子宫非典型息肉样腺肌瘤研究进展

Research Progress of Atypical Polypoid Adenomyoma of the Uterus

非典型息肉样腺肌瘤(atypical polypoid adenomyoma,APA)是一种罕见的子宫上皮和间质混合肿瘤。其发病机制尚不明确,可能与雌激素水平升高有关。主要临床表现为不规则阴道出血及不孕等。APA的影像学检查缺乏特征性,确诊需依据组织病理学,镜下组织结构常复杂多样,免疫组织化学是辅助诊断的重要方法。APA是良性肿瘤,但具有恶性潜能,有进展成子宫内膜癌的风险,临床上容易漏诊、误诊。目前,结合患者的生育要求、年龄及术后病理诊断选择个体化的治疗方案。综述APA的发病机制、临床表现、诊断和治疗及其预后的最新进展。

Atypical polypoid adenomyoma(APA)is a rare uterine epithelial and stromal tumor.The pathogenesis of APA is not clear,and it may be related to the increased level of estrogen.The main clinical manifestations were irregular vaginal bleeding and infertility.The characteristics of imaging examination of APA are atypical,the diagnosis depends on histopathology.The tissue structure under the microscopy is often complex and diverse.Immunohistochemistry is an important method to assist the diagnosis.APA is a benign tumor,but with malignant potential,there is a risk of progression into endometrial cancer.It is easy to miss diagnosis or misdiagnosis clinically.At present,the clinical treatment strategy of APA is to select the individualized treatment according to the fertility requirements,age and postoperative pathological diagnosis.The pathogenesis,clinical manifestations,diagnosis,treatment and prognosis of APA were reviewed.