Travaglino Antonio, Raffone Antonio, Santoro Angela, Raimondo Diego, Improda Francesco Paolo, Cariati Federica, De Marco Margot, Casadio Paolo, Seracchioli Renato, Zullo Fulvio, Insabato Luigi, Zannoni Gian Franco
Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Geburtshilfe Frauenheilkd. 2021 Nov 4;81(11):1217-1223. doi: 10.1055/a-1533-1651. eCollection 2021 Nov.
Leiomyoma with bizarre nuclei (LBN) is a variant of uterine leiomyoma, which has replaced the previous category of "atypical leiomyoma" and must be distinguished from smooth muscle tumors of uncertain malignant potential (STUMP). However, previously published series of "atypical leiomyoma" might have included both LBN and STUMP, due to the lack of strict diagnostic criteria. Based on such hypothesis, we aimed to define the risk of recurrence in LBN. A systematic review and meta-analysis was performed by searching 4 electronic databases for all studies assessing the outcome of patients with "atypical leiomyoma" or LBN. The pooled absolute risk of recurrence was calculated. The included studies were subdivided into two subgroups based on the criteria used: "LBN + STUMP" or "LBN-only". Twelve studies with 433 patients were included. The pooled risk of recurrence was 5.5% overall. The funnel plot showed two cluster of studies which superimposed to the two subgroups. In the LBN + STUMP cluster/subgroup, the pooled risk of recurrence was 7.7%. In the LBN-only cluster/subgroup, the pooled risk of recurrence was 1.9%. Statistical heterogeneity was null in all analyses. Our results show a risk of recurrence of 1.9% for LBN; higher recurrence rates in older studies are likely due to the inclusion of STUMPs.
奇异核平滑肌瘤（LBN）是子宫平滑肌瘤的一种变体，它已取代了先前的“非典型平滑肌瘤”类别，并且必须与恶性潜能不确定的平滑肌肿瘤（STUMP）相区分。然而，由于缺乏严格的诊断标准，先前发表的“非典型平滑肌瘤”系列研究可能同时纳入了LBN和STUMP。基于这一假设，我们旨在确定LBN的复发风险。通过检索4个电子数据库，对所有评估“非典型平滑肌瘤”或LBN患者结局的研究进行了系统评价和荟萃分析。计算了汇总的绝对复发风险。根据所使用的标准，将纳入的研究分为两个亚组：“LBN + STUMP”或“仅LBN”。纳入了12项研究，共433例患者。总体汇总复发风险为5.5%。漏斗图显示了两组研究，分别对应两个亚组。在LBN + STUMP组/亚组中，汇总复发风险为7.7%。在仅LBN组/亚组中，汇总复发风险为1.9%。所有分析中的统计异质性均不存在。我们的结果显示LBN的复发风险为1.9%；早期研究中较高的复发率可能是由于纳入了STUMP。
