妊娠合并宫颈癌32例临床分析  

Clinical analysis of 32 cases of cervical cancer associated with pregnancy

作　　者：王凯歌 纪妹[1] 何南南[1] 赵曌[1] 李悦[1] 许鹏琳 刘惠娜[1] WANG Kaige;JI Mei;HE Nannan;ZHAO Zhao;LI Yue;XU Penglin;LIU Huina(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇产科,河南郑州450052

出　　处：《肿瘤基础与临床》2021年第2期117-121,共5页journal of basic and clinical oncology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190122)。

摘　　要：目的总结分析妊娠合并宫颈癌患者临床病理特点、治疗方案及预后,结合文献探讨妊娠合并宫颈癌患者的管理方法。方法回顾性分析2012年6月至2019年6月郑州大学第一附属医院诊治的32例妊娠合并宫颈癌患者的临床病理资料。结果共入组妊娠合并宫颈癌患者32例中,孕早期10例(31.25%)、孕中期7例(21.88%)、孕晚期6例(18.75%)、产后9例(28.12%)。妊娠期患者确诊时,平均孕周为18+5周。患者确诊年龄为(33.9±5.5)岁。早期宫颈癌患者28例(87.50%)。主要临床表现为接触性出血14例(43.75%)、妊娠期阴道异常出血13例(40.62%)。主要病理类型为鳞癌27例(84.38%)。23例妊娠期患者中,20例妊娠期患者确诊后选择立即终止妊娠并开始宫颈癌治疗,2例患者因有强烈的生育要求而延迟治疗至胎儿成熟后行剖宫产术的同时行宫颈癌根治术,1例患者剖宫产终止妊娠后强烈拒绝后续治疗;9例产后患者确诊后均立即行宫颈癌治疗。32例患者无瘤生存25例,5例疾病进展死亡,2例治疗中途放弃治疗并失访,1 a累积生存率为86.67%。结论妊娠合并宫颈癌临床表现多为接触性出血及妊娠期阴道出血,多误诊为先兆流产等,妊娠期应注意宫颈癌的筛查;妊娠合并宫颈癌临床分期相对较早,多于早孕期诊断,妊娠合并宫颈癌的治疗方案应根据患者具体情况进行个体化制定。Objective To summarize and analyze the clinical and pathological characteristics,treatment and prognosis of patients with pregnancy complicated with cervical cancer.Methods The data of 32 cases of cervical cancer complicated with pregnancy from June 2012 to June 2019 of the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Results Of the 32 patients,10(31.25%)patients were diagnosed in the first trimester,7(21.88%)patients were diagnosed in the second trimester,6(18.75%)patients were diagnosed in the third trimester,and 9(28.12%)patients were diagnosed in postpartum period.The mean gestational age of patients diagnosed during pregnancy was 18 weeks and 5 days at diagnosis.The mean age of diagnosis was(33.9±5.5)years old.Twenty-eight(87.50%)patients were diagnosed at the early stage.The main clinical manifestations were contact bleeding(43.75%)and irregular vaginal bleeding(40.62%)during pregnancy.The main pathological type was squamous cell carcinoma(84.38%).Of the patients diagnosed during pregnancy,20 patients terminated the pregnancy and began cervical cancer treatment immediately,and 2 cases choose to underwent caesarean section and radical surgery for cervical cancer until fetal maturation,and 1 patient refused treatment after caesarean section.Patients diagnosed after delivery all began cervical cancer treatment immediately.Of the 32 patients,25 patients survived without tumor,5 patients died due to disease progression,and 2 patients were lost.The 1-year cumulative survival rate was 86.67%.Conclusion The clinical manifestations of pregnancy complicated with cervical cancer are mostly contact bleeding and vaginal bleeding during pregnancy,and it always be misdiagnosed as threatened abortion;the screening of cervical cancer during pregnancy should be taken seriously.clinical stage of pregnancy complicated with cervical cancer is relatively early,and the cervical cancer was mostly diagnosed at the first trimester.The treatment of pregnancy complicated with cervical cancer should

关 键 词：妊娠 宫颈癌 预后 

分 类 号：R737.33[医药卫生—肿瘤]