恶性滋养细胞肿瘤预后评分标准的初步评价

Assessment of staging and prognostic scoring system for malignant trophoblastic neoplasia

目的对恶性滋养细胞肿瘤2000年国际妇产科联盟(FIGO)预后评分标准进行初步评价。方法恶性滋养细胞肿瘤患者223例,治疗前除临床分期外,按2000年FIGO预后评分标准判定其高危因素,评价以此选择治疗方式的合理性。结果78例绒毛膜癌患者中,43例为高危,35例为低危;145例侵蚀性葡萄胎患者中,7例为高危,138例为低危。初治化疗的原则为低危患者以单药化疗为主,高危患者采用多药联合化疗。本组患者的1年、3年、5年生存率分别为986%、981%及971%。无一例因毒副反应或并发症而死亡。结论恶性滋养细胞肿瘤患者根据2000年FIGO预后评分标准选择治疗方案,取得较满意的治疗结果。

ObjectiveTo assess malignant trophoblastic neoplasia with the standards of the clinical stage and prognostic factor scoring system. MethodsThrough assessing the high-risk factors except clinical stages for 223 patients before treatment according to International Federation of Gynecology and Obstetrics(FIGO) scoring system published in 2000, appropriate treatments were selected for the different patients. ResultsForty-three of 78 cases of choriocarcinomas were with high-risk factors, the other 35 cases were with low-risk factors; 7 of 145 cases of invasive moles were with high-risk factors and the others were with low-risk factors. The primary chemotherapy principle was that one agent was used for those patients with low-risk factors and two or multiple-agents were used for those patients with high-risk factors. Among all patients, the one-year, three-year and five-year survival rates were 98.6%,98.1% and 97.1% respectively. No patient died of drug toxicity or complication. ConclusionSelection of treatment approaches according to the prognostic assessment of malignant trophoblastic neoplasia could lead to promising survival rate with no uncurable complication and toxic effects.