He W C
Second Hospital, Xian Medical College.
Zhonghua Zhong Liu Za Zhi. 1990 Nov;12(6):444-6.
Eleven patients with leiomyosarcoma of the uterus are analysed clinicopathologically. The youngest patient was 36 and the oldest was 61 with a mean of 50.8 years. The common clinical symptoms were menorrhagia or irregular vaginal bleeding, lower abdominal pain and rapidly enlarging abdominal mass. None was diagnosed before operation for lack of specific symptoms. All tumors with 10 or more mitotic figures (MF) per 10 high-power fields (HPF) were diagnosed as malignant whereas for those with less than 10 MF/10 HPF the diagnosis of uterine leiomyosarcoma must depend on cellular pleomorphism, number of giant cells, increase in nuclear-cytoplasmic ratio and presence or absence of boundary between the tumor and normal tissue. The main treatment was total hysterectomy and bilateral salpingo-oophorectomy. The 2- and 5-year survival rates were 36.3% and 27.3%, respectively. Five cases with Stage III and IV lesions died within 11 months after operation. The clinical stage at the initial treatment is the most important prognostic factor. For tumors confined to the uterus, cellular pleomorphism, mitotic figure and boundary between the tumor and normal tissue are the other important prognostic factors.
对11例子宫平滑肌肉瘤患者进行了临床病理分析。最年轻的患者36岁，最年长的61岁，平均年龄50.8岁。常见的临床症状为月经过多或不规则阴道出血、下腹痛和腹部肿块迅速增大。由于缺乏特异性症状，术前均未确诊。每10个高倍视野（HPF）有10个或更多有丝分裂象（MF）的所有肿瘤均被诊断为恶性，而对于每10个HPF中MF少于10个的肿瘤，子宫平滑肌肉瘤的诊断必须取决于细胞多形性、巨细胞数量、核质比增加以及肿瘤与正常组织之间是否存在边界。主要治疗方法是全子宫切除术和双侧输卵管卵巢切除术。2年和5年生存率分别为36.3%和27.3%。5例Ⅲ期和Ⅳ期病变患者术后11个月内死亡。初始治疗时的临床分期是最重要的预后因素。对于局限于子宫的肿瘤，细胞多形性、有丝分裂象以及肿瘤与正常组织之间的边界是其他重要的预后因素。
