宫颈胎盘部位滋养细胞肿瘤一例并文献复习  

Placental Site Trophoblastic Tumor: Diagnostic and Therapeutic Advancement and A Case Report

作　　者：肖萍[1] 尹如铁[1] 童龙霞[1] 王丹青[1] 李清丽[1] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041

出　　处：《华西医学》2012年第3期363-367,共5页West China Medical Journal

摘　　要：目的通过对1例原发于宫颈的胎盘部位滋养细胞肿瘤(PSTT)的资料及相关文献的复习,全面介绍胎盘部位滋养细胞肿瘤的临床特征、病理特点、治疗方式及预后。方法对收治1例罕见原发于宫颈部位的PSTT的临床病理资料进行分析,并以"胎盘部位滋养细胞肿瘤"为主题词查阅中国知网(CNKI)及PubMed等文献数据库进行文献复习。结果该例原发于宫颈部位的PSTT患者术后化学疗法后,目前情况良好,已随访3年,无复发及转移征象。2011年9月1日前,CNKI数据库共报道300余例PSTT病例,PubMed数据库共160余例,其中有2例原发于宫颈部位的PSTT。原发于宫颈部位的PSTT罕见,易误诊,往往需要宫颈活组织检查或宫颈搔刮才能确诊。结论原发于宫颈部位的PSTT的预后是否遵循PSTT尚需收集更多的病例证实。PSTT因其发病率低,临床表现多无特异性,通常需要通过诊断性刮宫、活组织检查甚至术后病理检查才能确诊。PSTT首选的治疗方式为手术,多数患者病灶清除后可治愈,对有高危因素的患者术后宜选择依托泊苷+甲氨蝶呤+放线菌素D+环磷酰胺+长春新碱(EMA-CO)方案或依托泊苷+甲氨蝶呤+放线菌素D+依托泊苷+顺铂(EMA-EP)方案进行化学治疗,以期改善预后。Objective To introduce the clinicopathological characteristics, treatments and prognosis of placental sitetrophoblastic tumor （PSTT） by reviewing a PSTT case and its related literatures. Methods We retrospectively studied arare case of PSTT primarily locating in the uterine cervix in our hospital, and reviewed the related literatures in PubMed andCNKI （China National Knowledge Infrastructure） databases using placental site trophoblastic tumor as the subject word.Results The patient had a good condition after receiving operation and chemotherapy without any evidence of recurrenceof metastasis during the 3-year follow-up. Before September 1st, 2011, there were more than 160 cases reported in PubMeddatabase including 2 cases of PSTT occurring in uterine cervix, and more than 300 cases in CNKI database. PSTT occurringin uterine cervix was rare and easy to be misdiagnosed, and histopathological diagnosis was necessary for the diagnosis.Conclusions Whether there are differences in the prognosis between PSTT occurring in cervix and uterine remains to beverified by more samples. The incidence of PSTT is rare, and there are no specific clinical features, so it is often diagnosedby curettage, biopsy or even postoperative pathologic results. PSTT is insensitive to chemotherapeutic drugs, and thepreferred therapy is operation. Most patients can get complete remission after foci eradication. To improve the prognosis ofpatients with high risks of recurrence and metastasis, EMA-CO （etoposide, methotrexate, actinomycinD, alternating withcyclophosphamide and vincristine） or EMA-EP （etoposide, methotrexate, actinomycinD, alternating with etoposide andcisplatin） chemotherapy is needed after operation.

关 键 词：胎盘部位滋养细胞肿瘤 宫颈 妊娠滋养细胞肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]