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Abstract：
BACKGROUND: This observation study aimed to differentiate between lobular endocervical glandular hyperplasia (LEGH) and gastric-type mucinous carcinoma (GAS) while evaluating the feasibility and efficacy of laparoscopic surgery in the preoperative diagnosis of cervical cystic lesions.
METHODS: A retrospective study was conducted to evaluate the diagnostic process and laparoscopic surgical management of cervical cystic lesions suspected to be LEGH or GAS. Preoperatively and postoperatively, MRI, cytology, histology, tumor marker analysis, and surgical outcomes (blood loss during surgery, operative time) were assessed. Six individuals were selected based on magnetic resonance imaging (MRI) results indicating a preoperative suspicion of LEGH or GAS. These patients underwent laparoscopic surgical treatment without indications of malignancy based on preoperative histology or cytology.
RESULTS: Initially, all individuals were suspected to have LEGH based on MRI findings. Postoperatively, two patients were diagnosed with LEGH, two with adenocarcinoma in situ (AIS) and minimal deviation adenocarcinoma (MDA), and two showed no notable findings on pathology (one diagnosed endometrioid carcinoma in endometrial tissue). Patients with malignancies exhibited longer surgical times and higher intraoperative blood loss. Preoperatively, no significant variation was observed in maximal lesion diameter between adenocarcinoma and LEGH. However, lesion diameter increased significantly over time in patients with GAS.
CONCLUSIONS: Laparoscopic surgery demonstrated feasibility and provided crucial diagnostic and therapeutic outcomes, with no postoperative recurrence observed in cases of malignancy, despite the challenges associated with preoperative differentiation. These findings underscore the potential of laparoscopic surgery in enhancing both diagnostic accuracy and therapeutic efficacy for cervical cystic lesions, offering promise for improved patient outcomes and management strategies in clinical practice.
METHODS: A retrospective study was conducted to evaluate the diagnostic process and laparoscopic surgical management of cervical cystic lesions suspected to be LEGH or GAS. Preoperatively and postoperatively, MRI, cytology, histology, tumor marker analysis, and surgical outcomes (blood loss during surgery, operative time) were assessed. Six individuals were selected based on magnetic resonance imaging (MRI) results indicating a preoperative suspicion of LEGH or GAS. These patients underwent laparoscopic surgical treatment without indications of malignancy based on preoperative histology or cytology.
RESULTS: Initially, all individuals were suspected to have LEGH based on MRI findings. Postoperatively, two patients were diagnosed with LEGH, two with adenocarcinoma in situ (AIS) and minimal deviation adenocarcinoma (MDA), and two showed no notable findings on pathology (one diagnosed endometrioid carcinoma in endometrial tissue). Patients with malignancies exhibited longer surgical times and higher intraoperative blood loss. Preoperatively, no significant variation was observed in maximal lesion diameter between adenocarcinoma and LEGH. However, lesion diameter increased significantly over time in patients with GAS.
CONCLUSIONS: Laparoscopic surgery demonstrated feasibility and provided crucial diagnostic and therapeutic outcomes, with no postoperative recurrence observed in cases of malignancy, despite the challenges associated with preoperative differentiation. These findings underscore the potential of laparoscopic surgery in enhancing both diagnostic accuracy and therapeutic efficacy for cervical cystic lesions, offering promise for improved patient outcomes and management strategies in clinical practice.
摘要：
背景：本观察研究旨在区分小叶性宫颈腺体增生（LEGH）和胃型黏液癌（GAS），同时评估腹腔镜手术在宫颈囊性病变术前诊断中的可行性和有效性。
方法：进行了一项回顾性研究，以评估怀疑为LEGH或GAS的宫颈囊性病变的诊断过程和腹腔镜手术治疗。术前和术后，MRI,细胞学,组织学,肿瘤标志物分析,和手术结果（手术过程中失血，手术时间）进行评估。根据磁共振成像（MRI）结果表明术前怀疑LEGH或GAS，选择了6名个体。根据术前组织学或细胞学检查，这些患者接受了腹腔镜手术治疗，没有恶性肿瘤的指征。
结果：最初，根据MRI检查结果,所有个体均怀疑患有LEGH.术后,两名患者被诊断为LEGH，两个原位腺癌（AIS）和微小偏差腺癌（MDA），2例无明显病理发现（1例诊断为子宫内膜组织中的子宫内膜样癌）。恶性肿瘤患者的手术时间较长，术中失血量较高。术前,在腺癌和LEGH之间，最大病变直径未观察到显着差异。然而,GAS患者病灶直径随时间显著增加。
结论：腹腔镜手术证明了可行性，并提供了关键的诊断和治疗结果，在恶性肿瘤病例中没有观察到术后复发，尽管与术前分化相关的挑战。这些发现强调了腹腔镜手术在提高宫颈囊性病变的诊断准确性和治疗效果方面的潜力。为临床实践中改善患者预后和管理策略提供了希望。
方法：进行了一项回顾性研究，以评估怀疑为LEGH或GAS的宫颈囊性病变的诊断过程和腹腔镜手术治疗。术前和术后，MRI,细胞学,组织学,肿瘤标志物分析,和手术结果（手术过程中失血，手术时间）进行评估。根据磁共振成像（MRI）结果表明术前怀疑LEGH或GAS，选择了6名个体。根据术前组织学或细胞学检查，这些患者接受了腹腔镜手术治疗，没有恶性肿瘤的指征。
结果：最初，根据MRI检查结果,所有个体均怀疑患有LEGH.术后,两名患者被诊断为LEGH，两个原位腺癌（AIS）和微小偏差腺癌（MDA），2例无明显病理发现（1例诊断为子宫内膜组织中的子宫内膜样癌）。恶性肿瘤患者的手术时间较长，术中失血量较高。术前,在腺癌和LEGH之间，最大病变直径未观察到显着差异。然而,GAS患者病灶直径随时间显著增加。
结论：腹腔镜手术证明了可行性，并提供了关键的诊断和治疗结果，在恶性肿瘤病例中没有观察到术后复发，尽管与术前分化相关的挑战。这些发现强调了腹腔镜手术在提高宫颈囊性病变的诊断准确性和治疗效果方面的潜力。为临床实践中改善患者预后和管理策略提供了希望。
