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目的探讨子宫交界性平滑肌肿瘤与子宫平滑肌瘤和平滑肌肉瘤在病程及临床表现方面的差异。方法回顾性分析131例富于细胞或生长活跃的平滑肌瘤患者的病理及临床资料。重新阅读病理切片,必要时重新取材,并对患者进行随访。结果子宫交界性平滑肌瘤预后良好,5年生存率达100%。但有19.1%(24/131)有远期复发,其中8例有多次复发,复发患者5年生存率为91.7%。分析复发特别是多次复发患者的病理特征,发现其有丝分裂及细胞异型性明显加重,即出现去分化的改变,多次复发者5年生存率仅为75.0%。结论子宫交界性平滑肌瘤的病理及临床行为在某些方面与子宫肌瘤或子宫平滑肌肉瘤存在差异,临床处理时应强调长期随访的重要性。
Objective To investigate the differences of course and clinical manifestation between borderline myometrial tumors and uterine leiomyomas and leiomyosarcomas. Methods Retrospective analysis of pathological and clinical data of 131 cases of leukemia patients with abundant cells or active growth. Re-read the biopsy, re-draw if necessary, and follow-up of patients. Results Uterine borderline leiomyoma prognosis is good, 5-year survival rate of 100%. However, 19.1% (24/131) had long-term recurrence, of which 8 had multiple recurrences and the 5-year survival rate of patients with recurrent disease was 91.7%. Analysis of recurrence, especially multiple recurrence pathological features of patients found that their mitosis and atypia significantly increased, that dedifferentiation change, repeated 5-year survival rate was only 75.0%. Conclusion The pathological and clinical behaviors of borderline leiomyoma of uterus are different from uterine leiomyoma or uterine leiomyosarcoma in some aspects. The clinical treatment should emphasize the importance of long-term follow-up.