子宫内膜癌合并子宫肌瘤或(和)子宫肌腺瘤16例临床分析

Clinical Analysis of 16 Cases of Endometrial Carcinoma Accompanied with Uterine Myoma or(and) Adenomyoma

目的探讨子宫内膜癌合并子宫肌瘤或（和）子宫肌腺瘤的临床表现及诊断方法。方法回顾性分析2003～2007年收治的16例子宫内膜癌合并子宫肌瘤或（和）子宫肌腺瘤患者的病史、临床表现及诊治经过。结果16例患者平均年龄53．93岁（45～80岁），其中围绝经期妇女8例（50．00%），绝经期妇女8例（50．00%）。13例（81．25％）有异常阴道流血并术前确诊；3例合并子宫肌腺瘤患者无异常阴道流血，仅表现下腹部疼痛性质改变，术前漏诊子宫内膜癌。结论围绝经期及绝经期子宫肌瘤或（和）子宫肌腺瘤患者有异常阴道流血者首先要除外子宫内膜癌，对合并子宫肌腺瘤患者即使没有异常阴道流血，但若下腹部疼痛性质改变，要高度警觉发生子宫内膜癌可能。

Objective To investigate the clinical manifestation and diagnostic approach to the endometrial carcinoma accompanied with uterine myoma or（and） adenomyoma. Methods A retrospective of 16 cases of endometrial carcinoma accompanied with uterine myoma or（and） adanmyoma was performed. Results The average age of 16 cases was 53. 93 years and 8 cases （50.00%） were postmenopausal women,8 cases（50.00%） were perimenopausal women. 13 cases （81.25%） had abnorminal vaginal bleeding and were comfirmed before operation. 3 cases who were missed diagnosis only had subabdominal pains, hadn＇t abnorminal vaginal bleeding. Conclusion The main manifestation of postmenopausal and perimenopausal women with endometrial carcinoma accompanied by uterine myoma or（and） adenowyoma was abnorminal vaginal bleeding. But when the subabdominal pains changed in the cases of postmenopausal and perimenopausal women with endometriosis, we should consider about the possibility of endometrial carcinoma.