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目的:探讨年轻未孕子宫Müllerian腺肉瘤患者的临床病理特征,提高对该病的认识。方法:分析5例年轻未孕子宫Müllerian腺肉瘤患者的临床表现及病理组织学特点。结果:5例患者均以经量增多伴阴道不规则流血为初诊主诉,子宫均增大,4例有息肉样物脱出宫颈。肿瘤由良性腺上皮成分和肉瘤性间质成分组成。免疫表型,肉瘤成分普遍Vimentin阳性,大部分CD10阳性,部分Desmin、SMA阳性。5例中术前诊断3例;4例经术后病理检查证实。治疗主要采用次广泛全子宫+单侧附件+盆腔淋巴结切除,术后预防性化疗。结论:年轻未孕子宫Müllerian腺肉瘤的基本形态由良性腺上皮和肉瘤性间质混合组成。对年轻未孕患者出现阴道不规则流血并伴有息肉样物脱出宫颈,且伴子宫增大时要警惕子宫Müllerian腺肉瘤。治疗以手术为主,可辅以化疗。
Objective: To investigate the clinicopathological features of young Müllerian adenosarcoma patients who are not pregnant and improve the understanding of the disease. Methods: The clinical features and histopathological features of 5 cases of young uterine Müllerian adenosarcoma were analyzed. Results: All the 5 patients were complained of the increased amount of vaginal bleeding and vaginal irregular blood flow. The uterus was enlarged and the polyp samples were removed in 4 cases. The tumor consists of benign glandular epithelial components and sarcomatoid interstitial components. Immunophenotype, sarcoma components generally Vimentin positive, most of CD10 positive, some Desmin, SMA positive. 5 cases of preoperative diagnosis in 3 cases; 4 cases confirmed by postoperative pathology. The main treatment used a wide range of uterine + unilateral annex + pelvic lymph node dissection, postoperative preventive chemotherapy. CONCLUSIONS: The basic morphology of young, non-pregnant uterine Müllerian adenosarcomas consists of a mixture of benign glandular epithelial cells and sarcomatoid interstitium. Uterine Müllerian adenosarcoma should be vigilant against vaginal irregular bleeding and polyp-like excretion of the cervix from young, uninfected patients. Surgical treatment-based, supplemented by chemotherapy.