子宫富于细胞型平滑肌瘤80例临床、手术及病理探讨

Clinical feature,operation and pathology of 80 patients with cellular leiomyoma of uterus

目的探讨子宫富于细胞型平滑肌瘤的发病因素、临床特征、病理特点及预后。方法收集2005年3月—2010年12月80例子宫富于细胞型平滑肌瘤患者的临床资料,对患者的症状、体征、手术所见、病理结果及发病相关因素等进行统计分析。结果本病发病率为19.56%;临床以月经量多、经期延长、月经紊乱为主要症状;以肌瘤较大、增长迅速、质地偏软为主要形态特征;以子宫平滑肌细胞丰富,有核分裂相或细胞异型性为病理特点;其发病与饮食习惯、性格特征、体质和营养状况以及家族遗传等因素相关。结论子宫富于细胞型平滑肌瘤近年来发病率显著增高,在病因、症状、体征、手术和病理等方面均有其自身特点,因属于特殊类型的交界性平滑肌瘤,应引起临床高度重视,选择合理的手术方案,并加强术后随访。

Objective It is to approach the pathogenic factor,clinical feature,pathologic character and prognosis of cellular leiomyoma of uterus（CLU）.Methods Clinical data of 80 patients with CLU were collected from March 2005 to December 2010.The symptoms,signs,finding during operation,pathological results and pathogenic factors of the patients were analyzed.Results The morbidity rate of CLU was 19.56%.Menorrhagia,menostaxis and menstrual disorder were the main symptoms in clinic.Larger myoma,rapid growth and soft uterine texture were the major morphological characteristics.The pathological features included enriched uterine smooth muscle cells,karyomitosis or atypical cellular.The pathogenic factors were related to dietary history,personality,nutrition,constitution and familial inheritance.Conclusion The morbidity rate of CLU is significantly increasing in recent years,and has its own characteristics in pathogenesis,symptoms,signs,operation and pathology.As CLU is belonged to special types of borderline malignancy,attention should be paid on selection of surgical types and follow up after surgery.