子宫交界性平滑肌瘤的病理诊断回顾性分析

A Retrospective Analysis of Pathological Diagnosis of Uterine JunctionLeiomyoma

目的分析子宫交界性平滑肌瘤的病理诊断方法和临床特征。方法选取2019年1月至12月平邑县中医医院收治的45例子宫交界性平滑肌瘤患者作为研究对象,对其病理特征和临床资料展开回顾性分析。结果45例患者中普通型30例,所占比例为66.67%;细胞型平滑肌瘤7例,所占比例为15.56%;不典型平滑肌瘤6例,所占比例为13.23%;奇异型1例,所占比例为2.22%,肉瘤1例,所占比例为2.22%。从细胞丰富程度、细胞异型与核分裂的角度来看,患者均按照常规子宫平滑肌瘤进行手术,手术后不进行特殊处理。肿块特征为灰白色,切面有漩涡状结构,与周围组织有清晰的分界且有假包膜情况,但平滑肌瘤在整体上并不具有明显差异。45例患者中有26例患者为增生期,19例患者为分泌期,但不同月经周期的细胞异型与核分裂结果比较差异无统计学意义(P>0.05)。在临床特征方面,子宫交界性平滑肌肿瘤患者常见症状为月经量异常增加伴有下腹痛或压迫现象,但细胞型、奇异型和不典型患者与一般子宫平滑肌肿瘤的临床症状特征相似,不具有明显区别。结论子宫交界性平滑肌瘤的病理诊断可以通过细胞丰富程度、瘤细胞的异型性状态以及核分裂组织学特征等进行分析,在治疗方式的选择上与一般平滑肌瘤保持相同,例如从分子生物学的角度判断交界性子宫平滑肌瘤的良性与恶性,协助诊断后确定治疗方案。

Objective To analyze the pathological diagnosis and clinical features of uterine borderline leiomyoma.Methods A total of 45 patients with uterine borderline leiomyoma admitted to Pingyi County Traditional ChineseMedicine Hospital from January to December 2019 were selected as the research objects,and their pathologicalcharacteristics and clinical data were analyzed retrospectively. Results In this study,there were 30 cases ofcommon type,accounting for 66.67%;7 cases of cellular leiomyoma,accounting for 15.56%;6 cases of atypicalleiomyoma,accounting for 13.23%;1 case of singular type,accounting for 2.22%,1 case of sarcoma,accountingfor 2.22%. From the point of view of cell richness,cell atypia and mitosis,the patients were operated accordingto the conventional uterine leiomyoma without special treatment. The mass features are gray white,with whirlpoolstructure on the section,clear boundary with surrounding tissues and pseudocapsule,but there is no significantdifference in leiomyoma on the whole. Among the 45 patients,26 patients were in proliferative phase and 19patients were in secretory phase. However,there was no significant difference in cell atypia and mitosis betweendifferent menstrual cycles(P>0.05). In terms of clinical characteristics,the common symptoms of patients withuterine borderline smooth muscle tumor are abnormal increase of menstrual volume accompanied with lower abdominalpain or compression phenomenon,but the clinical symptoms of cellular,singular and atypical patients are similarto those of general uterine smooth muscle tumor,and have no obvious difference. Conclusion In terms of diagnosisand treatment of uterine leiomyoma,the diagnosis and treatment of uterine leiomyoma can be based on the samemolecular diagnosis and treatment as that of benign leiomyoma.