Cramer S F, Patel A
Department of Pathology, Rochester General Hospital, University of Rochester School of Medicine, New York 14621.
Am J Clin Pathol. 1990 Oct;94(4):435-8. doi: 10.1093/ajcp/94.4.435.
As a leading cause of hysterectomy in premenopausal women. uterine leiomyomas are a major public health problem. However, very little work has been done on their epidemiology. Indeed, their true frequency has never been established using systematic and meticulous methods. In this study, gross serial sectioning at 2-mm intervals was applied as an adjunct to routine pathology processing in 100 consecutive total hysterectomy specimens. This tripled the number of leiomyomas noted in routine pathology reports. There were 649 leiomyomas in 77 of 100 uteri, with multiplicity of leiomyomas in 84%. Although leiomyomas were more numerous and larger in women with a clinical diagnosis of myomatous uterus, the incidence was no higher than in uteri removed for other reasons. The postmenopausal incidence of leiomyomas was no lower than the premenopausal incidence, although postmenopausal leiomyomas were smaller and fewer. These findings suggest that epidemiologic studies of leiomyomas may not be valid if they are based only on clinical diagnoses or routine pathology reports.
子宫平滑肌瘤是绝经前女性子宫切除的主要原因，是一个重大的公共卫生问题。然而，关于其流行病学的研究却很少。事实上，从未使用系统且细致的方法确定过其真实发病率。在本研究中，对100例连续的全子宫切除标本在常规病理处理的基础上每隔2毫米进行大体连续切片。这使得常规病理报告中记录的平滑肌瘤数量增加了两倍。100例子宫中的77例有649个平滑肌瘤，84%为多发性平滑肌瘤。尽管临床诊断为子宫肌瘤的女性体内平滑肌瘤数量更多、体积更大，但发病率并不高于因其他原因切除的子宫。绝经后平滑肌瘤的发病率并不低于绝经前，尽管绝经后平滑肌瘤体积更小、数量更少。这些发现表明，如果仅基于临床诊断或常规病理报告进行平滑肌瘤的流行病学研究，可能并不准确。
