• 系統編號 RB8610-1133
• 計畫中文名稱 子宮肌腺瘤之臨床病理學研究
• 計畫英文名稱 Clinicopathological Study on Adenomyosis.
• 主管機關 行政院國家科學委員會 • 計畫編號 NSC84-2331-B038-029
• 執行機構 私立台北醫學院醫學系
• 本期期間 8308 ~ 8407
• 報告頁數 0 頁 • 使用語言 英文
• 研究人員 黃德修 Huang, Teh-Shi
• 中文關鍵字 子宮肌腺瘤；卵泡激素接受器；黃體激素受器；臨床病理學；月經週期
• 英文關鍵字 Adenomyosis；Follicular hormone receptor；Progesterone receptor；Clinicopathology；Menstral cycle
• 中文摘要
子宮肌腺瘤是臨床上常見但常被忽視的一種婦科疾病。此良性疾病之組織發生及臨床意義一直是眾說紛紜。為了增加對於此
疾病的了解,我們完成了子宮肌腺瘤之臨床病理研究。由台北醫學院附設醫院外科病理檢查報告的檔案中,我們從西元一九八
九年至一九九二年共四年內接受子宮全切除術而病理診斷為子宮肌腺瘤的病例裡,找到 268 例子宮肌腺瘤的病例,去除了固定
不好、取樣不適當、及長有會影響子宮內膜週期變化之病灶(如:子宮內膜炎、黏膜下肌瘤等),再由觀察石臘切片,找出在異位內
膜有足夠腺體及間質之病灶的病例,共選出了一百零四個病例。由病歷中追查病人術前之各項臨床資料,包括病人的年齡、症狀
及徵候、生產相關病史、及人工流產之相關病史,再由重新觀察病理檢查報告及石臘切片,而得到病理學上的資料,包含病灶的位
置、原位性及異位性子宮內膜之月經週期的同步與否。利用統計學方法來比較各項臨床及組織病理資料之相關性。根據我們的
研究得到以下幾點結論:(1)子宮肌腺瘤在我們的研究中最常發生在四十到四十九歲的病人(59.6%),而平均年齡是四十二點四
歲。(2)最常見之主訴是痛經(61.5%)及經血過多(42.3%)。(3)大部分病人曾經懷孕(88.5%)及生產(85.6%)而不孕的病例極少 (1%)。(4)很多病人曾做子宮括除術(72.1%)。(5)對於曾經懷孕、生產、或人工流產的病人,病灶發生於子宮上部較下部為多。而未
曾懷孕、生產、及人工流產者,其病灶分布則較均勻。(6)在本研究中有 71.2%的病灶和原位之子宮內膜是月經週期上同步的。
• 英文摘要 Adenomyosis is a common disease of women in reproductive life, however, both the pathogenesis and clinical significance of this entity are poorly defined. In order to increase the understanding about this disease, a retrospective study focused on clinicopathologic correlation about adenomyosis uteri was carried out. Totally 104 hysterectomized cases of adenomyosis diagnosed histologically were selected from the files of the surgical pathology department in Taipei Medical College Hospital from 1989 to 1992. All cases included
in this study contained no less than three adenomyotic foci which had adequate amount of stroma and no less than three glands. Some clinical data including patient's age, obstetrical history, clinical signs and symptoms were compared with some pathological
informations including the anatomic distribution of adenomyotic foci and the synchronization of eutopic vs. ectopic endometrial tissue. According to our study, the peak incidence fell in the fifth decade (59.6%), with mean age of 42.4 years. The major symptoms were dysmenorrhea (61.5%) and menorrhagia (42.3%). Most of the cases were gravidous (88.5%) and parous (85.6%). The incidence of sterility in patients with adenomyosis was very low. Many cases have history of dilatation and curettage (D&C) (72.1%).
Histologically, 71.2% of the adenomytic lesions were synchronous with the eutopic endometrium in the menstral cycle if the ectopic endometrium is large enough. The adenomyosis was more frequently located in the upper wall than in the lower wall. This anatomic predominance is found more frequently in the gravidous and parous patients or in the patients with history of dilatation and curettage (D&C).
