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目的 分析子宫内膜间质肉瘤 (ESS)的发病情况、临床表现、诊断和治疗等临床资料。方法 回顾性分析 1991年 5月至 2 0 0 3年 5月我们收治的 8例ESS患者的临床资料。结果 ESS占我院同期妇科肿瘤的 3% ,占宫体恶性肿瘤的 5 .9%。术前月经不规律 6例 ,子宫增大 5例 ,术前诊断性刮宫符合率 2 9% ;宫腔镜直视下电切取材 4例 ,与术后病理符合率 10 0 % ;阴道彩超 5例 ,报道宫壁回声不均匀、回声增强 5例 ,与术后病理相符 ;术前外周肿瘤标记物 (CA12 5)测定 5例 ,升高 1例。 7例行全子宫加双附件切除术 ,1例行全子宫加单侧附件切除术 ;7例术后予以化疗 ,1例术后拒绝化疗。结论 明确诊断者根据分期行全子宫加双附件切除术或广泛子宫加双附件切除术加盆腔淋巴清扫术 ,术后辅以化疗或放疗。
Objective To analyze the incidence, clinical manifestations, diagnosis and treatment of endometrial stromal sarcoma (ESS). Methods The clinical data of 8 ESS patients who we treated from May 1991 to May 2003 were retrospectively analyzed. Results ESS accounted for 3% of gynecological tumors in our hospital at the same period, accounting for 5.9% of malignant tumors in the uterus. Preoperative irregular menstruation in 6 cases, uterine enlargement in 5 cases, preoperative diagnostic curettage coincidence rate of 29%; hysteroscopy under direct electric cutting in 4 cases, and postoperative pathology coincidence rate of 10%; vaginal ultrasound 5 Cases, reports of uterine wall uneven echo, echo enhancement in 5 cases, consistent with postoperative pathology; preoperative peripheral tumor markers (CA12 5) measured in 5 cases, an increase of 1 case. 7 cases of hysterectomy with double attachment resection, 1 case of hysterectomy and unilateral accessory resection; 7 cases were treated with chemotherapy, 1 case of postoperative chemotherapy. Conclusions The diagnosis of patients according to staging hysterectomy with double attachment resection or extensive uterine plus double attachment resection plus pelvic lymph node dissection, postoperative adjuvant chemotherapy or radiotherapy.