Barnaś Edyta, Książek Mariusz, Raś Renata, Skręt Andrzej, Skręt-Magierło Joanna, Dmoch-Gajzlerska Ewa
Institute of Obstetrics and Emergency Medicine, Medical Faculty, University of Rzeszow, Rzeszow, Poland.
Clinical Department of Pathology, Frederick Chopin Clinical Provincial Hospital No 1, Rzeszow, Poland.
PLoS One. 2017 Apr 20;12(4):e0175875. doi: 10.1371/journal.pone.0175875. eCollection 2017.
Benign metastasizing leiomyoma (BML) is a rare disorder that affects women with a history of uterine leiomyoma, which is found to metastasise within extrauterine sites. The aetiology of BML remains unexplained. Because BML is rare, and most publications contain descriptions of single cases, no statistically determined time relations were found between the primary and secondary surgeries, which may have aetiological implications.
To determine age before BML surgery, age during diagnosis of BML, type of prior surgery, and location of metastasis based on the literature.
A systematic review of four databases (Medline/PubMed, Embase, Web of Science, and Cochrane) covering articles published from 1 January 1965 to 10 April 2016. The inclusion criteria were full-text articles in English and articles containing case reports. Articles in languages other than English (39), articles containing incomplete data (14), i.e. no information regarding the time of surgery and/or the site of metastasis, articles bereft of case studies (25), and articles with access only to summaries, without access to the complete text (10) were excluded. Of 321 titles identified, only 126 articles met the aforementioned criteria.
The mean age during primary surgery and BML diagnosis was 38.5 years and 47.3 years, respectively. The most common surgery was total hysterectomy. The most frequent site of metastasis was the lungs; other organs were affected less frequently.The site of metastases and their number were not related to the longer time span between the patient's initial surgery and occurrence of metastasis. The analysed data, such as the age during primary surgery, age during BML diagnosis, site and type of metastasis, do not provide us a clear answer. Thus, BML pathogenesis is most probably complex in nature and requires further multidirectional research.
良性转移性平滑肌瘤（BML）是一种罕见疾病，影响有子宫平滑肌瘤病史的女性，其子宫平滑肌瘤会在子宫外部位发生转移。BML的病因尚不清楚。由于BML罕见，且大多数出版物包含单例描述，因此在初次手术和二次手术之间未发现经统计学确定的时间关系，而这种关系可能具有病因学意义。
根据文献确定BML手术前的年龄、BML诊断时的年龄、既往手术类型以及转移部位。
对四个数据库（Medline/PubMed、Embase、Web of Science和Cochrane）进行系统综述，涵盖1965年1月1日至2016年4月10日发表的文章。纳入标准为英文全文文章和包含病例报告的文章。排除非英文文章（39篇）、包含不完整数据的文章（14篇），即无手术时间和/或转移部位信息的文章、缺乏病例研究的文章（25篇）以及仅可获取摘要而无法获取全文的文章（10篇）。在识别出的321篇标题中，只有126篇文章符合上述标准。
初次手术和BML诊断时的平均年龄分别为38.5岁和47.3岁。最常见的手术是全子宫切除术。最常见的转移部位是肺部；其他器官受影响的频率较低。转移部位及其数量与患者初次手术和转移发生之间的较长时间跨度无关。所分析的数据，如初次手术时的年龄、BML诊断时的年龄、转移部位和类型，并未为我们提供明确答案。因此，BML的发病机制很可能本质上是复杂的，需要进一步进行多方向研究。
