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目的探讨富于细胞型子宫平滑肌瘤(cellular uterine leioyoma,CUL)的临床风险因素。方法回顾性收集2012年2月至2014年2月期间因子宫肌瘤于南京医科大学附属江宁医院妇科手术治疗的患者286例,关注其年龄、体重指数、肌瘤数目、肌瘤大小、肌瘤位置、术前是否合并使用GnRH-a药物、术后免疫组化结果,并选择部分患者进行随访;收集46术后病理回报为CUL的患者相关临床等方面的资料,并选择部分患者进行随访,比较普通型平滑肌瘤和CUL相关临床特征、术前是否合并使用GnRH-a药物、免疫组化等方面的差异;结果普通型平滑肌瘤在体重指数、肌瘤数目、术前是否合并使用GnRH-a药物、术后免疫组化结果方面与CUL差异无统计学意义(P>0.05),而CUL患者的年龄、肌瘤位置、肌瘤大小与普通型平滑肌瘤相比差异有统计学意义(P<0.05),并且发现CUL术后1年肌瘤累计复发率显著高于对照组(P<0.05)。结论肌瘤位置(浆膜下肌瘤与黏膜下肌瘤)、肌瘤大小(肌瘤大小为5~8cm)、年龄因素(年龄≥40岁)是CUL发生的危险因素。
Objective To investigate the clinical risk factors of cellular uterine leiomyoma (CUL). Methods A total of 286 patients with myoma of uterine fibroids underwent gynecologic surgery at Jiangning Hospital Affiliated to Nanjing Medical University from February 2012 to February 2014 were retrospectively collected. Their age, body mass index, number of fibroids, fibroid size, fibroids GnRH-a drug was preoperatively combined, the results of immunohistochemistry and postoperative immunohistochemistry were selected and some patients were followed up. The clinical data of 46 patients with postoperative pathological findings of CUL were collected, and some patients were followed up, Compare the clinical features of common leiomyoma and CUL, preoperative whether combined with GnRH-a drugs, immunohistochemistry and other differences; results of common type leiomyoma in body mass index, the number of fibroids, whether preoperative combination of GnRH -a drug, postoperative immunohistochemical results and CUL no significant difference (P> 0.05), while the CUL patients with age, myoma location, fibroid size and the average type of leiomyoma was statistically significant (P <0.05). The cumulative recurrence rate of fibroids at 1 year after CUL was significantly higher than that of the control group (P <0.05). Conclusion The location of fibroids (subserosal fibroids and submucosal fibroids), fibroids size (fibroids size of 5 ~ 8cm), age factors (age ≥ 40 years) is a risk factor for CUL.