1、不同类型子宫肉瘤不同类型子宫肉瘤诊断、治疗选择诊断、治疗选择发病率子宫肉瘤常见组织学分类发病顺序SEER美国美国中国中国MMMT0.82/100000MMMT(50%)LMS(63%)LMS0.64/100000LMS(30%)ESS(22%)ESS0.19/100000ESS(15%)MMMT(15%)SEER:Surveillance,Epidemiology,and End Result Program病因病因-遗传因素发病年龄术前诊断术前诊断LMSGoto A,TakeuchiS,Sugimura K,Maruo T.Usefulness of Gd-DTPA contrast-enh
2、anced dynamic MRI and serum determination ofLDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus.Int J Gynecol Cancer 2002;12:35461A 肌瘤变性肌瘤变性(n=130)B/C LMS (n=10)症状临床表现:快速生长诊断诊断及鉴别诊断诊断及鉴别诊断转移转移治疗手术放疗化疗化疗目前关于子宫肉瘤治疗的研究LMS LMSLMS LMS手术-LMS 化疗-LMS
3、对于LMS的RCT研究化疗-LMS化疗-LMS放疗-LMSESSLG-ESSLG-ESSHG-ESSA:LG-ESS 400B:HG-ESS 400手术-ESS手术-ESS化疗 ESS放疗-ESS激素治疗LG-ESS激素治疗LG-ESSESS-5年生存率MMMTMMMTMMMTSreenan JJ,Hart WR.Carcinosarcomas of the female genital tract:a pathologic study of 29 metastatic tumors:further evidence for the dominant role of the epithelial component and the conversion theory of histogenesis.Am J Surg Pathol 1995;19:66674.MMMTMMMTCarcinosarcoma with heterologous(chondroid)elements 200)MMMTMMMT关于MMMT化疗的RCT研究相关的预后因素相关的预后因素值得重视的问题