Usefulness of a management protocol for patients with cervical multicystic lesions: A retrospective analysis of 94 cases and the significance of GNAS mutation
| Autor: | Tanri Shiozawa, Hiroyasu Kashima, Akiko Takatsu, Tsutomu Miyamoto, Keiko Ishii, Hirofumi Ando, Yasunari Fujinaga |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Pathology medicine.medical_treatment Conization gastric mucins Uterine Cervical Neoplasms Cervix Uteri Hysterectomy Gastroenterology 03 medical and health sciences 0302 clinical medicine follow‐up studies Internal medicine Cytology Chromogranins GTP-Binding Protein alpha Subunits Gs Carcinoma medicine Atypia GNAS complex locus Humans Nabothian cyst Aged Retrospective Studies adenocarcinoma Hyperplasia biology business.industry Obstetrics and Gynecology Original Articles Middle Aged medicine.disease Treatment Outcome 030104 developmental biology Lobular Endocervical Glandular Hyperplasia 030220 oncology & carcinogenesis Mutation biology.protein Adenocarcinoma Original Article Female business |
| Zdroj: | The Journal of Obstetrics and Gynaecology Research |
| ISSN: | 1447-0756 1341-8076 |
| DOI: | 10.1111/jog.13083 |
| Popis: | Aim The proper preoperative diagnosis and management of cervical proliferative disorders presenting with multiple cysts, including minimal deviation adenocarcinoma (MDA), lobular endocervical glandular hyperplasia (LEGH), and nabothian cyst (NC), have not been fully established. We previously proposed a management protocol comprising a diagnostic approach using cytology, magnetic resonance imaging, and gastric-type mucin and subsequent treatment. We herein evaluate the usefulness of this protocol and implications of GNAS mutations in LEGH. Methods The clinical courses of 94 patients with cervical multicystic lesions who visited our hospital between June 1995 and September 2014 were retrospectively analyzed. GNAS mutations were investigated in 10 LEGH, five LEGH with atypia, and two MDA cases. Results Of the 94 patients, the conditions of 10, 59, and 25 were clinically diagnosed as suspicious of MDA or carcinoma (S/O MDA-Ca), suspicious of LEGH (S/O LEGH), and NC, respectively. Ten patients each with S/O MDA-Ca and S/O LEGH underwent hysterectomy, and the correct ratio for diagnosis was 90% (18/20). Of the 42 S/O LEGH cases followed-up for more than 12 months, three showed an increase in tumor size. After hysterectomy, two were LEGH with atypia while one was NC. The GNAS mutation was detected in two cases of LEGH with atypia, one of which showed an increase in tumor size during follow-up. Conclusion The management protocol we propose herein will be useful. An increase in tumor size is important to detect potentially malignant LEGH. GNAS mutations may be involved in the tumorigenesis of potentially malignant LEGH. |
| Databáze: | OpenAIRE |
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