20例足月产后绒毛膜癌患者临床特征和预后分析  

Presentation,management and prognosis of Postpartum choriocarcinoma in 20 cases

作　　者：白云[1] 崔妹娟 赵郡 张雅静 冯玉珍[1] 庞义存[1] BAI Yun;CUI Mei-Juan;ZHAO Jun(Department of Obstetrics and Gynecology,the Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北医科大学第三医院妇产科,河北石家庄050000 [2]河北医科大学第三医院病案室,河北石家庄050000

出　　处：《中国妇幼保健》2021年第22期5122-5125,共4页Maternal and Child Health Care of China

基　　金：河北省卫生健康委员会医学科学研究重点课题计划(20201004)。

摘　　要：目的探讨足月产后绒毛膜癌的临床表现和预后,提高对该病的认识,减少误诊误治。方法收集河北医科大学第三医院妇产科2011-2019年期间确诊为足月产后绒毛膜癌患者资料共20例。结果中位年龄为27.5岁;16例患者以阴道出血为首发症状;中位诊断时间为产后8周,从症状出现到开始治疗的中位时间为8周。16例患者存在转移,但这与诊断延迟无关。FIGO预后评分中位数为9.5分。多数患者采用多药治疗,2例低危患者应用5-氟尿嘧啶单药化疗耐药后改为多药化疗。2例伴有脑转移的患者死于该疾病。结论足月产后绒毛膜癌以阴道出血为主要表现,需引起各科医师的高度重视。对于出现非生殖系统症状的患者,尤其是有症状的脑转移患者,迅速考虑到妊娠滋养细胞肿瘤的可能性,对于这些患者至关重要。多药化疗仍为足月产后绒毛膜癌治疗的首选方案。Objective To determine the clinical presentation and outcome of postpartum choriocarcinoma, in order to improve the awareness of the disease and decrease misdiagnosis and mistreatment.Methods Twenty patients diagnosed with postpartum choriocarcinoma were selected from the Third Hospital of Hebei Medical University between 2011 and 2019.Results Median age was 27.5 years.Sixteen patients complained of vaginal bleeding.Median time from delivery until diagnosis was 8 weeks postpartum, with a median delay from onset of symptoms to treatment of 8 weeks.Sixteen patients had metastatic diseases, but this did not correlate with delay in diagnosis.The median International Federation of Gynecology and Obstetrics score was 9.5.Multidrug regimens were used in most patients.Two low-risk patients treated with fluorouracil alone turned to multidrug regimens due to drug resistance.Two patients died from this disease because of brain metastasis.Conclusion Postpartum choriocarcinoma presents mainly with vaginal bleeding, there is a need for physicians in all disciplines to remain aware of this possibility.A rapid awareness of the possibility of gestational trophoblastic neoplasiamay be fatal in patients that present with non-gynecology symptoms, especially symptomatic brain metastases.Multidrug regimens are still the first choice for these patients.

关 键 词：绒毛膜癌 足月产后 妊娠滋养细胞肿瘤 化疗 

分 类 号：R737.33[医药卫生—肿瘤]