Adenocarcinoma of the uterine cervix: Particularities in diagnosis and treatment

作者：Vandenbroucke L; Robert A L; Lavoue V; Foucher F; Henno S; Leveque J^*

来源：Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 2013, 42(3): 207-216.

DOI：10.1016/j.jgyn.2012.07.003

• Uterine cervix
• Adenocarcinoma in situ
• Invasive adenocarcinoma
• Cervical neoplasia
• Conization
• Hysterectomy
• Radiotherapy
• Chemotherapy

Introduction. The adenocarcinoma of the uterine cervix accounts for 10 to 20% of the premalignant and malignant lesions and is different from the cervical intraepithelial neoplasia and invasive squamous cell carcinoma.
Materials and methods. Recent literature review (from 1985 to 2012) based on the literature available.
Results and discussion. Adenocarcinoma in situ is an induced HPV lesion (role of HPV 18) of the glandular epithelium: its preferential endocervical situation explains the difficulties in the diagnosis and follow-up after conservative treatment. If the hysterectomy remains the gold standard for treatment, the conservative treatments (resection in sano of the lesions with margins of more than 1 cm, meticulous study of the operative specimen, compliance with the follow-up) are possible in the young patients who desire to preserve their fertility. The invasive adenocarcinoma is characterized by a more difficult diagnosis because of its endocervical development, and a prognosis less favorable when compared to squamous cell carcinoma with a greater frequency of the lymphatic node involvement and metastatic diffusion. Its treatment must take into account the particular gravity of the factors of worse prognosis (FIGO stage, tumor size, lymphatic node spreading, adenosquamous histological subtype) in particular in the advanced stages and includes beside the surgery, radiotherapy and chemotherapy.

• 出版日期2013-5