EndometralCa1子宫内膜增生与子宫内膜癌前病变河北医大二院左宏玲第一页,共一百二十六页。EndometralCa2正常子宫内膜周期性再生、分化、剥脱,依赖女性激素作用。无排卵、排卵不规那么妇女因雌激素刺激,子宫内膜持续增生与长期受雌激素刺激、缺乏孕激素有关:单用雌激素一年,20%子宫内膜增生;以腺体病变为主、伴有少量间质病变,少数内膜增生可以开展成癌第二页,共一百二十六页。EndometralCa3国际妇科病理协会分期(ISGP,1987)〔InternationalSocietyofGynecologyPathology〕单纯增生〔simplehyperplasia〕良性病变,原腺囊性增生〔cysitichyperplasia〕复合增生〔complexhyperplasia〕良性病变原腺瘤性增生〔adenomatoushyperplasia)非典型增生〔atypicalhyperplasia〕癌前病变第三页,共一百二十六页。EndometralCa4Thisisthemicroscopicappearanceofnormalproliferativeendometriuminthemenstrualcycle.Theproliferativephaseisthevariablepartofthecycle.Inthisphase,tubularglandswithcolumnarcellsandsurroundingdensestromaareproliferatingtobuilduptheendometriumfollowingsheddingwithpreviousmenstruation.Hereisearlysecretoryendometrium.Theappearancewithprominentsubnuclearvacuolesincellsformingtheglandsisconsistentwithpost-ovulatoryday2.Thehistologicchangesfollowingovulationarequiteconstantoverthe14daystomenstruationandcanbeutilizedtodatetheendometrium.(proliferativeendometrium)(earlysecretoryendometrium)第四页,共一百二十六页。EndometralCa5Thisisnormalsecretoryphaseendometrium.Notethelargertortuousglandswithsecretions.Thesecretoryphasefollowsaset14daycourseleadingtoeitherimplantationofafertilizedovumormenstruation.第五页,共一百二十六页。EndometralCa6单纯增生〔simplehyperplasia〕子宫内膜腺体和间质增生,腺体不规那么,可扩张呈囊性并有群集间质致密无细胞异型性第六页,共一百二十六页。EndometralCa7复合增生〔complexhyperplasia〕腺体高度增生,成芽状或乳头状,腺体不规那么,呈现结构复杂和背靠背的群集,细胞呈复层或假复层无细胞异型性第七页,共一百二十六页。EndometralCa8细胞极性消失,大小不一,核深染,腺上皮细胞异行型;无间质浸润。根据腺上皮增生程度分为轻、中、重。第八页,共一百二十六页。EndometralCa9Thisisendometrialcystichyperplasiainwhichtheam...