妊娠合并宫颈癌13例临床分析

An Clinical Analysis of 13 Cases with Cervical Cancer Complicating Pregnancy

[目的]探讨妊娠合并宫颈癌的临床特征及诊治方式。[方法]回顾性分析13例妊娠合并宫颈癌患者的临床特征、诊治经过和随访情况。[结果]13例患者,妊娠期诊断7例（孕周为18~38周,中位孕周29周）,产后6个月内诊断6例。5例ⅠA1期,均为无任何症状仅在产检时发现;ⅠB1期3例、ⅠB2~ⅡA期3例均有接触性出血或不规则阴道出血症状;ⅡB期和ⅢB期各1例,均有持续阴道出血症状。妊娠期5例ⅠA1期及1例可疑ⅠB1期行延迟治疗;2例ⅠB1期和3例ⅠB2~ⅡA期行综合治疗。[结论]宫颈细胞学筛查对妊娠合并宫颈癌患者早诊断、早治疗具有重要意义,应作为首次产检的常规项目;在妊娠中晚期发现ⅠA期和ⅠB1期宫颈癌可以考虑延迟治疗。

[Purpose] To investigate the clinical characteristics,diagnosis and treatment of pregnant women with cervical cancer.[Methods] The clinical data of diagnosis,treatment and follow-up of 13 pregnant women with cervical cancer were retrospectively analyzed.[Results] Of 13 cases,7 cases were diagnosed in pregnancy（gestational age 18 to 38 weeks,median 29 weeks）,6 cases were diagnosed within 6 months postpartum.There were 5 cases with cervieal cancer stage ⅠA 1 without any symptoms being diagnosed by antenatal examination;3 cases stage ⅠB 1 and 3 cases stage ⅠB 2 ~ⅡA with contact bleeding or irregular vaginal bleeding;1 case stage ⅡB and 1 case stage Ⅲ B with continuous vaginal bleeding.Five cases stage ⅠA 1 and 1 case suspicious stage ⅠB 1 were treated until postpartum.Two cases stage ⅠB 1 and 3 cases stage ⅠB 2 ~ⅡA were treated with comprehensive therapy.[Conclusion] Cervical cytologic screening is very important for early diagnosis and treatment for pregnant women.It should be considered as routine test of the first antenatal examination.Cervival cancer of stage ⅠA and ⅠB 1 in mid-late trimester pregnancy may be treated until postpartum.