摘要
目的探讨苗勒腺肉瘤的临床特点。方法回顾性分析2004年7月至2016年11月中国医科大学附属盛京医院收治的56例病理诊断为苗勒腺肉瘤患者的临床病理特征及诊治经过。结果病变多数发生在子宫体部(41/56,73.21%),其次发生于宫颈部(11/56,19.64%)。患者平均年龄49.71岁。子宫体腺肉瘤患者≤40岁者占19.5%(8/41)。子宫腺肉瘤(宫体及宫颈腺肉瘤)的主要症状为异常阴道流血、下腹痛,主要体征为子宫增大、息肉样组织脱出宫颈外口等。超声提示病灶以低回声为主,可检出血流信号。CT和磁共振检查提示囊实混合性包块,增强扫描表现为不均匀强化。术前活检准确率为34.6%。肌层浸润大于1/2的患者全部出现宫外转移。结论异常阴道流血及子宫增大为子宫腺肉瘤的典型临床表现;影像学检查有助于明确诊断;术前病理活检准确性不高;肌层浸润大于1/2可能是发生宫外转移的高危因素。
Objective To investigate the clinical features of Müllerian adenosarcoma.Methods The clinicopathological features of 56 cases of Müllerian adenosarcoma and the diagnosis and treatment were analyzed retrospectively.Results The most common site of adenocarcinoma was uterine corpus（41/56,73.21%）,and the second common site was uterine cervix（11/56,19.64%）.The average age of the patients was 49.71 years.Eight patients with uterine corpus adenosarcoma were equal to or younger than 40 years（8/41,19.5%）and four cervical adenosarcoma patients are equal to or younger than 40 years（4/11,36.4%）.The main symptoms were abnormal vaginal bleeding and abdominal pain,and the typical signs were enlargement of uterus and prolapse of polyp-like tumor from uterine cervix.Ultrasound feature of adenosarcoma was nodule with low echo and blood flow signal.CT and MR showed mixed density shadow,and enhanced scan showed uneven enhancement.The accuracy rate of pre-surgery biopsy was 34.6%.All patients with deeper muscular involvement（over 1/2）showed metastasis beyond uterus.Conclusion The typical clinical features are abnormal uterine bleeding and enlargement of uterus.Image examination is helpful in diagnosis. The pre-surgery biopsy is not very reliable. Deeper muscular involvement（over 1/2）may be the high-risk factor of metastasis beyond uterus.
作者
李海燕
宋苗苗
马欣
周欣
LI Hal-yah;SONG Miao-miao;MA Xin;ZHOU Xin(Department of Obstetrics and Gynecology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2018年第9期1047-1050,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
辽宁省教育厅重点实验室项目(LS201602)
关键词
苗勒腺肉瘤
临床特征
病理特征
Mullerian adenosarcoma
clinical features
pathological features
