目的观察和分析宫颈腺样基底细胞癌(ABC)的临床和病理学特征,期望能更多的了解其临床病理特点、诊断及临床处理。方法回顾性分析15例宫颈ABC,收集相关临床病理学参数,分析该肿瘤的一般临床病理学特征及临床处理规律,采用免疫组织化学方法检测肿瘤组织Ki-67、p16、p63及p53的表达情况。结果 15例宫颈ABC发病中位年龄60岁,1例因绝经后阴道出血就诊,1例绝经后阴道分泌物异常就诊,余均无症状,阴道镜检查及切除标本肉眼观无明显肿块。ABC均合并鳞状上皮内病变或更重病变,且ABC癌巢均位于合并病变的深部,部分癌巢在空间上靠近血管和神经束,但无累及证据。11例可获得完整病理资料,镜下癌巢在宫颈纤维肌层中浸润性生长,浸润深度0.16~1.5 cm,浸润宽度0.11~1.7 cm,癌巢周间质反应从无明显改变至水肿伴/不伴炎症细胞浸润,2例间质出现黏液样变性。癌巢一般较小,基底样细胞构成实性癌巢或其内有单个腺腔结构,也可散在多个腺腔。6/11例癌细胞胞质发生透明变性,10/11例出现不同程度的鳞化,鳞化细胞可伴异型性,Ki-67增殖指数较未发生鳞化癌巢表达稍高。9/15例患者行诊断性/治疗性LEEP术,7/15例患者行至少全子宫切除术。结论宫颈ABC多发生于>50岁妇女,患者无明显症状,阴道镜检查及切除标本肉眼观未见肿块,通常显微镜下才能观察到病灶。该肿瘤临床进程缓慢,生物学行为惰性,虽在宫颈纤维肌层内浸润性生长,但并未如其他恶性肿瘤般破坏性生长,亦无癌性促结缔组织反应,ABC癌周间质反应轻,与周围组织“和平共处”。ABC癌细胞巢常发生鳞化,可伴异型性及增殖活性升高,此时应注意与鳞状上皮内病变累腺、浸润性鳞状细胞癌、腺样囊性癌、腺鳞癌等其他恶性肿瘤鉴别,一旦ABC合并其他恶性肿瘤,患者的临床处理应参考合并肿瘤的组织学类型、分级、分期等做出判断。 Objective To observe and analyze the clinical and pathological features of cervical adenoid-basal cell carcinoma (ABC), expecting to know more about its clinicopathological characteristics, diagnosis and clinical treatment. Methods A retrospective analysis of 15 cases of cervical ABC, collecting the relevant clinical and pathological parameters, the general clinical and pathological features of the tumor and clinical management of the law, the use of immunohistochemical detection of tumor Ki-67, p16, p63 and p53 expression . Results The median age of 15 cases with cervical ABC onset was 60 years old. One case was treated by vaginal bleeding after menopause. One case had abnormal vaginal discharge after the menopause. All the patients were asymptomatic. There was no obvious tumor in the macroscopic examination and colposcopy. ABC were associated with squamous intraepithelial lesion or heavier lesions, and ABC cancer nest are located in the deep lesions, part of the cancer nests in space close to the blood vessels and nerve bundles, but no evidence of involvement. Eleven patients were able to obtain the complete pathological data. The cancerous nests grew infiltratively in the cervical fibromium, the depth of invasion was 0.16-1.5 cm and the infiltration width was 0.11-1.7 cm. The interstitial reaction of the cancerous nests changed from no obvious change to edema / Inflammatory cells without infiltration, two cases of interstitial mucinous degeneration. Cancer nests are generally smaller, basal-like cells constitute a solid cancer nests or there are a single glandular cavity structure, but also scattered in multiple glandular cavity. In 6/11 cases, the cytoplasm of the cancer cells became transparent and degenerated. In 10/11 cases, squamous cells appeared with varying degrees of squamous cell differentiation and Ki-67 proliferation index was slightly higher than that without squamous cell carcinoma. In 9/15 patients undergoing diagnostic / therapeutic LEEP surgery, 7 of 15 patients underwent at least total hysterectomy. Conclusions Cervical ABC occurred mostly in women> 50 years old. There were no obvious symptoms in the patients. Colposcopy and excision of the macroscopic findings of the macroscopic specimens were not observed. The lesions were usually observed under the microscope. The slow clinical course of the tumor, biological behavior of inertia, although infiltrative growth in the cervical fibromyalterin, but not as destructive growth like other malignant tumors, there is no cancerous connective tissue reaction, ABC cancer interstitial reaction light , “Peaceful coexistence” with the surrounding organizations. ABC squamous cell carcinoma often occurs scaling, with atypia and proliferative activity may be increased, this time should pay attention to squamous intraepithelial lesions, invasive squamous cell carcinoma, adenoid cystic carcinoma, adenosquamous carcinoma and other Malignant tumor identification, once ABC with other malignant tumors, the clinical treatment of patients with reference to the histological type of tumor consolidation, grading, staging to make judgments.