子宫腺肌病诊治及其与子宫内膜癌关系的研究进展

子宫腺肌病(adenomyosis)是以子宫内膜腺体及间质侵入子宫肌层而导致的以月经过多和进行性痛经为主的一种临床常见疾病,严重影响患者的生活质量,多发生于育龄期经产妇。该病的发病机制尚不明确,目前存在子宫内膜损伤内陷学说、上皮间质转化学说和干细胞学说等各种学说。组织学检查是其诊断的金标准,但临床上常根据患者的临床表现及影像学检查作出初步诊断。子宫腺肌病可导致不孕,并且对整个妊娠过程产生不利影响。子宫腺肌病虽然是一种良性疾病,但近年越来越多报道证实了该病有恶变的风险。研究显示合并子宫腺肌病的子宫内膜癌患者,子宫腺肌病对癌症的侵袭浸润起到保护作用,这类患者往往临床预后更好。子宫腺肌病的治疗包括药物治疗和手术治疗,目前尚无根治性药物,手术是其主要的治疗手段。

Research Progress on Diagnosis,Treatment and the Relation between Endometrial Cancer and Adenomyosis

Adenomyosis is characterized by the presence of endometrial glands and stroma in myometrium.It is a common disease that cause significant symptoms such as hypermenorrhea and progressive dysmenorrhea in reproductive-aged women,and seriously affect patients′quality of life.The pathogenesis of the disease is not clear.There are many theories such as endometrial injury depression theory,epithelial mesenchymal transformation theory,stem cell theory and so on.Histological examination is the gold standard of diagnosis.The clinical manifestations and imaging findings of patients are often used to make the initial diagnosis.Adenomyosis can lead to infertility and have adverse effect on the whole pregnancy process.Although adenomyosis is a benign disease,more and more reports in recent years have confirmed the risk of malignant transformation.Studies have shown that patients have endometrial cancer with adenomyosis,which protects against cancer invasion and infiltration,tend to have better clinical outcomes.Treatment of adenomyosis includes medication and surgery.Clinical studies have confirmed that there is no radical drugs,and surgery is the main treatment.