【摘要】 目的 总结子宫恶性肿瘤合并子宫内膜异位症患者的临床病理特征,并探讨两者的相互关系。方法 回顾性对北京大学人民医院1991年1月～2000年12月住院治疗的子宫恶性肿瘤合并子宫内膜异位症患者的临床病理资料进行分析。结果 188例子宫恶性肿瘤患者中合并子宫内膜异位症12例(6.38％),平均年龄50.67岁。常见的临床症状为阴道不规则出血或阴道排液。全部患者经手术治疗,术后病理证实合并内异症的子宫恶性肿瘤恶性程度较低(8例内膜癌均为I期,4例内膜间质肉瘤均为低度恶性)。异位病灶部位:卵巢9例,宫颈1例,淋巴结1例,骶骨韧带1例,其中合并子宫腺肌症2例。10例异位内膜表现不同程度的非典型增生(5例轻度,4例中重度,1例可见轻到中、重度的改变,最后发展成为间质肉瘤)。2例失访,1例死亡,余9例平均随访37个月,均存活。结论合并内异症的子宫恶性肿瘤疾病分期早,患者无瘤生存期长。临床工作中应仔细观察异位病灶的增生情况,对重度非典型增生患者进行全面检查和长期严密随访。更多还原

【Abstract】 Objective To analyze the clinicopathological characteristics of uterine malignant tumor coexisting with endometriosis. Methods Retrospectively analyze the clinicopathological materials of uterine malignant tumor coexisting with endom-etriosis treated in Peking University People ’ s Hospital during recent 10 years. Results 12 patients of uterine malignant tumor coexisted with endometriosis among 188 cases (6.38% ), average age 50.67 years, and the most common symptoms were vaginal irregular bleeding or secretion. All patients were treated by operation. Postoperative pathology proved the malignancy of uterine tumor coexisting with endometriosis was lower (8 endometrial adenocarcinoma I, 4 low - grade malignant stromal carcinoma) .The region of endometriosis: 9 ovary, 1 cervix uteri, 1 lymph node, luterosacral ligament, and 2 coxisting with adenomyosis. 10 endometriosis appeared atypical neoplasm (5 mild, 4 moderate or severe, 1 found the changes from mild to moderate or severe atypical neoplasm which was proved to be malignant stromal carcinoma by the second operation.2 lost prognosis, 1 died, 9 were followed -up average 37 months, and all survival. Conclusions The prognosis of the patients of uterine malignant tumor coexisting with endometriosis are better than the patients without endometriosis, the phase earlier and the survival interval longer. We should raise the diagnostic rate of endometriosis, observe carefully the atypical neoplasm of the endometriotic focus, examine completely and longtime closed follow - up to the patients with severe atypical neoplasm in order to alarm the malignant transformation of endometriosis.更多还原