中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
3期
204-207
,共4页
唐志坚%周蓉%鲍冬梅%刘晨%魏丽惠
唐誌堅%週蓉%鮑鼕梅%劉晨%魏麗惠
당지견%주용%포동매%류신%위려혜
息肉%子宫内膜肿瘤%癌,子宫内膜样%绝经期%腺癌,透明细胞
息肉%子宮內膜腫瘤%癌,子宮內膜樣%絕經期%腺癌,透明細胞
식육%자궁내막종류%암,자궁내막양%절경기%선암,투명세포
Polyps%Endometrial neoplasms%Carcinoma,endometrioid%Menopause%Adenocarcinoma,clear cell
目的 总结子宫内膜息肉(EP)恶变的临床特征.方法 回顾性分析病理检查确诊为EP潜在恶变(指不典型增生)或恶变(简称:恶变)患者42例的临床病理资料,并分为绝经前组(10例)与绝经后组(32例).结果 EP恶变率为1.42％ (42/2 965),绝经前EP的恶变率为0.48％(10/2 064),绝经后EP的恶变率为3.55％(32/901).息肉大小(以三径线的均值计)平均为(1.6±0.8)cm.90％(38/42)的患者出现异常子宫出血,且时间长短不一(0.1～ 280.0个月).绝经前组患者EP恶变均为子宫内膜样腺癌,绝经后组中出现4例(12％,4/32)透明细胞癌、9例(28％,9/32)浆液性腺癌.绝经前组患者息肉大小为(1.1±0.6)cm,绝经后组为(1.7±0.9)cm,两组比较,差异有统计学意义(P＜0.05).免疫组化染色显示,绝经前组患者ER均阳性(9/9),绝经后组16例ER阳性(59％,16/27),两组比较,差异无统计学意义(P =0.059);绝经前组患者PR阳性者8例(8/9),绝经后组PR阳性者15例(56％,15/27),两组比较,差异也无统计学意义(P =0.169).结论 绝经后妇女EP恶变率增加,EP恶变者ER、PR的阳性率降低,容易恶变为特殊的病理类型.绝经后的EP患者,尤其是伴有异常子宫出血的较大息肉,应当尽快手术治疗.
目的 總結子宮內膜息肉(EP)噁變的臨床特徵.方法 迴顧性分析病理檢查確診為EP潛在噁變(指不典型增生)或噁變(簡稱:噁變)患者42例的臨床病理資料,併分為絕經前組(10例)與絕經後組(32例).結果 EP噁變率為1.42％ (42/2 965),絕經前EP的噁變率為0.48％(10/2 064),絕經後EP的噁變率為3.55％(32/901).息肉大小(以三徑線的均值計)平均為(1.6±0.8)cm.90％(38/42)的患者齣現異常子宮齣血,且時間長短不一(0.1～ 280.0箇月).絕經前組患者EP噁變均為子宮內膜樣腺癌,絕經後組中齣現4例(12％,4/32)透明細胞癌、9例(28％,9/32)漿液性腺癌.絕經前組患者息肉大小為(1.1±0.6)cm,絕經後組為(1.7±0.9)cm,兩組比較,差異有統計學意義(P＜0.05).免疫組化染色顯示,絕經前組患者ER均暘性(9/9),絕經後組16例ER暘性(59％,16/27),兩組比較,差異無統計學意義(P =0.059);絕經前組患者PR暘性者8例(8/9),絕經後組PR暘性者15例(56％,15/27),兩組比較,差異也無統計學意義(P =0.169).結論 絕經後婦女EP噁變率增加,EP噁變者ER、PR的暘性率降低,容易噁變為特殊的病理類型.絕經後的EP患者,尤其是伴有異常子宮齣血的較大息肉,應噹儘快手術治療.
목적 총결자궁내막식육(EP)악변적림상특정.방법 회고성분석병리검사학진위EP잠재악변(지불전형증생)혹악변(간칭:악변)환자42례적림상병리자료,병분위절경전조(10례)여절경후조(32례).결과 EP악변솔위1.42％ (42/2 965),절경전EP적악변솔위0.48％(10/2 064),절경후EP적악변솔위3.55％(32/901).식육대소(이삼경선적균치계)평균위(1.6±0.8)cm.90％(38/42)적환자출현이상자궁출혈,차시간장단불일(0.1～ 280.0개월).절경전조환자EP악변균위자궁내막양선암,절경후조중출현4례(12％,4/32)투명세포암、9례(28％,9/32)장액성선암.절경전조환자식육대소위(1.1±0.6)cm,절경후조위(1.7±0.9)cm,량조비교,차이유통계학의의(P＜0.05).면역조화염색현시,절경전조환자ER균양성(9/9),절경후조16례ER양성(59％,16/27),량조비교,차이무통계학의의(P =0.059);절경전조환자PR양성자8례(8/9),절경후조PR양성자15례(56％,15/27),량조비교,차이야무통계학의의(P =0.169).결론 절경후부녀EP악변솔증가,EP악변자ER、PR적양성솔강저,용역악변위특수적병리류형.절경후적EP환자,우기시반유이상자궁출혈적교대식육,응당진쾌수술치료.
Objective To investigate the clinicopathologic characteristics of premalignant and malignant endometrial polyps (EP) in premenopausal and postmenopausal women.Methods A retrospective analysis was conducted in 42 cases of premalignant and malignant EP from 1993 to 2012.Polyps were classified into premenopausal (group A,10 cases) and menopausal (group B,32 cases),including 26 cases of endometrioid adenocarcinoma,4 of clear cell carcinoma,9 of serous adenocarcinoma,and 3 of atypical hyperplasia.Results The prevalence rate of premalignant and malignant EP was 1.42％ (42/2 965),the prevalence rate of malignancy in postmenopausal and postmenopausal women was 0.48％ (10/2 064) and 3.55％ (32/901),respectively.The mean size of EP was (1.6 ± 0.8) cm,abnormal uterine bleeding was positive in 90％ (38/42) of cases.The EP pathological diagnosis showed all were endometrioid adenocarcinoma in group A,while there were 4 of clear cell carcinoma,9 of serous adenocarcinoma in group B.The mean size of EP was (1.1 ± 0.6) and (1.7 ± 0.9) cm in group A and B respectively (P ＜0.05).According to immunohistochemistry,all cases of group A were ER positive,but 41％ (11/27) of group B were ER negative (P =0.059).The PR positive rate was 8/9 and 56％ (15/27) in group A and B,respectively (P =0.169).Conclusions The risk of the EP malignancy rate is higher,while ER,PR positive rate are lower in postmenopausal womcn.Postmenopausal EP,especially accompanied by abnormal uterine bleeding and large polyps should be removed as soon as possible.
