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恶性潜能未定的子宫平滑肌瘤1例并文献复习
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Abstract:
目的：分析恶性潜能未定的子宫平滑肌瘤(STUMP)的临床特征、诊断、治疗及预后情况，并总结最新的诊断及治疗方法，以提高该病的诊治水平。方法：回顾性分析了一例STUMP患者的临床资料，并复习了国内外相关文献。对患者的临床表现、诊断方法、治疗措施和预后进行了详细讨论。结果：STUMP的临床表现缺乏特异性，诊断主要依赖于组织病理学检查。目前尚无统一的治疗指南，但手术仍是主要治疗方式。STUMP的总生存率较高，但存在一定的复发率，规律随访对于早期发现复发病灶至关重要。
Objective: This study aimed to analyze the clinical characteristics, diagnosis, treatment, and prognosis of uterine smooth muscle tumors of uncertain malignant potential (STUMP), and to summarize the latest diagnostic and treatment methods to enhance the management level of this disease. Methods: A retrospective analysis of clinical data from a case of STUMP was conducted, and relevant literature from domestic and international sources was reviewed. Detailed discussions were conducted on the clinical manifestations, diagnostic methods, treatment measures, and prognosis of the patient. Conclusion: The clinical manifestations of STUMP lack specificity, and diagnosis primarily relies on histopathological examination. Currently, there is no unified treatment guideline, but surgery remains the main treatment modality. STUMP has a relatively high overall survival rate, but there is a certain recurrence rate, highlighting the importance of regular follow-up for early detection of recurrent lesions.
| [1] | Dall’Asta, A., Gizzo, S., Musaro, A., et al. (2014) Uterine Smooth Muscle Tumors of Uncertain Malignant Potential (STUMP): Pathology, Follow-Up and Recurrence. International Journal of Clinical and Experimental Pathology, 7, 8136-8142. |
| [2] | Bell, S.W., Kempson, R.L. and Hendrickson, M.R. (1994) Problematic Uterine Smooth Muscle Neoplasms. The American Journal of Surgical Pathology, 18, 535-558. https://doi.org/10.1097/00000478-199406000-00001 |
| [3] | Gupta, M., Laury, A.L., Nucci, M.R. and Quade, B.J. (2018) Predictors of Adverse Outcome in Uterine Smooth Muscle Tumours of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 22 Cases with a Proposal for the Inclusion of Additional Histological Parameters. Histopathology, 73, 284-298. https://doi.org/10.1111/his.13515 |
| [4] | Ferrandina, G., Aristei, C., Biondetti, P.R., Cananzi, F.C.M., Casali, P., Ciccarone, F., et al. (2020) Italian Consensus Conference on Management of Uterine Sarcomas on Behalf of S.I.G.O. (Societa’ italiana di Ginecologia E Ostetricia). European Journal of Cancer, 139, 149-168. https://doi.org/10.1016/j.ejca.2020.08.016 |
| [5] | Huo, L., Wang, D., Wang, W., Cao, D., Yang, J., Wu, M., et al. (2020) Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases. Frontiers in Oncology, 10, Article 647. https://doi.org/10.3389/fonc.2020.00647 |
| [6] | Akad, F., Filip, B., Mocanu, V., et al. (2021) Rare Case of Smooth Muscle Tumor of Uncertain Malignant Potential—Clinical Case. Maedica, 16, 302-306. |
| [7] | Jeon, J., Park, J., Lee, E., Han, J., Kim, D., Park, J., et al. (2023) Prolapsed Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Case Report and Review of Radiological Findings. Current Medical Imaging, 20, Article ID: e140623217957. https://doi.org/10.2174/1573405620666230614093128 |
| [8] | Lapresa-Alcalde, M.V., Ruiz-Navarro, M.J., Sancho de Salas, M. and Cubo, A.M. (2023) A Review and Follow-Up of Uterine Smooth Muscle Tumours of Uncertain Malignant Potential (STUMP): A Case Series and Literature Review. Diseases, 11, Article 99. https://doi.org/10.3390/diseases11030099 |
