子宫交界性平滑肌瘤的病理诊断及临床特征

Histological diagnosis and cbnical features inborderline smooth muscle tumors of the uterus.

在子宫平滑肌瘤与肉瘤之间存在一组交界性肿瘤，包括子宫富于细胞型、奇异型、核分裂活跃型、不典型及恶性潜能未定型平滑肌瘤。本研究对原诊断为子宫富于细胞型平滑肌瘤４２例，进行重新诊断，同时收集其临床资料并随访。结果：４２例中，富于细胞型平滑肌瘤５例，奇异型平滑肌瘤１例，不典型平滑肌瘤７例，恶性潜能未定型平滑肌瘤２例，肉瘤１例及普通平滑肌瘤２６例。在细胞丰富的基础上，细胞异型与核分裂的关系密切；不同月经周期的细胞异型及核分裂变化不显著；交界性平滑肌瘤的临床特征与普通平滑肌瘤相同，预后良好。病理诊断子宫交界性平滑肌瘤应综合细胞丰富、细胞异型及核分裂三项组织学特征，其临床处理可同普通平滑肌瘤，但有必要作进一步研究。

etween leiomyoma and leiomyosarcoma thereexists a series of borderline smooth muscle tumors ofthe uterus, including cellular, bizzare, mitoticallyactive, atypical and uncertain malignant potentialleiomyomas. A histological criterion was presented inthis study for diagnosis of smooth muscle tumors ofthe uterus. Forty-two cases originally diagnosed asuterine cellular leiomyomas were re-examinedhistologically, analyzed clinically and followed up. Theresults showed that among the 42 cases, there were 5cases of cellular leiomyoma, 1 case of bizzareleiomyoma, 7 cases of atypical leiomyoma, 2 cases oftumors of uncertain malignant potential, 1 case ofleiomyosarcoma and 26 cases of usual leiomyoma. Thehistological critiria of dense cellularity, cell atypia andnuclear mitosis showed a close correlation, but did notvary at different phases of menstrual cycle. Clinicalfeatures of borderline tumors were similar to those ofusual leiomyomas, and their prognosis was also good.It is suggested that diagnosis of borderline smoothmuscle tumors of the uterus should be made on thebasis of three histological characteristics, includingeellular density, cell atypia and nuclear mitotic figures.Management of the borderline cases seems to be thesame as that of usual leiomyoma, but a further studymay be necessary.