良性葡萄胎恶变时间的探讨

A Retrospective Analysis about the Time of Hydatidiform Mele Developing toInvasive Mole or Choriocarcinoma

回顾１９６３～１９９２年我院１３２例末次妊娠为葡萄胎且经病理确诊的恶性滋养细胞肿瘤病例，并探讨葡萄胎恶变成恶性葡萄胎（恶葡）或绒毛膜上皮细胞癌（绒癌）的时间相关性。结果，距葡萄胎妊娠结束时间在６月以内、６～１２月、１２月以上确诊的绒癌分别占同期病例的９／８０、１４／１７、３４／３５，提示绒癌发生与距葡萄胎妊娠结束时间呈正相关。我们认为，在未获得病理证实的情况下，对于葡萄胎排出后６月之内发病的恶性滋养细胞肿瘤，临床应诊断为恶葡，６月以上者则应诊为绒癌。

From 1963 to 1992,there were 132cases of malignant trophoblastic tumor verified bypathology with antecedent pregnancy of hydatidiformmole in Zhejiang Province Cancer Hospital.The timecorrelation of that hy-datidiform mole developsto inva-sive mole or choriocarcinoma was evaluated in thispaper.The case number of choriocarcinoma in dura-tion<6 months,6 ～ 12 months,and>12 monthsfrom the termination of hydatidiform mole was 9/80,14/17,and 34/35,respectively.Indicating that thefrequency of choriocarcinoma occurrance had a signif-icant postive correlation with the time after termina-tion of hydatidiform mole (P<0.01).The authorssuggest,the patients with duration of disease lessthan 6 months from termination of hydatidiform moleShould be diagnosed as invasive mole ;with durationof 6 months or more,diagnosed as choriocarcinoma,if the histologic verification of disease is absent.