中文摘要：

目的探讨不同组织学类型的子宫肉瘤的临床特点。方法回顾性分析安徽省立医院2013—2015年收治的14例子宫肉瘤患者，其中子宫内膜间质肉瘤4例，占28．57％、子宫平滑肌肉瘤7例，占50．00％、癌肉瘤2例，占14．29％、7昆合性子宫内膜间质肉瘤-平滑肌肉瘤1例，占7．15％。I期8例，Ⅱ期4例，Ⅲ期1例，Ⅳ期1例。结果①子宫内膜问质肉瘤的平均发病年龄为（42．5±8．96）岁（31～51）、子宫平滑肌肉瘤的平均发病年龄为（51．0±8．91）岁，而癌肉瘤的平均发病年龄为（61．0±4．24）岁；②子宫内膜问质肉瘤、子宫平滑肌肉瘤的临床表现以下腹包块为主，其中子宫平滑肌肉瘤的肿瘤直径均〉8em，癌肉瘤以阴道异常出血为主；③10例患者获得完整术前B超资料，其中8例患者B超提示肿块内部回声不均匀，4例提示肿块血供丰富；其余患者B超改变不典型；④4例患者行子宫及双侧附件切除术加腹膜后淋巴结清扫术，6例行子宫及双侧附件切除术，8例术后加用化学治疗。14例患者均存活，其中1例子宫平滑肌肉瘤追加全子宫＋双附件切除术术后1年半复发（可能与首次手术腹腔镜下肌瘤旋切有关）。结论子宫肉瘤的临床症状不典型，术前诊断率较低，B超一般提示肿块局部血供丰富、不均质回声。子宫内膜间质肉瘤发病年龄较轻，子宫平滑肌肉瘤发病年龄接近围绝经期，肿瘤一般大于或接近8cm；癌肉瘤的发表年龄多为绝经后，临床症状以阴道出血为主。

英文摘要：

Objective To explore the clinical features of uterine sarcoma of different histological types. Methods Fourteen patients with uterine sarcoma treated in the hospital from 2013 to 2015 were analyzed retrospectively,including four patients（ 28. 57%） with endometrial interstitial sarcoma,seven patients（ 50. 00%） with uterine leiomyosarcoma,two patients（ 14. 29%） with carcinoma sareomatodes,and one patient（ 7. 15%） with mixed endometrial interstitial sarcoma-uterine leiomyosarcoma. Clinical stages： stage Ⅰ（ eight patients）,stage Ⅱ（ four patients）,stage Ⅲ（ one patient）,stage Ⅳ（ one patient）. Results The median age of the patients with endometrial interstitial sarcoma was（ 42. 5±8. 96） years old（ age range： 31-51 years old）; the median age of the patients with uterine leiomyosarcoma was（ 51. 0±8. 91） years old; the median age of the patients with carcinoma sareomatodes was（ 61. 0±4. 24） years old. The patients with endometrial interstitial sarcoma and uterine leiomyosarcoma usually manifested with palpable mass of lower abdomen,the diameter of endometrial interstitial sarcoma was more than 8 cm on average,the patients with carcinoma sareomatodes usually manifested with abnormal vaginal bleeding. Complete ultrasonographic information before surgery was collected from ten patients,eight patients were found with irregular echo in lesion,four patients were found with blood flow around lesion,the others were found with atypical ultrasonographic changes. Four patients were treated by hysterectomy,bilateral salpingooophorectomy,and pelvic lymphadenectomy,six patients were treated by hysterectomy and bilateral salpingooophorectomy,eight patients were treated by chemotherapy. All the 14 patients were still live,relapse occurred in one patient with uterine leiomyosarcoma after 1. 5 years of hysterectomy and bilateral salpingooophorectomy,which might be correlated with laparoscopic rotary-cut of fibroids during the first operation. Conclusion The clinical symptoms of