Amant F, Dreyer L, Makin J, Vergote I, Lindeque B G
Department of Obstetrics and Gynaecology, Pretoria Academic Hospital, South Africa.
Eur J Gynaecol Oncol. 2001;22(3):194-200.
There is considerable evidence for a higher incidence of uterine sarcomas in blacks when compared to whites. However, whether this higher incidence is related to differences in clinicopathologic presentation is not known.
We reviewed slides and clinical charts of 81 patients with a primary diagnosis of uterine sarcoma referred between 1991 and 1999 to Kalafong Academic and Pretoria Academic Hospital. After review, 49 cases remained for study.
Uterine sarcomas were distributed between leiomyosarcoma (LMS) (39%), carcinosarcoma (CS) (49%) and endometrial stromal sarcoma (ESS) (12%). LMS and ESS tend to present at an earlier age when compared to CS (respectively p < 0.008 and 0.02). Of women with LMS more women are premenopausal when compared to CS (p < 0.009). Lower abdominal pain is more common in LMS (p < 0.009), whereas bleeding is more common in women suffering from CS (p < 0.01). Lymphovascular space involvement and cervical involvement are more common in CS when compared to LMS. In CS, the carcinoma component has most of the metastatic potential.
Among black South African women different clinicopathologic features for uterine LMS, CS and ESS are observed. We also present genetic and/or hormonal factors possibly contributing to the pathophysiology of uterine sarcomas in blacks.
有大量证据表明，与白人相比，黑人子宫肉瘤的发病率更高。然而，这种较高的发病率是否与临床病理表现的差异有关尚不清楚。
我们回顾了1991年至1999年间转诊至卡拉方学术医院和比勒陀利亚学术医院的81例初诊为子宫肉瘤患者的幻灯片和临床病历。经复查，49例患者纳入研究。
子宫肉瘤分布于平滑肌肉瘤（LMS）（39%）、癌肉瘤（CS）（49%）和子宫内膜间质肉瘤（ESS）（12%）。与CS相比，LMS和ESS往往在更早的年龄出现（分别为p<0.008和0.02）。与CS相比，LMS患者中绝经前女性更多（p<0.009）。下腹部疼痛在LMS中更常见（p<0.009），而出血在CS患者中更常见（p<0.01）。与LMS相比，CS中淋巴管间隙受累和宫颈受累更为常见。在CS中，癌成分具有大部分转移潜能。
在南非黑人女性中，观察到子宫LMS、CS和ESS具有不同的临床病理特征。我们还提出了可能导致黑人子宫肉瘤病理生理的遗传和/或激素因素。
