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平滑肌瘤变异型、未分类子宫肌层病变及肉瘤的临床-放射-组织病理学相关性:一项回顾性研究

Clinico-radio-histopathological Correlation of Leiomyoma Variant, STUMP, and Sarcoma: A Retrospective Study.

作者信息

Santhosh Jayasree, Al-Mughairfi Shima, Al-Ghaithi Huda, Al-Hilal Zainab, Al-Maqbali Reem Hamood, Al-Salmi Ahmed, Al-Kalbani Jokha, Al-Shamsi Ruqaiya, Al-Rawahi Thuria

机构信息

High Risk Pregnancy Unit, Royal Hospital, Muscat, Oman.

Obsterics and Gynecology Residency Training Program, Oman Medical Specialty Board, Muscat, Oman.

出版信息

Oman Med J. 2025 Jan 31;40(1):e715. doi: 10.5001/omj.2025.49. eCollection 2025 Jan.

Abstract

OBJECTIVES

We sought to compare the epidemiological and clinical features of variant leiomyoma, smooth muscle tumors of uncertain malignant potential (STUMP), and sarcoma to classical leiomyoma and assess the radio-histological correlation.

METHODS

This retrospective, observational study was conducted in Royal Hospital, Muscat, Oman. We included all patients who underwent surgical treatment for uterine fibroids from 1 January 2011 to 31 December 2016. Data was retrospectively collected from electronic patient records, pictures archiving system, and histopathology reports, and analyzed using SPSS version 29 and MedCalc Statistical Software.

RESULTS

Out of the 14269 patients who attended the gynecology outpatient department, 19.5% were clinically diagnosed with uterine fibroids. Surgical procedures were performed in 545 (19.6%) women. Diagnosis from histopathology reports was classical leiomyoma in 508 (93.2%) cases, variant leiomyoma in 35 (6.4%), and sarcomas in two (0.4%); there were no cases of STUMP. Magnetic resonance imaging (MRI) correctly identified 125 (89.9%) cases of classical leiomyoma and 2/11 (18.2%) cases of variants. The sensitivity and specificity of MRI to predict non-classical varieties was 22.22% and 88.65%, respectively. MRI had a strong negative predictive value (94.7%) for leiomyoma variants. The area under the curve for classical and variant leiomyoma was 0.63 (0.55-0.71) and 0.55 (0.47-0.64). The accuracy of MRI in predicting classical leiomyoma was 86.00 (79.40-91.12) and 84.67 (77.87-90.03) the non-classical varieties.

CONCLUSIONS

Epidemiological and clinical features were not helpful in distinguishing between classical leiomyoma and non-classical varieties. MRI had weak discriminatory power to distinguish between classical and non-classical varieties.

摘要

目的

我们试图比较变异型平滑肌瘤、恶性潜能不确定的平滑肌肿瘤(STUMP)和肉瘤与经典平滑肌瘤的流行病学和临床特征,并评估放射学与组织学的相关性。

方法

这项回顾性观察研究在阿曼马斯喀特的皇家医院进行。我们纳入了2011年1月1日至2016年12月31日期间所有接受子宫肌瘤手术治疗的患者。数据通过电子病历、图片存档系统和组织病理学报告进行回顾性收集,并使用SPSS 29版和MedCalc统计软件进行分析。

结果

在14269名妇科门诊患者中,19.5%临床诊断为子宫肌瘤。545名(19.6%)女性接受了手术治疗。组织病理学报告诊断为经典平滑肌瘤508例(93.2%),变异型平滑肌瘤35例(6.4%),肉瘤2例(0.4%);无STUMP病例。磁共振成像(MRI)正确识别出125例(89.9%)经典平滑肌瘤和2/11例(18.2%)变异型。MRI预测非经典类型的敏感性和特异性分别为22.22%和88.65%。MRI对平滑肌瘤变异型具有较强的阴性预测价值(94.7%)。经典和变异型平滑肌瘤的曲线下面积分别为0.63(0.55 - 0.71)和0.55(0.47 - 0.64)。MRI预测经典平滑肌瘤的准确率为86.00(79.40 - 91.12),预测非经典类型的准确率为84.67(77.87 - 90.03)。

结论

流行病学和临床特征无助于区分经典平滑肌瘤和非经典类型。MRI区分经典和非经典类型的鉴别能力较弱。

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