子宫腺肉瘤的临床病理分析

Clinicopathologic analysis of uterine adenosarcoma

目的探讨子宫腺肉瘤的临床病理学特征、诊断、治疗及预后。方法回顾性分析中国医学科学院肿瘤医院自2001年～2013年收治的13例子宫腺肉瘤患者的临床病理资料及随访结果。结果患者年龄36～71岁,平均54岁。主要表现为异常阴道出血,特征性病理表现为肿瘤间质"套袖样"或息肉样突入腺腔内。13例患者均接受手术治疗,9例术后行辅助化疗,3例行放疗。随诊期间1例Ⅳ期患者因化疗无效于术后1个月死亡;3例患者于初始治疗后数月内死于肿瘤复发、转移,另外9例患者随访至今无复发。结论子宫腺肉瘤临床罕见,无特异性临床表现,确诊依赖于术后病理学检查;临床呈低度恶性,治疗应采用手术为主的综合治疗,晚期及存在高危因素的患者预后不良。疾病易复发,应长期随诊。

Objective To study the clinical and pathological characteristics, diagnosis, treatment, and prognosis of uterine adenosarcoma. Method The clinieopathological data of 13 cases of uterine adenosarcoma in cancer hospital of CAMS from 2001 to 2013 were retrospectively analyzed. Result The mean age was 54 years old （ range 36 - 71 years old）. The main clinical manifestation was abnormal vaginal bleeding. The predominant histologic feature showed benign or atypia glandular epithelium within a sareomatous stroma which appeared as periglandular cuffs or intraglandular polypoid projections. All patients received surgical treatment and 9 had post-operative chemotherapy, 3 had radiotherapy. During the follow-up, 1 patient of clinical stage 1V died 1 months after surgery and chemotherapy. 3 patients died from recurrence and metastasis within a few months after the initial treatment. Others survived with tumor-free. Conclusion Uterine ade- nosarcoma is a rare tumor without specific manifestations. The diagnosis depends on pathotnorphologic examinations. The tumors show low malignant potential and the main treatment strategy is surgery. The prognosis is poor in patients with ad- vaneed disease and risk factors. Due to the relatively high rate of recurrence, long-term follow-up is necessary.