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目的 提高对子宫内膜间质肉瘤 (endometrialstromalsarcoma ,ESS)的诊断和处理水平。方法 回顾性分析 1 991～ 2 0 0 0年天津市中心妇产科医院 1 6例ESS的临床资料。以世界卫生组织 1 994年关于ESS的分类和国际抗癌协会 (UICC AJCCS)对子宫肉瘤的分期为标准 ,进行分类和分期。全部病例均经手术治疗。基本术式为全子宫双附件切除 ,术后辅助化疗和放疗。结果 1 6例ESS中 ,高度恶性 2例 ,低度恶性 1 4例。前者预后差 ,因肿瘤转移死于术后 2 1个月内。后者预后较好 ,随访至 2 0 0 1～ 2 0 0 3年 ,存活 1 3例 ,5年存活率 91 7%。结论 ESS的恶性度与预后关系密切 ,应力争术前或术中确诊 ,作较广泛的切除 ,术后辅助放疗和化疗 ,以减少复发和提高存活率。
Objective To improve the diagnosis and treatment of endometrial stromal sarcoma (ESS). Methods The clinical data of 16 ESS cases from Tianjin Obstetrics and Gynecology Hospital from 1991 to 2000 were retrospectively analyzed. Classification and staging were based on the World Health Organization classification of ESS in 1994 and the staging of uterine sarcoma by the International Society Against Cancer (UICC AJCCS). All cases were surgically treated. The basic technique for the whole hysterectomy double attachment, postoperative adjuvant chemotherapy and radiotherapy. Results Among the 16 ESS cases, 2 were highly malignant and 14 were low-grade. The former poor prognosis, died of tumor metastasis within 21 months after surgery. The latter has a good prognosis. The follow-up was from 2001 to 2003, with 13 cases surviving, and the 5-year survival rate was 91.7%. Conclusion The malignant degree of ESS is closely related to the prognosis of ESS. ESS should be diagnosed preoperatively or intraoperatively, and extensive resection should be performed. Adjuvant radiotherapy and chemotherapy should be performed to reduce recurrence and increase survival rate.