈癌 转移 切除术 古生物学 生物
作者
Kye Jin Park,Mi‐Hyun Kim,Jeong Kon Kim,Kyoung‐Sik Cho
出处
期刊:International Journal of Gynecological Cancer [BMJ]
卷期号:28 (6): 1203-1210 被引量:14
标识
DOI:10.1097/igc.0000000000001275
摘要

Objective

Gastric-type mucinous adenocarcinoma (GAS) of uterine cervix has been suggested as distinct clinicopathologic behavior. Our study aimed to investigate the distinguishing imaging features and clinical outcomes of GAS.

Methods

Fifteen cases of GAS and 45 cases of 3:1 age-matched usual-type endocervical carcinoma (UEA) were assessed. Clinical parameters (age, tumor size, clinical stage, and time to recurrence [TTR] or death) and pathologic results confirmed by surgery were recorded. Imaging features (tumor shape, margin, presence of vaginal involvement, or cyst) on magnetic resonance T2-weighed images were evaluated by consensus reading. Parametrial invasion was assessed by 2 independent readers on a 4-point scale system.

Results

Gastric-type mucinous adenocarcinomas were associated with a higher stage at presentation and higher rates of deep cervical stromal invasion, parametrial invasion, and lymphovascular invasion. On magnetic resonance images, GASs also demonstrated a more infiltrative shape (93.3% vs 22.2%; P < 0.001) with/without cysts, ill-defined margin (93.3% vs 31.8%; P < 0.001), endocervical location (46.7%) or extension to the entire cervix (46.7%), higher rates of vaginal involvement (40.0% vs 4.4%; P = 0.002), and higher grade of parametrial invasion by both readers (66.7% vs 22.2%; P = 0.003) compared with UEAs. Patients with GAS had a significantly shorter TTR compared with UEA cases (P < 0.001) by log-rank test. A multivariate Cox proportional hazards model revealed that an infiltrative tumor shape (hazard ratio, 5.92; P = 0.004) and stage II or greater (hazard ratio, 4.19; P = 0.011) were prognostic indicators of a shorter TTR.

Conclusions

Gastric-type mucinous adenocarcinoma may have characteristic imaging features and poorer outcomes compared with UEA.
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