Parker W H, Fu Y S, Berek J S
Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine, Jonsson Comprehensive Cancer Center.
Obstet Gynecol. 1994 Mar;83(3):414-8.
To determine the incidence of uterine sarcoma in patients operated on for symptomatic uterine leiomyomas or "rapidly growing" leiomyomas.
We reviewed the medical records of 1332 women admitted to either of two community hospitals between 1988-1992 for hysterectomy or myomectomy for uterine leiomyomas. The incidence of leiomyosarcoma, endometrial stromal sarcoma, and mixed mesodermal tumor was calculated. Patient ages, admitting symptoms, and operative and pathologic findings were analyzed. The study included 371 women (28%) operated on for rapidly growing leiomyomas. All patients operated on during the same interval and found to have a uterine sarcoma were reviewed.
One of the 1332 patients operated on for presumed leiomyoma was found to have a leiomyosarcoma. This women was the only patient found to have a sarcoma among 371 women operated on for rapid growth of the uterus. None of 198 patients who met a published definition of rapid growth had a uterine sarcoma. Two women (0.15%) had endometrial stromal sarcoma, but none had a mixed mesodermal tumor. During the same interval, nine additional patients were found to have uterine sarcomas, and for these women, the preoperative diagnosis was sarcoma in four, endometrial cancer in three, ovarian cancer in one, and prolapsed uterus in one.
The total incidence of uterine sarcoma (leiomyosarcoma, endometrial stromal sarcoma, and mixed mesodermal tumor) among patients operated on for uterine leiomyoma is extremely low (0.23%). The incidence of sarcoma among patients having surgery for "rapidly growing" leiomyoma (0.27%) or among those who met published criteria for rapid growth (0%) does not substantiate the concept of increased risk of sarcoma in these women.
确定因有症状的子宫平滑肌瘤或“快速生长”的平滑肌瘤而接受手术治疗的患者中子宫肉瘤的发病率。
我们回顾了1988年至1992年间因子宫平滑肌瘤接受子宫切除术或肌瘤切除术而入住两家社区医院之一的1332名女性的病历。计算了平滑肌肉瘤、子宫内膜间质肉瘤和混合性中胚层肿瘤的发病率。分析了患者年龄、入院症状以及手术和病理检查结果。该研究包括371名因平滑肌瘤快速生长而接受手术的女性（28%）。对同一时期接受手术且被发现患有子宫肉瘤的所有患者进行了回顾。
在1332名因疑似平滑肌瘤而接受手术的患者中，有1名被发现患有平滑肌肉瘤。这名女性是371名因子宫快速生长而接受手术的女性中唯一被发现患有肉瘤的患者。在198名符合已发表的快速生长定义的患者中，没有一人患有子宫肉瘤。有两名女性（0.15%）患有子宫内膜间质肉瘤，但没有人患有混合性中胚层肿瘤。在同一时期，又发现9名患者患有子宫肉瘤，对于这些女性，术前诊断为肉瘤的有4人，子宫内膜癌的有3人，卵巢癌的有1人，子宫脱垂的有1人。
因子宫平滑肌瘤接受手术的患者中子宫肉瘤（平滑肌肉瘤、子宫内膜间质肉瘤和混合性中胚层肿瘤）的总发病率极低（0.23%）。因“快速生长”的平滑肌瘤接受手术的患者中肉瘤的发病率（0.27%）或符合已发表的快速生长标准的患者中肉瘤的发病率（0%），均不能证实这些女性患肉瘤风险增加的概念。
