Discussion On The Characteristics Of Unsuspected Uterine Sarcoma (UUS) Cases

Objective: to analyze the characteristics of unexpected uterine sarcomas and leiomyomas retrospectively,and to make a preoperative scoring table so as to accurately evaluate the possibility of uterine sarcomas before operation.Methods: a total of 130 patients were enrolled,65 of whom were confirmed as uterine sarcomas by postoperative pathology,65 as uterine fibroids by postoperative pathology,and 56 as unexpected uterine sarcomas by postoperative pathology.1,Comparative analysis of unexpected uterine sarcoma and uterine fibroids of two groups of cases of clinical manifestations,age,preoperative serological examination,pelvic color Doppler ultrasound,gynecological surgery history and other characteristics;2.To explore the clinical features of different pathological types of unexpected uterine sarcoma and to make preoperative scoring table.Using SPSS 19.0 software for statistical processing,t test and chi-square test to calculate the p value,p < 0.05 for the difference was statistically significant.Results: 1)endometrial stromal sarcoma(ESS),leiomyosarcoma(LMS)and adenosarcoma(AS)were the most common types of unexpected uterine sarcomas.2)The average age of uterine sarcomas of different pathological types was from big to small: unexpected LMS,unexpected as,unexpected ess.3)the average age of group A was 46.3 years.The average age of group B was39.3 years,the age difference between the two groups was statistically significant(p <0.001),and the age of uterine sarcoma patients was relatively large.4)More than half of the patients in group A had premenopausal onset(38 / 56 67.9 %).8 cases of LMS,4 cases of ESS,5 cases of AS,include LMS 12 cases,ESS 26 cases,AS 1 case in 39 cases of premenopausal patients.The menopausal status of the patients was statistically different among different pathological types(p = 0.002).The proportion of unsupected LMS and as menopause was higher than that of unexpected ESS.5)The common clinical manifestations of 56 cases of unexpected uterine sarcoma were: menstrual disorder(21 / 56 17.4 %),irregular vaginal bleeding(12 / 56 21.4 %),vaginal fluid(2 / 56 3.6 %),abdominal pain(8 / 56 14.3 %),no obvious symptoms(20 / 5635.7 %),compression symptoms(2 / 56 3.6 %).There were significant differences in clinical manifestations between different pathological types(p = 0.001).The clinical manifestations of A and B groups were statistically significant: irregular vaginal bleeding(p < 0.001),asymptomatic(p < 0.001),menstrual disorders(p = 0.039).6)Preoperative serum CA125 has no specificity for the diagnosis of uterine sarcoma.In this study,the value of CA125 in unsuspected ESS was higher than normal.7)The mean maximum diameter of unsuspected LMS mass was 9.56 cm,the mean maximum diameter of unsuspected ESS mass was 6.60 cm,and the mean maximum diameter of unsuspected AS mass was 5.95 cm.There was significant difference in the mass size between different pathological types of unsuspected uterine sarcoma(p < 0.01).There was significant difference in the maximum diameter of mass between group a and group b(p = 0.004).8)In 65 cases of uterine sarcoma patients,the unsuspected uterine sarcoma patients were confirmed by preoperative diagnostic curettage pathology for uterine sarcoma diagnosis,and 56 cases of unsuspected uterine sarcoma patients,33 patients underwent preoperative diagnostic curettage,including 30 patients with negative curettage pathology,preoperative diagnostic curettage of uterine sarcoma diagnosis is necessary,but its diagnosis rate is low.9)Make preoperative suspiciousuterine sarcoma score table,age 45.5 years old or higher score 2 points,platelet count290(10 * 9 / l)score 2 points,color Doppler ultrasound suggests that the largest diameter line of mass ? 6.5(cm)score 1 points,if score more than 2 points,should be alert to the existence of uterine sarcoma.Conclusion: 1)Among unsuspected uterine sarcoma,endometrial stromal sarcoma(ESS)is the most,followed by uterine leiomyosarcoma(LMS),adenosarcoma(AS)is the least.2)Compared with uterine fibroids,unexpected uterine sarcomas are older(? 45.5 years old)and more frequently occur in premenopausal women.There was no difference in preoperative weight and gynecological operation history.3)The most common clinical manifestations of unsuspected uterine sarcoma are irregular vaginal bleeding and menstrual disorders.There were significant differences in clinical manifestations between different pathological types.4)Unexpected uterine sarcoma color Doppler ultrasound suggests that the mass is usually large,and RI value is still unable to determine whether it is uterine sarcoma.5)Unsuspected uterine sarcoma preoperative diagnosis is difficult,make preoperative suspicious uterine sarcoma score table,score more than 2 points,should be alert to the existence of uterine sarcoma.