【摘要】 目的 :探讨子宫内膜间质肉瘤 (ESS)术前诊断、合理治疗方法和预后因素。方法 :单纯手术治疗 2例 ,手术加化疗 8例 ,手术加放疗 1例 ,手术加化疗加放疗 5例。结果 :ESS的术前诊断率为 5 0 % (8/16 ) ,术前病理检查 10例 ,其中阳性 7例 ;总的5年生存率为 6 8.75 %。病灶局限于子宫者 (Ⅰ～Ⅱ期 ) 5年生存数大于病变超过子宫者 (Ⅲ～Ⅳ ) (P =0 .0 5 ) ,子宫大于孕 3月大者 5年生存数与小于孕 3月者差异无显著性 (P >0 .0 5 ) ;2例单纯手术均复发 ,手术加辅助治疗复发率为 2 8.6 %。结论 :ESS的术前诊断率不高 ,其预后与核分裂数、病变范围、子宫大小有关 ,ESS术前采用放疗和 (或 )化疗能降低复发率更多还原

【Abstract】 Objective:To investigate the preoperative diagnosis,treatment modality and prognostic factors for endometrial stromal sarcomas(ESS).Methods:Two cases were treated by surgery alone,eight by surgery combined with chemotherapy,one by surgery plus radiotherapy and five by surgery plus radiotherapy and chemotherapy.Results:The rate of preoperative diagnosis was 50%.The over all 5 years survival rate was 68.75 %.The 5 years survival rate for the patients whose disease was limited to the uterus(stage Ⅰ～Ⅱ) was higher than those whose disease had invaded to the extrauterus(stage Ⅲ～Ⅳ)( P =0.05).When the uterus was smaller than a 3 months pregnant one,the 5 years survival rate was 81.8%.When the size was larger than that of a 3 months pregnant uterus,the survival rate was 25.0%( P >0.05).The disease recurred in 4(28.6%) of the 14 patients who received adjuvant treatment and in both of the 2 patients who did not.Conclusions:The preoperative diagnostic rate of the ESS is low.The prognosis is associated with the mitotic count and diseased scope extent.Postsurgical adjuvant treatment can decrese the recurrence rate.更多还原