子宫内膜间质肉瘤28例临床分析

Clinical analysis of twenty-eight cases with endometrial stromal sarcoma.

目的：研究子宫内膜间质肉瘤的诊断、治疗和预后。方法：回顾分析28例子宫内膜间质肉瘤的临床资料。结果：确诊主要依靠病理检查。术前确诊率为67．9％，术中冰冻病理切片可将确诊率提高至89．3％。采取以手术为主的综合治疗，Ⅰ-Ⅱ期5年生存率为82．4％，Ⅲ-Ⅳ期5年生存率为0％；低度恶性子宫内膜间质肉瘤的3年和5年生存率分别为100％和92．9％，未分化子宫内膜肉瘤的3年生存率为22．2％。结论：术中冰冻切片至关重要，可明显提高确诊率；治疗以手术为主，综合放化疗。预后与临床分期、分化程度、治疗方法密切相关。

Objective：To determine the diagnosis,treatment and prognosis of endometrial stromal sarcoma. Method：Retrospective analysis was performed on 28 cases with endometrial stromal sarcoma. Results：Diagnosis was mainly confirmed by pathologic results. The diagnostic rate was 67.9% preoperatively. The frozen section examination could increase the diagnostic rate up to 89.3% intraoperatively. Operation was the main treatment, combined with chemotherapy and radio therapy. The 5 years survival rate was 82.4% in stage Ⅰ and Ⅱ , and 0% in stage Ⅲand Ⅳ. The 3 and 5 year survival of low-grade endometrial stromal sarcoma was 100% and 92.9% respectively, and the 3 years survival rate of undifferentiated endometrial sarcoma was 22.2%. Conclusion： The frozen section examination is necessary and can increase the diagnostic rate intraoperatively. Operation is the main treatment ,while adjuvant chemotherapy or radiotherapy are auxiliary. The prognosis of endometrial stromal sarcoma is closely related to clinical stage, histologic type and treatment.