围绝经期子宫异常出血870例子宫内膜组织病理学分析
Histopathology analysis of andometrium of abnomal ulterine bleeding in perimenopausal women
目的 探讨围绝经期子宫异常出血的子宫内膜组织病理学变化,了解引起围绝经期子宫异常出血的常见原因.方法 对870例围绝经期子宫异常出血的子宫内膜活检标本进行回顾性分析.结果:围绝经期子宫异常出血的子宫内膜病变中最常见的是子宫内膜增生(76.67%),其中绝大多数表现为单纯性增生(66.12%),患子宫内膜癌的患者占3.0%,以高分化子宫内膜样腺癌居多(88.46%).子宫内膜样腺癌的组织学特点是:子宫内膜腺上皮排列失去极性,细胞核变大、变圆,核仁突出,染色质颗粒粗或呈空泡状,同时子宫内膜间质消失,代之以肉芽组织或纤维组织,常有炎性反应.结论 异常子宫出血多发生在围绝经期,子宫内膜增生是该期异常子宫出血的主要原因.围绝经期妇女子宫内膜癌多数为高分化子宫内膜样腺癌,应注意与子宫内膜不典型增生及不典型息肉状腺肌瘤的鉴别.
更多Objective To investigate the histopathologic changes of andometrium and research the cause of abnomal uterine bleeding in permenopausal women.Methods The biopsy sample of andometrium of 870 cases with abnomal uterine bleeding in permenopausal women were restrospectively analyzed.Results The most commonly hostopathologic change in andometrium of abnomal ulterine bleeding in permenopausal women is endometrial hyperplasia(76.67%).The most cases were simple hyperplasia(66.12%).3.0%of cases were endometrial carcinoma,most of them were well-differentiated endometrioid adenocarcinoma(88.46%).The morphological features of the endometrial adenocarcinomas is loss of polarity of the endometrial glands.The tumor cells have large round vesicular nuclei,prominent nucleoli and coarse chromatin.In addition,endometrial stroma was instead of by the fibrous and/or granulation tissue type stroma,usually with inflammatory response.Conclusions Abnormal ulterine bleeding occurred mainly in permenopausal period.Endometrial hyperplasia is the main cause of abnomal ulterine bleeding in permenopausal period.Most endometrial carcinomas in perimenpausal period are well-differentiated endometrioid adenocarcinomas.An important differential diagnosis of the endometrioid carcinoma in a curettage specimen is to differentiate it from atypical endometrial hyperplasia and atypical polypoid adenomyoma.
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