子宫内膜增生与子宫内膜上皮内瘤变的临床病理分析  

Clinical and pathological analysis of endometrial hyperplasia and endometrial intraepithelial neoplasia

作　　者：李晓超[1] 宋文静[1] 

机构地区：[1]天津医科大学病理学教研室,300041

出　　处：《临床与实验病理学杂志》2011年第9期959-962,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨WHO1994有关子宫内膜增生(endometrial hyperplasia,EH)和子宫内膜上皮内瘤变(endometrial intraepithelial neoplasia,EIN)的形态学特点以及分类的优点。方法观察474例刮宫标本HE切片中的EH性病变(包括子宫内膜单纯性增生、复杂性增生及两者伴有的不典型增生),根据新标准找出EIN,总结分析EH分类与EIN分类的关系,同时对部分EIN患者进行随访。结果 379例子宫内膜单纯性增生中EIN 11例(2.9%),16例伴有不典型增生的单纯性增生中EIN 1例(6.25%)4,8例子宫内膜复杂性增生中EIN 6例(12.5%)3,1例伴有不典型增生的复杂性增生中EIN 28例(90.3%)。共随访到EIN患者13例,因恶变摘除子宫者3例(23.07%)。结论 EIN为单克隆增生(肿瘤增生)性病变,恶变潜能较高,完全不同于良性的EH,具有其特殊的形态学特点和生物学行为,EIN的分类方法在诊断标准上和对恶变潜能的预判方面优于WHO 1994年分类,明确EIN的病理学诊断特点对今后的诊断及治疗都有极其重要的意义。Purpose To study the morphological characteristics of the two classification systems of endometrial hyperplasia（EH） which is defined by World Health Organization 1994 and endometrial intraepithelial neoplasia（EIN） system and to evaluate the advantage of EIN system.Methods 474 cases endometrial biopsy and curettage specimens of endometrial hyperplasia（including simple or complex hyperplasia with or without atypia） were observed by used of optical microscope and EIN was found in these endometrial hyperplasia,then sumed up and statisticed the relation of EIN and endometrial hyperplasia.Results At the sametime,we followed up part of the patients with EIN.EIN was detected 11 in 48 cases simple hyperplasia with atypia（2.9%） of EH,1 of 16 cases simple hyperplasia with atypia（6.25%）,6 ones of 48 cases complex hyperplasia without atypia（12.5%） and 28 ones of 31cases complex hyperplasia with atypia（90.3%）.13 cases patients of EIN were followed up and the uterus of 3 cases were excised because of malignant change（23.70%）.Conclusions Endometrial intraepithelial neoplasia should be as monoclonal hyperplasia（neoplastic proliferation） with higher malignant transformation potential and it is completely different concepts from benign endometrial hyperplasia as its special morphological characteristics and biological behaviour,EIN classification system has many superior in WHO1994 classification system in diagnostic criteria and anticipation of malignant transformation potential.It is very important to clear the pathological diagnosis characteristics of EIN.

关 键 词：子宫内膜上皮内瘤变 子宫内膜增生性病变 病理分析 

分 类 号：R365[医药卫生—病理学]