子宫脉管内平滑肌瘤的生物学行为与临床处理

The Study on Biologic Manner and Clinical Management of Intravenous Uterine Leiomyoma

目的 探讨子宫脉管内平滑肌瘤的生物学行为和临床处理与预后的关系。方法 回顾性分析我院 1994年至 1998年间经手术并病理检查证实为子宫脉管内平滑肌瘤的 11例患者的临床病理资料。雌激素测定方法为免疫组织化学法。结果 11例患者中 9例 (81 8% )表现为月经过多 ,其中 2例 (18 2 % )伴贫血 ;子宫≥ 3个月妊娠大小者 7例 (6 3 6 % ) ,其中 6例 (6 / 7)B超显示有多个结节及血供丰富 ,与 <3个月妊娠大小的子宫相比 ,差异有显著性 (P <0 0 5 ) ;术前确诊率 0 0 % ,术中确诊率 6 3 6 % (P <0 0 5 ) ;7例 (6 3 6 % )具有典型的子宫脉管内平滑肌瘤的病理变化特征 ;6例测定雌激素受体者均阳性 ;1例 (9 1% )复发。结论 子宫脉管内平滑肌瘤具有独特的临床病理特征 ,其不良的生物学行为及临床处理与预后有关。

Objective To investigate the biologic manner of intravenous uterine myoma and the clinical management. Methods Analysed 11 cases of intravenous leiomyoma retrospectively from 1994 to 1998, of which all specimens of intravenous leiomyoma were confirmed by pathologic examination. The estrogen receptor was measured by immunohistochemistry. Results Nine patients (81 8%) presented menarrhagia, two patients (18 2%) appeared anemia. The size of uterus more than three pregnancy months was seen in seven cases (63 6%), of which six patients (6/7) showed uterine multiple nodule and abundant blood flow by ultrasound compared with those whose uterine size smaller than three pregnancy months ( P> 0 05). The correct diagnosis before operation was 0 percent, 63 6% of the patients was diagnosed during operation ( P< 0 05). Seven patients (63 6%) had classical pathological appearance of intravenous leiomyoma. Positive estrogen receptors were detected in six patients. One patient (9 1%) was recurred. Conclusions Uterine intravenous leiomyoma has typical clinical and pathologic feature. The adverse biologic manner and the clinical treatment are related to prognosis.