子宫内膜非典型息肉样腺肌瘤43例临床分析  

Atypical Polypoid Adenomyoma of the Uterus: A Clinical Analysis of 43 Cases

作　　者：李文敏[1] 马葆荣[1] 杜晓琴[2] 庞淑杰[3] 郎玉萍[1] 

机构地区：[1]天津市中心妇产科医院普妇科,300100 [2]天津市中心妇产科医院内分泌科,300100 [3]天津市中心妇产科医院病理科,300100

出　　处：《国际妇产科学杂志》2016年第2期190-192,共3页Journal of International Obstetrics and Gynecology

摘　　要：目的：探讨子宫内膜非典型息肉样腺肌瘤（atypical polypoid adenomyoma,APA）的临床特点、诊治方法及预后。方法：回顾性分析2012—2013年天津市中心妇产科医院收治的经病理证实的43例APA患者临床资料。结果：43例患者年龄17~74岁,平均（47.0±2.3）岁。36例（83.72%）患者有异常子宫出血;3例无症状,查体提示宫腔内光团;4例卵巢肿瘤手术时发现。39例患者宫腔镜检查中发现,28例单发、11例多发,病变位于子宫体部28例,子宫下段及峡部4例,宫颈7例,直径1~4 cm。所有病例均经组织学病理确诊。34例宫腔镜下病灶切除,27例手术成功;1例放弃治疗;15例全子宫切除,其中5例发生子宫内膜样腺癌。结论：APA虽为良性病变,但有恶性潜能,治疗及随访应依据患者年龄、是否有生育要求及腺上皮不典型增生程度决定,需要长期随访。Objective：To discuss the clinical characteristics, diagnosis and treatment of atypical polypoid adenomyma（APA） of the uterus. Methods：A retrospective study was made of 43 patients with APA, who were pathologically confirmed in Tianjin Central Hospital of Gynecology Obstetrics between 2012-2013. Results：The age of these 43 patients ranged from 17-74, with an average of （47.0±2.3） years. 36 cases（83.72%） had irregular uterus bleeding clinically; 3 cases without symptoms indicated that there were intrauterine light in the body examination. 4 cases were found in the ovarian tumor surgery. 39 patients were performed hysteroscope, among which 28 cases were characteristically polypoid and 11 cases were multipolypoid. 28 cases were located in the uterine cavity. 4 cases were located in the lower uterine segment. 7 cases were located in the cervix. The diameter of polypoid were 1-4 cm. All of the cases were diagnosed by pathology. 34 cases of patients in the resection of lesions under hysteroscopy. 27 cases were successfully operated. 1 case gave up treatment. 15 patients had hysterectomy, among them, 5 patients were deteriorated with carcinoma of endometrium. Conclusions：Although most cases of APA were benign, a few cases were associated with low malignant potential of recurrence. The treatment should depend on the age and epithelial dysplasia degree and reproductive desire of patient, and long-term follow-up is suggested.

关 键 词：子宫内膜肿瘤 腺肌瘤 宫腔镜检查 超声检查 

分 类 号：R737.33[医药卫生—肿瘤]