子宫内膜间质肉瘤的临床与彩色多普勒超声特征  

Clinical and Color Doppler Ultrasound Features of Endometrial Stromal Sarcoma

作　　者：谢丽君[1] 刘新秀[1] 李海英[1] 魏巍丽 周彦 甘玲[1] XIE Lijun;LIU Xinxiu;LI Haiying;WEI Weili;ZHOU Yan;GAN Ling(Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;College of Mathematics and Statistics, Shenzhen University, Shenzhen 518060, China)

机构地区：[1]福建医科大学附属第一医院超声影像科,福州350005 [2]深圳大学数学与统计学院,深圳518060

出　　处：《福建医科大学学报》2022年第2期165-169,共5页Journal of Fujian Medical University

基　　金：福建省科技厅引导性项目(2018Y0025);福建医科大学启航基金项目(2018QH1081)。

摘　　要：目的探讨子宫内膜间质肉瘤(ESS)的临床及超声表现。方法回顾性纳入2013年1月—2020年12月27例经病理证实为ESS的患者的临床和超声影像资料,以60例子宫肌瘤(UF)患者为对照组,分析两组患者的临床及超声特征。结果单因素分析显示:ESS组和UF组患者的年龄分别为(48.5±9.9)岁和(41.1±9.5)岁,绝经率分别为48.1%和20.0%,异常阴道出血率分别为59.3%和13.3%;超声表现上,ESS组和UF组患者的瘤体最大径分别为(8.04±4.56)cm和(4.91±1.83)cm,边界不清概率分别为61.5%和12.2%,囊实性回声概率分别为44.4%和15.0%,血流分级Ⅱ~Ⅲ级分别占77.8%和30.0%,血流阻力指数(RI)分别为(0.46±0.09)和(0.61±0.05),以上差别均有统计学意义(P<0.05)。logistic多因素分析结果提示,年龄(OR=1.194)、阴道出血(OR=20.262)为ESS的危险因素(P<0.05),RI(OR=0.000)为ESS的保护因素(P<0.05)。受试者工作特征曲线分析结果提示,年龄、阴道出血、RI三者联合检查可鉴别ESS和UF。结论ESS临床易被误诊,恶性程度较高,充分认识其临床表现和超声特征,有助于提高鉴别诊断能力。Objective To investigate the clinical and ultrasonic manifestations of endometrial stromal sarcoma(ESS).Methods The clinical and ultrasonic image data of 27 patients with ESS confirmed by pathology in our hospital from January 2013 to December 2020 were collected,and 60 patients with uterine fibroids(UF)were used as control.The clinical and ultrasonic characteristics of the two groups were analyzed.Results In univariate analysis,the ages of patients with ESS and UF were(48.5±9.9)years and(41.1±9.5)years,the menopausal rates were 48.1%and 20.0%,and the abnormal vaginal bleeding rates were 59.3%and 13.3%,respectively.In terms of ultrasound findings,the maximum diameter of ESS and UF patients were(8.04±4.56)cm and(4.91±1.83)cm,the probability of unclear boundary was 61.5%and 12.2%,the probability of cystic and solid echo was 44.4%and 15.0%,the probability of blood flow gradeⅡ-Ⅲwas 77.8%and 30.0%,and the resistance indes(RI)value was(0.46±0.09)and(0.61±0.05),respectively.The above differences were statistically significant(P<0.05).Logistic multivariate analysis showed that age(OR=1.194)and vaginal bleeding(OR=20.262)were the risk factors of ESS(P<0.05),and RI(OR=0.000)was the protective factor of ESS(P<0.05).ROC curve analysis showed that the combined examination of age,vaginal bleeding and RI could distinguish ESS and UF.Conclusion ESS is easy to be misdiagnosed clinically and has a high degree of malignancy.A full understanding of its clinical manifestations and ultrasonic features will help to improve its ability of differential diagnosis.

关 键 词：子宫内膜间质肉瘤 彩色多普勒超声 血流阻力指数 子宫肌瘤 

分 类 号：R73[医药卫生—肿瘤]