邵玉涵,孙 敏,吴 强

目的探讨宫颈不典型微腺体增生（MGH）的临床病理特征、诊断及鉴别诊断要点，分析其误诊原因，以期提高临床诊断准确性，避免过度治疗。方法回顾性分析1例初诊误判的宫颈不典型MGH病例的临床资料、组织形态学及免疫表型特征，并结合近年文献，探讨其诊断依据及鉴别陷阱。结果患者，51岁。经阴道超声检查示：宫颈管低回声（息肉待排）。宫腔镜于宫颈管见一直径约3 cm的新生物，表面见异形血管，予以摘除送检。镜下见组织表面被覆宫颈管腺上皮，上皮下固有层内见实性片状、腺管状或梁状排列的细胞，多数细胞形态温和，部分呈印戒细胞样、靴钉样，局灶细胞轻-中度非典型，偶见核分裂象，病理性核分裂象不可见，间质黏液样变性、玻璃样变性伴急慢性炎细胞浸润。免疫组化结果显示:P16(-)，P40（-），CK5/6（+），CK7（+），ER（部分+），EMA（+），Ki-67（+，约10%），TRPS1（+），Villin（-），PAX-8（+），Vim（+），CD10（-），P63（-），CEA（-），CD117（+）。结论宫颈不典型MGH属良性增生性病变，但其形态易与多种恶性病变混淆。诊断需紧密结合形态学特征和免疫组化标记，谨慎鉴别，以防止误诊及不必要的治疗。

宫颈微腺体增生；免疫组化；误诊；病理；鉴别诊断

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