上皮样滋养细胞肿瘤临床病理特点及预后分析  

Clinicopathologic features and prognosis factor analysis in patients with epithelioid trophoblastic tumor

作　　者：沈晓燕[1] 向阳[1] 郭丽娜[2] 冯凤芝[1] 万希润[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院病理科,北京100730

出　　处：《中国实用妇科与产科杂志》2011年第5期374-376,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：十一五国家科技支撑计划课题(2008BAI57B05)

摘　　要：目的探讨上皮样滋养细胞肿瘤(ETT)的临床病理特点及预后相关的因素。方法回顾性分析北京协和医院2002年1月至2010年8月间9例ETT的临床病理特点、治疗和预后。结果 7例发生转移(7/9,77.8%),4例为多脏器转移。7例不良结局者均存在子宫多发病灶,侵及子宫全层,累及浆膜,伴大片坏死,6例子宫增大≥如孕8周,2例为低分化。所有患者均给予手术联合化疗的综合治疗,初治完全缓解(CR)5例,部分缓解(PR)1例,病情进展死亡3例(3/9,33.3%);随诊2～103个月,其中3例CR后复发(3/9,33.3%),复发后经治疗再次CR。结论 ETT恶性程度比胎盘部位滋养细胞肿瘤高。提高ETT早期诊断率,早期识别不良预后因素,对不良预后者尽早给予多手段的综合治疗,以改善患者预后。Objective To investigate the clinicopathologic features and prognosis factor in patients with epithelioid tropho- blastic tumor （ETT）. Methods Nine patients with ETT were treated at Peking Union Medical College Hospital （PUMCH） between Jan 2002 and Ang 2010. The clinicopathologic characteristics, treatments, outcomes and prognosis were studied retrospectively in our institution. Results Seven of nine cases had metastases （ 7/9, 77. 8% ）, four of them with multiple organ metastases. The histopathology results of seven patients with poor outcome showed diffuse multifocal disease within the uterus, full-thickness myometrial invasion, uterine serosal involvement and extensive necrosis. The uterine size was greater than the equivalent of 8 weeks＇gestation in six of them. Two of them had poorly differentiated carcinoma. All patients were treated with muhimodality treatment which combined with surgery and chemotherapy. After initial treatments, five patients achieved a complete remission （CR） , one reached an initial partial remission （PR）, and three patients （3/9, 33.3% ） had no response to treatments and died of progressive disease. After followed up for 2 - 103 months （mean, 24. 5 months）, three cases （3/9, 33. 3% ） of five patients with initial CR presented signs of recurrence reached CR by aggressive multimodality treatment. Conclusion The degree of malignancy of ETT is higher than placental site trophoblastic tumor. To improve survival in ETT we should increase early diagnostic accuracy, identify prognostic factor in an early stage and provide promptly exactitude muhimodality treatment to the patients with poor prognostic factors.

关 键 词：中间型滋养细胞肿瘤 上皮样滋养细胞肿瘤 预后 

分 类 号：R71[医药卫生—妇产科学]