EndometralCaEndometralCa11子宫内膜增生子宫内膜增生与与子宫内膜癌前病变子宫内膜癌前病变河北医大二院左宏玲河北医大二院左宏玲EndometralCaEndometralCa22（（endometrialendometrialhyperplasiahyperplasia，，EHEH））正常子宫内膜周期性再生、分化、剥脱，依赖女性激正常子宫内膜周期性再生、分化、剥脱，依赖女性激素作用。素作用。无排卵、排卵不规则妇女因雌激素刺激，子宫内膜持无排卵、排卵不规则妇女因雌激素刺激，子宫内膜持续增生续增生与长期受雌激素刺激、缺乏孕激素有关与长期受雌激素刺激、缺乏孕激素有关::单用雌激素单用雌激素一年，一年，20%20%子宫内膜增生；子宫内膜增生；以腺体病变为主、伴有少量间质病变，少数内膜增生以腺体病变为主、伴有少量间质病变，少数内膜增生可以发展成癌可以发展成癌EndometralCaEndometralCa33国际妇科病理协会分期国际妇科病理协会分期(ISGP,1987)(ISGP,1987)（（InternationalSocietyofGynecologyPathologyInternationalSocietyofGynecologyPathology））单纯增生（单纯增生（simplehyperplasiasimplehyperplasia）良性病变）良性病变,,原腺囊性增生（原腺囊性增生（cysitichyperplasiacysitichyperplasia））复合增生（复合增生（complexhyperplasiacomplexhyperplasia）良性病变）良性病变原腺瘤性增生（原腺瘤性增生（adenomatoushyperplasia)adenomatoushyperplasia)非典型增生（非典型增生（atypicalhyperplasiaatypicalhyperplasia））癌前病变癌前病变EndometralCaEndometralCa44Thisisthemicroscopicappearanceofnormalproliferativeendometriuminthemenstrualcycle.Theproliferativephaseisthevariablepartofthecycle.Inthisphase,tubularglandswithcolumnarcellsandsurroundingdensestromaareproliferatingtobuilduptheendometriumfollowingsheddingwithpreviousmenstruation.Hereisearlysecretoryendometrium.Theappearancewithprominentsubnuclearvacuolesincellsformingtheglandsisconsistentwithpost-ovulatoryday2.Thehistologicchangesfollowingovulationarequiteconstantoverthe14daystomenstruationandcanbeutilizedtodatetheendometrium.正常子宫内膜增生期早期分泌期(proliferativeendometrium)(earlysecretoryendometrium)EndometralCaEndometralCa55Thisisnormalsecretoryphaseendometrium.Notethelargertortuousglandswithsecretions.Thesecretoryphasefollowsase...
