妊娠合并恶性肿瘤6例临床分析

A clinical analysis on 6 pregnant women with malignant tumors

目的探讨妊娠合并恶性肿瘤的发病特点及常见误诊漏诊原因。方法回顾性分析2008年1月1日至2010年12月31日在我院产科分娩的6例妊娠合并恶性肿瘤的病例资料。结果3年问我院产科总分娩人数15216人，妊娠合并恶性肿瘤6例，发病率0．04％．其中肺癌2例，鼻咽癌1例，乳腺癌1例，宫颈癌1例，1例转移性肝癌原发部位不详。诊断为恶性肿瘤时的孕周31-40^＋6周。6例均于诊断为恶性肿瘤后1周内行剖宫产术终止妊娠。新生儿Apgar评分，1分钟评分：8分1例，9分1例，10分4例，5分钟评分均为10分。随访至今均无异常。产妇产后3个月内死亡3例，产后9个月死亡1例。2例仍在后续治疗，目前病情稳定。6例诊断时均为中晚期病变，其中5例有诊断贻误情况。结论妊娠合并恶性肿瘤漏诊误诊率高，应高度重视早期异常情况，提高妊娠合并恶性肿瘤的早期诊断率，改善产妇预后。

Objective To investigate the features of malignant tumors with pregnancy and common reasons of misdiagnosis and missed diagnosis. Methods The clinical data on 6 pregnant women with malignant tumors who had labored in our hospital during the period of January 1, 200g to December 31, 2010 were retrospectively analyzed. Results 6 of the 15 216 （ 0,04% ） pregnant women were found to have malignant tumors 2 of whom had lung cancer, one nasopharyngeal darcinoma, one cervical cancer, one breast cancer, and one metastatic liver cancer. All the malignant tumors were diagnosed at the gestational weeks of 31 to 40. Pregnancy was terminated by C-section within one week after the diagnosis was made. One-minute Apgar test showed 8 score in one neonate, 9 in one, and 10 in the remaining fore; five-minute test showed 10 score in all the six neonates. They were all healthy so far. 3 of the women were dead within 3 months and one died 9 months after delivery; the rest 2 were still under treatment and their condition was stable. All the women were diagnosed at the middle or late stage and the dianosis were delayed in five of them. Conclusions The rate of misdiagnosis and missed diagnosis of malignant tumors with pregnancy is rather high. More attention should be paid on early abnormal symptoms in pregnant women to improve the early diagnosis and prognosis of malignant tumor.