子宫内膜非典型息肉样腺肌瘤的临床特点  

Atypical polypoid adenomyma of the uterus： an analysis of 17 cases

作　　者：陈波[1] 朱兰[1] 郎景和[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,100730

出　　处：《中华医学杂志》2012年第15期1049-1051,共3页National Medical Journal of China

摘　　要：目的探讨子宫内膜非典型息肉样腺肌瘤（APA）患者的临床特点、诊治方法及预后。方法回顾性分析至2010年北京协和医院收治的17例APA患者的临床资料，对其临床特点、诊断治疗方法及预后进行分析。患者年龄19—53岁（中位39岁），其中15例为生育期女性，1例合并不孕。2例已绝经。结果14例患者临床表现为异常阴道出血。病变多为〉1cm的“息肉样病灶”。15例呈息肉样单发，1例为息肉样多发，1例病变广泛。8例病变位于宫腔，6例位于子宫下段，3例完全位于宫颈。所有病例术前均未诊断，均经术后病理证实。15例行病灶切除术（其中5例术后药物治疗），2例行全子宫切除术。2例药物治疗后妊娠、1例发生子宫内膜癌。结论APA虽为良性病变，但有恶变潜能。治疗及随访应该结合腺上皮不典型增生程度、生育要求等个体化处理。Objective To investigate the clinical characteristics, diagnosis and treatment of Atypical Polypoid Adenomyma of the uterus（APA）. Methods A retrospective study was made of 17 patients with APA,who were hospitalized at Peking Union Medical College Hospital from 2003 to 2010. Those patients＇ clinical characteristics, diagnosis, and treatments are analyzed respectively. The patients ranged from 19 to 53（ median 39）years old, Most of them （15/17） are during child-bearing period. There was one patient with infertility, two of the patients were postmenopausal. Results Fourteen cases had irregular vaginal bleeding clinically. Most of the pathology were polypous, which is more than 1 cm. Fifteen cases were characteristically polypoid, among which there were one case with muhipolypoid and one case was extensive. Eight cases were located in the uterine cavity. Six cases were located in the lower uterine segment. Three cases were located in cervix. None of the cases were diguosed, while all of them were diguosed by pathology after primary surgical. Fifteen patients had polypectomy （ among them, five patients took drug therapy after the surgical）, while the remaining two patients had hysterectomy. Two of the five patients, who took drug therapy, were pregnant. One patient was deteriorated with carcinoma of endometrium. Conclusion Although most cases of APA were begine, a few cases were associated with low malignant potential of recurrence. The treatment should depend on the age and reproductive desire of patient. And long-term follow- up is suggested.

关 键 词：子宫内膜非典型腺息肉样腺肌瘤 子宫内膜肿瘤 不育 

分 类 号：R737.33[医药卫生—肿瘤]