70例子宫内膜间质肉瘤的临床分析  

Clinical feature and treatment of 70 patients with endometrial stromal sarcoma

作　　者：王雪卿[1] 潘凌亚[1] 戴志琴[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2008年第3期161-164,共4页Journal of Reproductive Medicine

摘　　要：目的分析子宫内膜间质肉瘤的临床特点及治疗。方法收集1983年1月至2005年12月,我院收治的子宫内膜间质肉瘤70例,其中低度恶性47例、高度恶性23例。分析其临床特点、治疗以及预后。结果70例患者的中位年龄45岁,其中50例(71%)表现不正常阴道出血,46例(66%)子宫增大,17例(24%)为宫颈口或阴道内的赘生物。21例行诊刮术、阳性率为91%,术前诊断26例(37%)。全子宫、双侧附件切除术是主要的手术方式。平均随诊时间56个月,无瘤生存期低度恶性为43个月、高度恶性为15.5个月。结论本组子宫内膜间质肉瘤是子宫肉瘤最常见的组织学类型;诊断性刮宫可能提高术前诊断率;肿瘤的病理类型、临床分期以及手术方式与预后显著相关。Objectives. To analyze the clinical features and treatments of endometrial stromal sarcoma. Methods ： Data the period of 1983 low-grade ESS and were collected from 70 patients with endometrial stromal sarcoma （ESS） treated during to 2005 in Peking Union Medical College Hospital. 47 patients were diagnosed as 23 patients as high-grade ESS. Their clinical characteristics, treatment and prognosis were analyzed. Results.. The median age of the patients was and sign of enlargement of uterus were presented new growths or vaginal new growths were found 45 years old. The symptom of irregular vaginal bleeding in 71% and 66% of the patients respectively. Cervical os in 24% of the patients. A diagnostic curettage was performed in 21 patients and the positive rate was 91% ,37% of patients were diagnosed before the operation. Total hysterectomy and bilateral salping-oophorotomy were the major surgical methods. The period of follow-up was 56 months in median. The survival stage without tumor for low-grade ESS was about 43 months and that for high-grade ESS was about 15.5 months. Conclusions： Endometrial stromal sarcoma was the most common histological type of uterine sarcoma in the study. The rate of preoperative diagnosis may be improved by diagnostic curettage. The pathologic type, stage and operative patterns were related to prognosis of the disease significantly.

关 键 词：子宫内膜间质肉瘤 诊断 治疗 

分 类 号：R737.3[医药卫生—肿瘤]