子宫苗勒氏管腺肉瘤的诊断与治疗  

Diagnosis and Treatment of Uterine Mullerian Adenosarcoma

作　　者：刘志强[1] 刘辉[1] 彭芝兰[1] 杨开选[1] 

机构地区：[1]四川大学华西第二医院,四川成都610041

出　　处：《实用妇产科杂志》2007年第1期43-45,I0001,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：提高对子宫苗勒管腺肉瘤的诊断和治疗水平。方法：回顾性分析我院收治的9例子宫苗勒氏管腺肉瘤病例,分析其临床病理特征、治疗和预后。结果：①主要表现为阴道流血及宫颈赘生物等；②组织学特征主要为良性或非典型腺上皮组织伴有肉瘤间质,具有“腺周套袖”和息肉样突入腺腔的结构,初诊诊断率44．4%；③8例行手术治疗,其中7例术后给予化疗,1例单纯宫颈病灶摘除；④随访7例,除1例Ⅲ期患者死亡,余存活。结论：阴道流血常为本病首发症状；年轻患者易误诊为良性疾病；治疗以较广泛的手术并辅以化疗为宜；该病通常为低度恶性,预后与临床分期、患者年龄关系密切。Objective： To study the diagnosis and treatment of uterine Mullerine adenosarcoma. Methods： The medical data of 9 cases with uterine adenosarcoma treated in our hospital was analyzed retrospectively, and focused on the dinicopathologic features,treatment and the prognosis. Results：①The maJn dinical manifestation of these patients was vaginal bleeding and cervical neoplasm.②The predominant histologic features showed the glands be lined by benign or atypia glandular epithelium with sarcoma stromal cells which showed characteristic structures of periglandular cuffs of increased cellularity and intraglandular polypoid projections. The rate of preliminary diagnosis was 44.4%. ③8 patients were treated with total hysterectomy with or without pelvic lymphadenectomy and 7 received chemotherapy after operation. 1 patient accepted the excision of cervical neoplasm only.④7 cases were followed up and only 1 case in stage Ⅲ dead.Conclusions：This disease usually presents as vaginal bleeding and easily misdiagnosed with lower incidence and higher grade. Surgery combined chemotherapy is the first-line therapy, Its prognosis relate with clinical stage and patient＇s age.

关 键 词：子宫肿瘤 腺肉瘤 诊断 治疗 

分 类 号：R737.33[医药卫生—肿瘤]