子宫肉瘤32例临床分析

Clinical Analysis on 31 Cases with Uterine Sarcoma

目的:探讨子宫肉瘤的临床特点、治疗和预后。方法:回顾性分析我院收治的子宫肉瘤患者32例的临床资料,其中子宫平滑肌肉瘤15例(46.9%),子宫内膜间质肉瘤10例(31.3%),子宫恶性苗勒管混合瘤7例(21.9%)。Ⅰ期16例,Ⅱ期7例,Ⅲ期6例,Ⅳ期3例。结果:①子宫肉瘤临床表现以阴道异常出血为主(65.6%),其次为下腹痛(43.8%),下腹部包块(37.5%),阴道排液(31.3%)、全身症状(18.8%)等;②术前诊断率34.4%(11/32);③治疗方案有18例(56.3%)行全子宫切除术加双侧附件切除术,2例(6.3%)行广泛子宫切除术加盆腔淋巴结清扫术,9例(28.1%)行肿瘤细胞减灭术,3例(9.4%)未行手术治疗。结论:子宫肉瘤的临床症状不典型,以阴道异常出血为主,术前诊断率低,治疗以手术为主,可辅以放疗和化疗,预后差,并与多种因素有关。

Objective：To investigate the relation of the clinical features, clinical treatment and the prognosis of uterine sarcoma. Methods：Thirty two cases with uterine sarcoma were analyzed retrospectively, among which there were 15 cases with leiomyosarcoma （46.9%）, 10 cases with malignant endometrial interstitialsarcomas （31.3%）, 7 cases with malignant Mullerian mixed tumor （21.9%）. 16 cases were on stage Ⅰ , 7 cases were on stage Ⅱ, 6 cases were on stage Ⅲ, and 3 cases belonged to stage IV. Results： ①The patients usually manifested with abnormal vaginal bleeding （65.6 % ）, pain on lower abdomen （43.8 % ）, palpable mass of lower abdomen （37.5 % ）, vaginal discharge （31.3 % ）, symptoms of discomfort feeling （18.8 % ）. ②The rate of preoperative diagnosis was 34.4 %. ③In treatment, 18 cases （56.3 % ） was treated by hysterectomy and bilateral salpingooophorectomy, 2 cases （6.3%） was treated by radical hysterectomy and pelvic lymphadenectomy; 9 cases （28.1% ） was treated by removal of the bulk of tumor, 3 cases （9.4%） was not treated by operative. Conclusion： The clinical symptom of uterine sarcoma is nonspecific （mostly abnormal vaginal bleeding） and the rate of preoperative diagnosis,, is low. The treatment is mostly by operation. Chemotherapy and radiotherapy are given after operation. The prognosis of uterine sarcoma is poor and related to many factors.