O'Connor D M, Norris H J
Department of Gynecologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Hum Pathol. 1990 Feb;21(2):223-7. doi: 10.1016/0046-8177(90)90133-p.
Seventy-three smooth-muscle tumors of the uterus, with five to nine mitotic figures per 10 high-power fields but lacking cytologic atypia, were studied. Pathologic features assessed included necrosis, hemorrhage, vascular intrusion, abnormal mitoses, and the number of mitotic figures. Vascular ingrowth by the tumor was present in 11 neoplasms. Follow-up ranged from 23 months to 15 years, with all patients alive and well at last contact. In 14 patients, myomectomy was the only treatment. Thirteen of these patients demonstrated no subsequent residual or recurrent tumor. One woman developed a persistent or recurrent mitotically active leiomyoma 8 years after myomectomy. We conclude that mitotically active smooth-muscle tumors of the uterus, having five to nine mitoses per 10 high-power fields and no cellular atypia, have a metastatic rate too low to be regarded as sarcomas. Hysterectomy need not automatically follow myomectomy if follow-up is done.
对73例子宫平滑肌肿瘤进行了研究，这些肿瘤每10个高倍视野有5至9个核分裂象，但无细胞异型性。评估的病理特征包括坏死、出血、血管浸润、异常核分裂及核分裂象数量。11例肿瘤存在肿瘤性血管长入。随访时间为23个月至15年，最后一次随访时所有患者均存活且情况良好。14例患者仅接受了肌瘤切除术。其中13例患者术后未出现残留或复发性肿瘤。1名女性在肌瘤切除术后8年出现持续性或复发性有核分裂活性的平滑肌瘤。我们得出结论，每10个高倍视野有5至9个核分裂象且无细胞异型性的有核分裂活性的子宫平滑肌肿瘤，其转移率过低，不能被视为肉瘤。如果进行随访，肌瘤切除术后不必自动进行子宫切除术。
