摘要
目的 探讨年轻妇女子宫肉瘤的特点以及与预后有关的因素。方法 回顾性分析 1979年至 1999年我院收治的 <40岁的 43例子宫肉瘤临床资料 ,其中子宫平滑肌肉瘤 2 5例 ( 5 8% ) ,子宫内膜间质肉瘤 14例( 3 2 % ) ,子宫恶性米勒管混合瘤 4例 ( 9% )。临床分期Ⅰ期 3 4例 ,Ⅱ期 4例 ,Ⅲ期 5例。术前误诊率为 60 %。治疗以手术为主 ,辅以化疗及放疗。手术以全子宫及双 (单 )附件切除术为主 ( 70 % ) ,其次为广泛全子宫及双附件切除 +盆腔淋巴结清扫术 ( 2 3 % )。术后 3 3例 ( 76% )加用了化疗 ,3例 ( 7% )加用了放疗。结果 总的二年存活率为 86% ,五年存活率为 82 %。子宫平滑肌肉瘤及内膜间质肉瘤二年、五年存活率高于恶性米勒管混合瘤(P <0 .0 1)。早期 (Ⅰ期 )子宫肉瘤的二年、五年的存活率高于中、晚期 (Ⅱ、Ⅲ期 ) (P <0 .0 1)。手术方式与预后无统计学差异 (P >0 .0 5 )。结论 年轻妇女的子宫肉瘤以平滑肌肉瘤及内膜间质肉瘤多见 ,临床期别比较早 ,二年、五年的存活率高于文献报道的存活率 ,预后相对较好。
Purpose: To study the features and factors affecting the prognosis of uterine sarcoma in young women. Methods: Fourty-three cases of uterin sarcoma under 40 years old treated were analyzed retrospectively from 1979 to 1999, among which there were 25 cases with leimyosarcoma (58%), 14 cases with endometrial stromal sarcoma (32%) and 4 cases with malignant Mullerian mixed tumor. According to union international control cancer (UICC) staging, 34 cases were on stage I, 4 cases stage II and 5 cases stage III. The rate of preoperative misdiagnosis was 60%. Operation was the first choice, the chemothelopy and radiothelopy were the second choice. 70% of the patients were treated by hysterectomy and bilateral (lateral) annexectomy; 23% of them by radical hysterectomy, bilateral annexectomy and pelvic lymphadenectomy. After operation, 33 cases (76%) were treated by chemotherapy, 3 cases (7%) by radiotherapy. Results: The overall 2-year survival rate was 86% and 5-year survival rate was 82%. The 2 and 5-year survival rate of leiomyosarcoma and endometrial stromal sarcoma was higher than malignant Mullerian mixed tumor (P 0.05). Conclusions: Leiomyosarcoma and endometrial stromal sarcoma were mostly seen in young women and early stage was chief. The survival rate of 2 and 5-year was higher than literature reports. The prognosis was better. It must be prudent to reserve the uterine and overies in operations of uterine sarcoma of young women.
出处
《复旦学报（医学版）》
EI
CAS
CSCD
北大核心
2003年第1期44-46,55,共4页
Fudan University Journal of Medical Sciences
