中间型滋养细胞肿瘤8例并文献回顾  

Diagnosis,Treatments and Prognosis of Intermediate Trophoblastic Tumors

作　　者：陈思思[1] 张虹[2] 

机构地区：[1]天津医科大学,300070 [2]天津市中心妇产科医院

出　　处：《国际妇产科学杂志》2017年第6期709-712,共4页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨中间型滋养细胞肿瘤(intermediate trophoblastic tumors,ITTS),包括胎盘部位滋养细胞肿瘤(placental site trophoblastic tumor,PSTT),上皮样滋养细胞肿瘤(epithelioid trophoblastic tumor,ETT)的临床特点、诊断、治疗及预后。方法:回顾性分析8例ITTS患者的临床资料。结果:8例患者中1例ETT,1例ETT、PSTT共存,6例PSTT。首发症状多为停经、不规则阴道出血、腹痛,伴血人绒毛膜促性腺激素(hCG)轻度升高,ITTS多由病理确诊。5例拟保留生育功能治疗(3例成功,2例失败),余下3例行全子宫+双附件切除,其中1例复发,化疗后再次缓解。结论:ITTS的诊断需结合临床,病理及免疫组化,治疗首选全子宫切除,存在高危因素时应联合化疗,对于年轻,有生育要求,病灶局限者可试行保留生育功能治疗;影响ITTS预后的因素尚不明确。Objective:To investigate the clinical features, diagnosis, treatment and prognosis of intermediate trophoblastic tumors(ITTS), including the placental site trophoblastic tumor(PSTT), epithelioid trophoblastic tumor(ETT).Methods:A restrospective study was performed. Of 8 cases with ITTS. Results:Of the 8 patients, 1 was ETT, 1 coexisting with ETT and PSTT, 6 PSTT. Most of the first symptoms were menopause, irregular vaginal bleeding, abdominal pain, and a slight increase in human chorionic gonadotropin(hCG) with blood, and ITTS was mostly confirmed by pathology. 5 cases were prepared to retain fertility(3 successful, 2 failed), the remaining 3 cases receiving total uterus + double appendage resection, of which 1 cases relapsed, after chemotherapy remission again. Conclusions:The diagnosis of ITTS should be combined with clinical features, pathological and immunohistochemical. The first choice is total hysterectomy. When there are high risk factors,chemotherapy should be combined. For young patients, with strong fertility restriction and limited foci can try to preserve fertility. The factors influencing prognosis of ITTS are not yet clear.

关 键 词：妊娠滋养细胞肿瘤 滋养层瘤 胎盘部位 葡萄胎 侵袭性 生育力 

分 类 号：R737.33[医药卫生—肿瘤]