子宫腺肉瘤的研究进展

腺肉瘤是由良性腺上皮和恶性间质构成的一种低度恶性的混合性肿瘤，大多数腺肉瘤原发于子宫内膜，偶可发生在卵巢或子宫外组织。子宫腺肉瘤是罕见的女性生殖道恶性肿瘤，以绝经后妇女多见，缺乏特异的临床症状，多数患者表现为阴道出血、宫颈口脱出物及子宫增大。该病早期诊断困难，超声、磁共振成像（MRI）等影像学检查有一定的诊断价值，“袖口”状结构是术后病理检查的特征性表现。子宫腺肉瘤的发生可能与子宫内膜异位症、长期雌激素暴露等因素有关，但其具体的发病机制目前尚未明确。该病的主要治疗方法为全子宫双附件切除（因淋巴结转移少见故不常规行淋巴结清扫），放化疗及激素治疗疗效尚不确切。但患者的生存时间及肿瘤的术后复发与是否伴肉瘤过度生长、疾病分期、子宫肌层侵犯深度、有无淋巴结转移及脉管浸润等因素密切相关。

Research Progress of Uterine Adenosarcoma

Adenosarcoma is constituted by benign glandular epithelium and malignant stroma as a low degree of malignant potential of mixed tumor, mostly derived from the endometrium, occasionally can occur in the ovary or extrauterine tissue. Uterine adenosarcoma is a rare female genital tract malignant tumor, more common in postmenopausal women, lack of specific clinical symptoms. The most common clinical manifestations are vaginal bleeding, cervical prolapse and uterine enlargement. Early diagnosis of the disease is difficult. Ultrasound and MRI have a certain diagnostic value, and"cuff"-like structure is the postoperative pathological characteristics of the performance. The occurrence of uterine adenosarcoma may be associated with endometriosis, long-term estrogen exposure and other factors, but the specific pathogenesis is not yet clear. The main treatment of the disease for the unilateral uterine adnexectomy (lymph node metastasis is rare, so lymph node dissection is not routine), radiotherapy and chemotherapy and hormone therapy is not yet accurate. But the survival and recurrence are closely affected by sarcoma overgrowth, disease staging, uterine muscle invasion depth, lymphatic metastasis, vascular invasion and so on.