SMOOTH-MUSCLE NEOPLASMS OF THE UTERUS OTHER THAN ORDINARY LEIOMYOMA - A STUDY OF 46 CASES, WITH EMPHASIS ON DIAGNOSTIC-CRITERIA AND PROGNOSTIC FACTORS
SMOOTH-MUSCLE NEOPLASMS OF THE UTERUS OTHER THAN ORDINARY LEIOMYOMA - A STUDY OF 46 CASES, WITH EMPHASIS ON DIAGNOSTIC-CRITERIA AND PROGNOSTIC FACTORS
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DOI：
10.1002/1097-0142(19881115)62:10
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发表时间：
1988-11-15
期刊：
影响因子：
6.2
通讯作者：
FINN, KP
中科院分区：
文献类型：
--
作者：
EVANS, HL;CHAWLA, SP;FINN, KP
37例子宫平滑肌肉瘤，沿着9例平滑肌瘤变种，他们被区分。所有患者均随访至少10年。在具有核多形性的病例中，当在肿瘤的最活跃区域的10个连续高倍（× 400）视野中有5个或更多的有丝分裂像时，以及当有较少的有丝分裂像但广泛的肿瘤坏死时（只有一个平滑肌肉瘤没有核多形性，并且它在10个高倍视野中有20个以上的有丝分裂像），诊断为平滑肌肉瘤。肿瘤大小是平滑肌肉瘤组的主要预后因素;肿瘤最大尺寸小于5 cm的8例患者中有5例存活，而肿瘤较大的患者无一存活。其他病理和临床变量，包括有丝分裂率，肿瘤坏死，核多形性程度，血管浸润，和患者年龄，没有显着关系的生存或肿瘤的行为在平滑肌肉瘤时，考虑到肿瘤的大小。9例平滑肌瘤变体病例包括3例非典型平滑肌瘤（核多形性，每10个高倍视野中有1个或无核分裂像，无坏死）、2例丛状平滑肌瘤、2例腹膜平滑肌瘤病、1例栅栏状平滑肌瘤和1例静脉平滑肌瘤病;所有这些患者在随访时均无肿瘤。
Thirty-seven cases of uterine leiomyosarcoma are presented, along with nine cases of leiomyoma variants from which they were distinguished. All patients were followed for a minimum of 10 years. In cases with nuclear pleomorphism, leiomyosarcoma was diagnosed when there were five or more mitotic figures in ten consecutive high-power (.times.400) fields in the most active area of the tumor, and also when there were fewer mitotic figures but extensive tumor necrosis (there was only one leiomyosarcoma without nuclear pleomorphism, and it had more than 20 mitotic figures in ten high-power fields). Tumor size was the major prognostic factor in the leiomyosarcoma group; five of eight patients with neoplasms measuring less than 5 cm in maximum dimension survived, whereas no patient with a larger tumor did so. Other pathologic and clinical variables, including mitotic rate, tumor necrosis, degree of nuclear pleomorphism, vascular invasion, and patient age, had no significant relationship to survival or tumor behavior in leiomyosarcoma when tumor size was taken into account. The nine cases of leiomyoma variants consisted of three atypical leiomyomas (which had nuclear pleomorphism, one or no mitotic figures per ten high-power fields, and no necrosis), two plexiform leiomyomas, two cases of peritoneal leiomyomatosis, one palisaded leiomyoma, and one case of intravenous leiomyomatosis; all of these patients were tumor-free on follow-up.