| [9] | Rubisz, P., Ciebiera, M., Hirnle, L., Zgliczyńska, M., ？oziński, T., Dzi？giel, P., et al. (2019) The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium. International Journal of Molecular Sciences, 20, Article 1136. https://doi.org/10.3390/ijms20051136 |
| [10] | Kobayashi, H., Uekuri, C., Akasaka, J., Ito, F., Shigemitsu, A., Koike, N., et al. (2013) The Biology of Uterine Sarcomas: A Review and Update. Molecular and Clinical Oncology, 1, 599-609. https://doi.org/10.3892/mco.2013.124 |
| [11] | Travaglino, A., Raffone, A., Gencarelli, A., Neola, D., Oliviero, D.A., Alfano, R., et al. (2021) p53, p16 and ki67 as Immunohistochemical Prognostic Markers in Uterine Smooth Muscle Tumors of Uncertain Malignant Potential (STUMP). Pathology-Research and Practice, 226, Article 153592. https://doi.org/10.1016/j.prp.2021.153592 |
| [12] | Rizzo, A., Ricci, A.D., Saponara, M., De Leo, A., Perrone, A.M., De Iaco, P., et al. (2020) Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of the Art. Anticancer Research, 40, 1229-1238. https://doi.org/10.21873/anticanres.14064 |
| [13] | Reed, J.C., et al. (1991) Mitochondrial Protein p26 BCL2 Reduces Growth Factor Requirements of NIH3T3 Fibroblasts. Experimental Cell Research, 195, 277-283. https://doi.org/10.1016/0014-4827(91)90374-4 |
| [14] | Mowers, E.L., Skinner, B., McLean, K. and Reynolds, R.K. (2015) Effects of Morcellation of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential and Endometrial Stromal Sarcoma: Case Series and Recommendations for Clinical Practice. Journal of Minimally Invasive Gynecology, 22, 601-606. https://doi.org/10.1016/j.jmig.2015.01.007 |
| [15] | Zhang, R., Tian, X., Qin, L., Lu, D. and Shen, J. (2015) High 18F-FDG Uptake for Uterine Smooth Muscle Tumor of Uncertain Malignant Potential. Clinical Nuclear Medicine, 40, 349-351. https://doi.org/10.1097/rlu.0000000000000727 |
| [16] | Ho, K.-C., Dean Fang, Y.-H., Lin, G., Ueng, S.-H., Wu, T.-I., Lai, C.-H., et al. (2018) Presurgical Identification of Uterine Smooth Muscle Malignancies through the Characteristic FDG Uptake Pattern on PET Scans. Contrast Media & Molecular Imaging, 2018, Article 7890241. https://doi.org/10.1155/2018/7890241 |
| [17] | Guntupalli, S.R., Ramirez, P.T., Anderson, M.L., Milam, M.R., Bodurka, D.C. and Malpica, A. (2009) Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Retrospective Analysis. Gynecologic Oncology, 113, 324-326. https://doi.org/10.1016/j.ygyno.2009.02.020 |
| [18] | Basaran, D., Usubutun, A., Salman, M.C., Narin, M.A., Boyraz, G., Turkmen, O., et al. (2018) The Clinicopathological Study of 21 Cases with Uterine Smooth Muscle Tumors of Uncertain Malignant Potential. International Journal of Gynecological Cancer, 28, 233-240. https://doi.org/10.1097/igc.0000000000001178 |
| [19] | Ly, A., Mills, A.M., McKenney, J.K., Balzer, B.L., Kempson, R.L., Hendrickson, M.R., et al. (2013) Atypical Leiomyomas of the Uterus. American Journal of Surgical Pathology, 37, 643-649. https://doi.org/10.1097/pas.0b013e3182893f36 |
| [20] | Peeters, N., Hulsbosch, S., Ballaux, F. and Baekelandt, J. (2016) Uterine Smooth Muscle Tumors of Uncertain Malignant Potential: Analysis of Diagnoses and Therapies Illustrated by Two Case Reports. European Journal of Gynaecological Oncology, 37, 367-373. |
| [21] | Vilos, G.A., Marks, J., Ettler, H.C., Vilos, A.G., Prefontaine, M. and Abu-Rafea, B. (2012) Uterine Smooth Muscle Tumors of Uncertain Malignant Potential: Diagnostic Challenges and Therapeutic Dilemmas. Report of 2 Cases and Review of the Literature. Journal of Minimally Invasive Gynecology, 19, 288-295. https://doi.org/10.1016/j.jmig.2011.12.025 |
