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目的:研究子宫内膜间质肉瘤的诊断、治疗和预后。方法:回顾分析36例子宫内膜间质肉瘤的临床资料。结果:确诊主要依靠病理检查,全部病例均经手术治疗,基本术式为全子宫双侧附件切除,术后辅以化疗和放疗。Ⅰ~Ⅱ期患者5年生存率为81.48%(22/27),Ⅲ~ⅣV期5年生存率为0%(0/9)。LESS的2年生存率为91.67%(22/24),5年生存率为83.33%(20/24),UES的2年生存率为41.67%(5/12)。结论:应术前或术中确诊,治疗以手术为主,综合放化疗,以减少复发和提高存活率。预后与临床分期、分化程度、治疗方法密切相关。
Objective: To study the diagnosis, treatment and prognosis of endometrial stromal sarcoma. Methods: The clinical data of 36 cases of endometrial stromal sarcoma were retrospectively analyzed. Results: The diagnosis was mainly based on pathological examination, all cases were treated by surgery, the basic surgical procedures for the removal of bilateral uterine attachment, postoperative adjuvant chemotherapy and radiotherapy. The 5-year survival rate was 81.48% (22/27) in stage Ⅰ-Ⅱ patients, and 0% (0/9) in stage Ⅲ-ⅣV patients. The 2-year survival rate of LESS was 91.67% (22/24). The 5-year survival rate was 83.33% (20/24). The 2-year survival rate of LES was 41.67% (5/12). Conclusion: It should be diagnosed preoperatively or intraoperatively. The main operation is surgery, combined with chemoradiotherapy to reduce the recurrence and improve the survival rate. Prognosis and clinical stage, degree of differentiation, treatment is closely related.