中国全科医学2011，Vol.14Issue(17)：1957-1961,5.
子宫内膜间质肉瘤临床诊治分析
Clinical Diagnosis and Treatment of Endometrial Stromal Sarcoma
金滢 1潘凌亚 1王雪卿 1戴志琴 1黄惠芳 1沈铿 1连丽娟1
作者信息
- 1. 100730北京市,中国医学科学院北京协和医院妇产科
- 折叠
摘要
Abstract
Objective To study the clinical features, treatment.outcome and prognosis of endometrial stromal sarcoma ( ESS ).Methods 70 ESS patients were treated hy Peking Union Medical College Hospital ( PUMCH ) from 1983 t0 2005 and 51 of them went through the whole process of tre.atment and follow - up.Demographic , clinicopathologic and survival information were retrospectively reviewed.Univariate and multivariate analysis was performed hy using Kaplan - Meier methods and Cox proportional hazards regression.Results ESS accounted for 44.3％ ( 70/158 ) of all uterine sarcomas.The mean age of the patients was 43.5 years.Irregular vaginal bleeding and uterine enlargement were the most common symptoms and signs.26 cases ( 37.1％ ) were diagnosed preoperatively through diagnostic curettage.Among the 51 patients who had went through the whole process of treatment and follow - up, 37 were diagnosed as low grade ESS ( LCESS ) with the other 14 diagnosed as high grade ESS, which is now classified as undifferentiated endometrial sarcoma ( UES ).The median overall survival time was 334 months and the 5 - year survival rate was 87.8％.Univariate analysis showed that disease free survival ( DFS ) was prolonged by classification of LGESS.bilateral salpingo - oophorectomy during the original surgery and adjuvant therapy ( P ＜ 0.0001 , 0.0001and P = 0.0013 respectively ) with overall survival prolonged by LGESS classification significantly ( P ＜ 0.0001 ).Multivariate analysis , on the other hand.showed that classification of LCESS and bilateral salpingo - oophorectomy during the original surgery were independent prognostic factors of DFS ( P ＜ 0.0001 , and P =0.0013 respectively ).Conclusion ESS is a rare kind of uterine malignancy, and the preoperative diagnosis could be improved hy diagnostic curettage.LGESS and UES represent two distinct clinical entities and should be treated differently.Pathological classification might he the most important independent prognostic factor.关键词
肉瘤,子宫内膜间质/未分化子宫内膜肉瘤/诊断/治疗分类
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金滢,潘凌亚,王雪卿,戴志琴,黄惠芳,沈铿,连丽娟..子宫内膜间质肉瘤临床诊治分析[J].中国全科医学,2011,14(17):1957-1961,5.
