Bokhman Y a, Tkeshelashvili V T, Vishnevsky A S, Volkova A T
Department of Gynecology, N. N. Petrov Research Institute of Oncology,Ministry of Health of USSR, Leningrand.
Eur J Gynaecol Oncol. 1988;9(5):355-9.
Development and (or) growth of myoma uteri in pre- and post-menopause is accompanied by hyperestrogenia which is shown by histological investigation of the endometrium and the ovaries. A comparative clinical and morphological study of 853 patients with myoma uteri, 996 patients with glandular, atypical hyperplasia and endometrial carcinoma was carried out. Benign tumors of the ovaries were revealed in 9.5% of patients with myoma, 12.7% of patients with atypical endometrial hyperplasia and 19.8% of patients with endometrial cancer. A significant increase of the occurrence of endometrial cancer in postmenopausal patients with myoma, in comparison with patients in the reproductive period was determined, 13.4% and 1.1% respectively, P = 0.01. In postmenopause "growth" of the tumor was more often and significantly simulated by malignant disease of the uterus and adnexa. In postmenopausal patients with myoma and uterine bleeding, endometrial carcinoma was 5.5 times more often revealed in comparison with the analogous group of patients in the reproductive period. The "relative risk" of the development of endometrial cancer, sarcoma uteri and ovarian tumors was calculated. The "relative risk" was shown to increase in the postmenopausal period. In the processes of observation of patients with myoma in postmenopause, cytological investigation of endometrial aspirates, ultrasound and mammographic screening should be carried out.
绝经前后子宫肌瘤的发生和（或）生长伴随着高雌激素状态，这在子宫内膜和卵巢的组织学检查中得到证实。对853例子宫肌瘤患者、996例腺性、非典型增生及子宫内膜癌患者进行了临床和形态学对比研究。在子宫肌瘤患者中，9.5%发现有卵巢良性肿瘤；在非典型子宫内膜增生患者中，12.7%发现有卵巢良性肿瘤；在子宫内膜癌患者中，19.8%发现有卵巢良性肿瘤。与生育期患者相比，绝经后子宫肌瘤患者子宫内膜癌的发生率显著增加，分别为13.4%和1.1%，P = 0.01。绝经后，肿瘤的“生长”更常且显著地被子宫和附件的恶性疾病所模拟。在绝经后有子宫肌瘤且子宫出血的患者中，与生育期类似患者组相比，子宫内膜癌的发现率高出5.5倍。计算了子宫内膜癌、子宫肉瘤和卵巢肿瘤发生的“相对风险”。结果显示，绝经后期“相对风险”增加。在绝经后子宫肌瘤患者的观察过程中，应进行子宫内膜抽吸物的细胞学检查、超声检查和乳腺钼靶筛查。
