子宫内膜息肉的病理诊断与恶变研究现状

doi:10.3877/cma.j.issn.1673-5250.2025.04.001

子宫内膜息肉(endometrial polyp)是妇科临床较为常见疾病，目前在临床病理诊断与临床诊断中存在差异。由于部分子宫内膜息肉可能发生恶变，需要引起临床关注。笔者拟重点介绍子宫内膜息肉的病理学诊断标准、息肉类型及恶性转化的相关研究现状，为临床精准诊断子宫内膜息肉及预防其发生恶变提供参考。

关键词: 息肉，子宫内膜, 病理学，临床, 子宫内膜增生, 活组织检查, 组织学，比较, 恶性转变, 子宫内膜肿瘤, 生殖器疾病，女(雌)性

Endometrial polyps are a relatively common lesion in gynecological clinic. There are differences between pathological and clinical diagnoses of endometrial polyps. The malignant changes are found in some endometrial polyps cases. It is necessary to pay attention to this. This article focuses on the research progress of the pathological diagnosis criteria, the types of polyps and malignant transformation in endometrial polyps, so as to provide a reference for the accurate clinical diagnosis of endometrial polyps and the prevention of their malignant transformation.

Key words: Polyps, endometrium, Pathology, clinical, Endometrial hyperplasia, Biopsy, Histology, comparative, Malignant transformation, Endometrial neoplasms, Genital diseases, female

图1 1例子宫内膜息肉患者(女性，45岁)组织病理学切片图(可见腺体及间质局限性增生，腺体排列不规则，部分囊性扩张，中心可见纤维性间质及厚壁血管成分)(HE染色)注：HE为苏木精-伊红

图2 1例非典型腺肌瘤样息肉患者(女性，37岁)组织病理学切片图(可见息肉在增生腺体间出现成束排列的平滑肌成分，间质血管更为明显，部分腺体伴有非典型性)(HE染色)注：HE为苏木精-伊红

图3 1例老年性息肉患者(女性，65岁)组织病理学切片图(可见周围子宫内膜呈现绝经后萎缩表现，息肉中间质纤维化，腺体囊性扩张)(HE染色)注：HE为苏木精-伊红

图4 1例子宫内膜息肉恶变伴有浆液性上皮内癌成分患者(女性，72岁)组织病理学切片图[图4A：低倍镜下，于息肉浅层中可见排列密集的异型腺体成分(HE染色)；图4B：中倍镜下，可见增生密集的腺体被衬异型细胞(HE染色)；图4C：免疫组化染色显示息肉表面部分上皮及异型腺体中的上皮细胞p53强阳性表达]注：HE为苏木精-伊红

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Current research status on pathological diagnosis and malignant transformation for endometrial polyps

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Current research status on pathological diagnosis and malignant transformation for endometrial polyps