Clinical Analysis Of 14 Cases With Uterine Sarcoma

Objective:To Discuss the characteristics of clinical performance in Uterine Sarcoma, so as to the essay can help early diagnosis and treatment for this disease.Methods:The Second Affiliated Hospital of Dalian Medical University were analyzed retrospectively since January 2003 - December 2010 treated patients with uterine sarcoma during fourteen cases, analysis, were the major clinical manifestations, auxiliary inspections, treatment, and discusses its surgical treatment options. Application of data SPSS17.0 statistics software, measurement data using the?χ±S says, rate of material usingχ2 test, think was statistically significant (P < 0.05).Result:1.According to clinical manifestations of uterine sarcoma,preoperative diagnosis is low, definite diagnosis still need pathology diagnosis. In the fourteen cases, five cases were diagnosed uterine fibroids before the operation, those eleven cases were diagnosed uterine sarcoma in frozen pathology or paraffin section pathology.2.Fourteen patients were performed surgery. Eight cases before and during the operation were diagnosed certainty by pathology , includingⅠperiod 6 cases do hysterectomy + double uterine adnexa resection, 1 caseⅠperiod required reserves for young sheba cervical and pathology report low-grade malignant uterine leiomyosarcoma,do subtotal hysterectomy + left uterine adnexa resection, 1 caseⅡperiod do extensive hysterectomy + bilateral abdominal lymph node dissection, 3 cases of intraoperative frozen pathological isn't sure. 3 cases not more than send intraoperative frozen.3. The two years and five years survival rates of Young patients are higher than older patients (P < 0.05), cause of death is mainly in MODS and distant metastasis.Conclusion:1.Clinical features:the incidence of uterine sarcoma is low,but the malignant is high,and it is easy to recurrence and distant metastasis in the early stage. Clinical manifestations and tumor markers are nonspecific, preoperative diagnosis rate is low, the misdiagnosis rate is high, easily misdiagnosed as uterine fibroids.2. Early diagnosis: Combined with medical history,preoperative color doppler ultrasound and CT can assist in making the diagnosis;MRI and PET can improve preoperative diagnosis rate. Curettage is more helper to the early diagnosis of endometrialstromal sarcoma and malignant mullerian mixed tumer.3.Treatment: surgery is still the first selection. At present, the relatively consistent view in domestic is,Ⅰperiod do hysterectomy + double uterine adnexa resection; Uterine sarcomaⅡperiod, cervical sarcomaⅠperiod, malignant mullerian mixed tumorⅠperiod should do extensive hysterectomy + double bilateral abdominal lymph node dissection,and at the same time probe paraaortic lymph nodes. Intraoperative should return celiac lavage fluid, with intraoperative frozen pathological to determine the clinical stages and surgical range, ensure as cut net lesions. According to the Postoperative pathologic complementary with chemoradiotherapy.