论文部分内容阅读
介绍子宫内膜间质肿瘤WHO(2003)新分类,包括子宫内膜间质结节(ESN)、低恶度子宫内膜间质肿瘤(LGESS)、未分化子宫内膜肉瘤(UES)、混合性子宫内膜间质平滑肌肿瘤。强调瘤细胞类似正常增殖期子宫内膜间质细胞围绕螺旋小动脉为特征,皆能向平滑肌、性索样、腺性、纤维黏液样、纤维样及上皮样分化。瘤细胞可分别表达中性内肽酶,雌孕激素受体,平滑肌动蛋白,抑制素,CD99及Vim。细胞遗传学证实,该瘤第7号染色体的细胞遗传学异常,呈JAZFI/JJAEI融合基因。阐明上述4型肿瘤与高度富于细胞平滑肌瘤的鉴别。LGESS复发及转移分别约为45%及33%。治疗方案首选手术根治,术后辅孕激素治疗。ESN属瘤样病变,局部切除即获痊愈。LGESS5年存活率约为85%,UES恶性度极高,2年内死亡率约33%。
Introduction to the new classification of endometrial stromal tumors WHO (2003), including endometrial interstitial nodules (ESN), low-grade endometrial stromal tumors (LGESS), undifferentiated endometrial sarcomas (UES), mixed Endometrial stromal smooth muscle tumors. Emphasize that tumor cells are similar to normal proliferative phase. Endometrial stromal cells are characterized by spiral arterioles, all of which can differentiate into smooth muscle, sex cord, adenoid, fibroids, fibroids and epithelioid. Neoplastic cells can express neutral endopeptidase, estrogen and progesterone receptor, smooth actin, inhibin, CD99 and Vim respectively. Cytogenetics confirmed that the tumor on chromosome 7 cytogenetic abnormalities were JAZFI / JJAEI fusion gene. Clarification of the above-mentioned type 4 tumors with a high degree of cell-rich leiomyoma identification. LGESS recurrence and metastasis were about 45% and 33% respectively. The first choice of treatment of radical surgery, postoperative progestogen hormone therapy. ESN tumor-like lesions, partial excision will be cured. LGESS5 85% annual survival rate, UES extremely high malignant, 2-year mortality rate of about 33%.