目的分析子宫平滑肌肉瘤的临床特点及治疗预后情况。方法选取2014年6月-2015年6月在我院诊治的86例子宫平滑肌肉瘤患者作为研究对象,探讨子宫平滑肌肉瘤的临床特点、治疗及预后情况。结果子宫平滑肌肉瘤患者肿瘤结节直径(8.2±1.6)cm,数目2~3个;实性病灶,子宫明显增大,宫腔内有不规则软组织影;35例结节内部探及丰富血流信号;49例CA125<35 U/mL,16例CA125≥35 U/mL;临床分期:ⅠB期52例,ⅡB期22例,ⅢA期8例,阔韧带平滑肌肉瘤4例。10例患者术后死亡,其中4例临床分期为IB期,年龄超过68岁;6例临床分期为ⅡB期,年龄超过58岁。76例患者中,有32例随访期间术后复发,24例追加开腹手术,8例追加腹腔镜手术。结论子宫平滑肌肉瘤的病情复杂,临床诊断有一定难度,尽早采取手术治疗及化疗手段,可改善患者的预后情况及术后生存状况。
Objective To analyze the clinical characteristics and prognosis of uterine leiomyosarcoma. Methods 86 cases of uterine leiomyosarcoma diagnosed and treated in our hospital from June 2014 to June 2015 were selected as the study objects. The clinical characteristics, treatment and prognosis of uterine leiomyosarcoma were discussed. Results Tumor nodules in patients with uterine leiomyosarcoma were(8.2±1.6) cm in diameter and 2 ~ 3 in number;solid lesions, uterus significantly enlarged,irregular soft tissue shadow in uterine cavity;abundant blood flow signals were detected in 35 nodules;49 cases CA125 < 35 U/mL, 16 cases CA125< 35 U/mL;clinical stage:Ⅰ B stage 52 cases,Ⅱ B stage 22 cases,Ⅲ A stage 8 cases. There were 4 cases of broad ligament leiomyosarcoma. 10 patients died after operation. 4 of them were in Ⅰ B stage, aged over 68 years, and 6 were in IIB stage, aged over 58 years. Of the 76 patients,32 patients had recurrence during follow-up, 24 patients had additional laparotomy and 8 had laparoscopic surgery. Conclusion The condition of leiomyosarcoma of uterus is complex and its clinical diagnosis is difficult.Early surgical treatment and chemotherapy can improve the prognosis and survival of patients.
China Continuing Medical Education