目的 探讨梭形细胞分化的恶性潜能未定子宫平滑肌肿瘤(uterine smooth muscle tumor of uncertain malignant potential,STUMP)的临床表现、辅助检查及诊断方法。方法 选取2009-01至2015-12在医院妇科接受手术治疗的梭形细胞分化的STUMP患者,病理科医师采用同一诊断标准对病理切片再次复核。通过搜集临床资料进行回顾性研究。结果 共23例,均为育龄期或围绝经期女性,年龄41~50岁的占60.9%;均表现出与子宫肌瘤或肉瘤相似的临床症状,但以月经量增多,经期延长者最多见(56.5%);22例术前超声将该肿瘤诊断为良性平滑肌瘤,1例被诊断为卵巢肿物;术中见肿瘤多生长于宫体肌壁间(60.9%);最大径线2～16 cm,平均6.4 cm;剖面与良性子宫肌瘤类似。结论 STUMP患者的年龄分布、临床表现、超声声像图等均与良性子宫平滑肌瘤更为相似,术前难以区分,确诊仍需依靠病理学检查。

Objective To investigate the clinical symptoms、manifestations and methods of auxiliary examination and diagnosis of uterine smooth muscle tumor of uncertain malignant potential(STUMP).Methods All the cases were selected from patients who had received surgery in the Army General Hospital between January 2009 and December 2015. The original surgical specimens of the patients were reviewed by pathologists using the same diagnostic criteria. Our study only included patients who were re-diagnosed as STUMP and represented spindle cell type differentiation. Detailed data was obtained by reviewing the medical records. Retrospective analysis was conducted in this study.Results Twenty-three patients were collected. All the patients were of childbearing age or peri-menopausal women. Most of the patients ranged from 41 to 50 in age (accounting for 60.9%). Patients who suffered from STUMP had similar symptoms to those with uterine leiomyoma or leiomyosarcoma,but menorrhagia and menostaxis were the most common symptoms (56.5%). Twenty-two of these cases of STUMPs were classified as benign uterine leiomyomas by ultrasound examination,while 1 case of STUMP was diagnosed as a big ovarian tumor before surgery. The tumors mostly grew between the intramural walls of the uterine body (60.9%) , and the maximum diameter ranged from 2cm to 16cm, with an average of 6.4cm. All the STUMPs had a similar appearance to benign leiomyomas.Conclusions The age distribution、clinical symptoms、pelvic ultrasound images of the patients with STUMP are more similar to those who have leiomyomas. Definite diagnosis still depends on pathological examination.