孟曦龙;杜雪;岳天孚;

• 1:天津医科大学总医院妇产科

摘要(Abstract)：

目的:分析子宫非典型息肉样腺肌瘤(APA)的临床特点,并探讨宫腔镜对其诊断和治疗的作用。方法:回顾性分析2005年4月～2012年3月天津医科大学总医院收治的15例APA患者的临床诊疗情况及结局。结果:15例患者中10例合并高血压和(或)糖尿病,1例肥胖,1例不孕。6例绝经患者中3例血清雌激素水平升高。宫腔镜下9例患者瘤体表面伴粗大血管;5例周围子宫内膜不均质增厚,2例萎缩,8例子宫内膜未见异常。15例中11例行宫腔镜下赘生物切除术+子宫内膜切除术,2例行宫腔镜下赘生物切除术,2例行全子宫双附件切除术。随访2～84个月,患者均无复发。结论:宫腔镜下赘生物切除加子宫内膜切除术,是保守治疗APA的有效方法。APA多发生于绝经前妇女,应根据患者有无生育要求及是否保留子宫进行个体化治疗。

关键词(KeyWords)： 腺肌瘤;子宫内膜;宫腔镜;息肉;子宫切除术;治疗学

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 孟曦龙;杜雪;岳天孚;

DOI: 10.13283/j.cnki.xdfckjz.2013.01.007

参考文献(References)：

• [1]Mazur MT.Atypical polypoid adenomyomas of the endome-trium[J].Am J Surg Pathol,1981,5(5):473-482
• [2]Heatley MK.Atypical polypoid adenomyoma:a systematicreview of the English literature[J].Histopathology,2006,48(5):609-610
• [3]Longacre TA,Chung MH,Rouse RV,et al.Atypical poly-poid adenomyofibromas(atypical polypoid adenomyomas)of the uterus.A clinicopathologic study of 55 cases[J].Am J Surg Pathol,1996,20(1):1-20
• [4]Clement PB,Young RH.Atypical polypoid adenomyoma ofthe uterus associated with Turner's syndrome.A report ofthree cases,including a review of"estrogen-associated"endometrial neoplasms and neoplasms associated withTurner's syndrome[J].Int J Gynecol Pathol,1987,6(2):104-113
• [5]Horn LC,Fischer U,Hockel M.Polypoid endometrial ade-nomyoma in a postmenopausal woman,mimicking cervicalcancer,associated with ovarian thecoma[J].Arch GynecolObstet,2002,267(2):101-103
• [6]Fukuda M,Sakurai N,Yamamoto Y,et al.Case of atypicalpolypoid adenomyoma that possibly underwent a serial pro-gression from endometrial hyperplasia to carcinoma[J].JObstet Gynaecol Res,2011,37(5):468-471
• [7]Ota S,Catasus L,Matias-Guiu X,et al.Molecular patholo-gy of atypical polypoid adenomyoma of the uterus[J].Hum Pathol,2003,34(8):784-788
• [8]Vilos GA,Ettler HC.Atypical polypoid adenomyoma andhysteroscopic endometrial ablation[J].J Obstet GynaecolCan,2003,25(9):760-762
• [9]Di Spiezio SA,Mazzon I,Gargano V,et al.Hysteroscopictreatment of atypical polypoid adenomyoma diagnosed in-cidentally in a young infertile woman[J].Fertil Steril,2008,89(2):456-459
• [10]Yahata T,Nonaka T,Watanabe A,et al.Complete hyste-roscopic resection of a large atypical polypoid adenomyo-ma,followed by a successful pregnancy[J].Fertil Steril,2011,95(7):2435-2439
• [11]Gunderson CC,Fader AN,Carson KA,et al.Oncologicand reproductive outcomes with progestin therapy inwomen with endometrial hyperplasia and grade 1 adeno-carcinoma:a systematic review[J].Gynecol Oncol,2012,125(2):477-482