宫颈非典型息肉样腺肌瘤10例临床分析  

Clinical analysis of 10 cases of cervical atypical polypoid adenomyoma

作　　者：张丽娟[1] 吴霞[1] 盛洁[1] Zhang Lijuan;Wu Xia;Sheng Jie(Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科,北京100026

出　　处：《中国医刊》2020年第7期734-736,共3页Chinese Journal of Medicine

摘　　要：目的探讨宫颈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2008年6月至2018年6月首都医科大学附属北京妇产医院诊治的10例宫颈APA患者的临床资料。结果患者绝经前9例,绝经后1例,2例合并不孕症;异常子宫出血是最常见症状,4例无明显症状,其中2例超声提示异常。2例合并子宫内膜病变,包括子宫内膜非典型性增生1例,复杂性增生1例;1例合并宫颈原位腺癌。术后随访20~102个月。宫腔镜术后进一步手术治疗3例,其中行全子宫及双侧附件切除术2例,宫颈锥切术1例;口服地屈孕酮药物治疗1例。1例因骨癌晚期多脏器功能衰竭死亡。宫颈APA复发1例,妊娠1例,均未发展为癌症。结论宫颈APA易发生误诊或漏诊,对于无症状的宫颈赘生物需进一步检查。宫腔镜手术是治疗宫颈APA的有效方法,术后需严密随访。Objective To analyze the clinical characteristics,diagnosis and prognosis of cervical APA.Method The clinical data of 10 cases with cervical APA admitted in our hospital from Jun.2008 to Jun.2018 were retrospectively analyzed.Result 9 cases were premenopause and 1case was post-menopause.2 cases had a history of infertility.The most common clinical symptom was irregular vaginal bleeding,but 4 cases were free of symptom.The ultrasound showed positive finding in 2 of 4 asymptomatic cases.Pathology found endometrial lesions in 2 cases,including 1 of endometrial hyperplasia with atypia and 1 of endometrial complex hyperplasia.1 case combined with cervical adenocarcinoma in situ.All cases were under follow up(20-102 months),1 case took dydrogesterone for therapy after the surgical,and 3 cases received supplementary surgery,including 2 of them were laparoscopic hysterectomy and bilateral adnexectomy and 1 case was operated on conization of cervix.1 case died of bone cancer with multiple organs failure.There was 1 recurrence and 1 pregnancy in all cases,no one progressed to cancer.Conclusion Cervical APA is prone to misdiagnosis or missed diagnosis,and further examination is required for asymptomatic cervical neoplasm.Hysteroscopy with complete excision of the lesion should be a preferred treatment method.The patients should need strict follow-up.

关 键 词：宫颈 非典型息肉样腺肌瘤 宫腔镜 

分 类 号：R737.33[医药卫生—肿瘤]