妊娠滋养细胞肿瘤105例临床分析

Clinical analysis of 105 patients with gestational trophoblastic tumor

目的探讨妊娠滋养细胞肿瘤的临床特点、治疗方法及转归。方法妊娠滋养细胞肿瘤患者105例,年龄18-54岁;绒癌34例,侵蚀性葡萄胎71例。根据预后评分的低危或高危分别选择单药或联合化疗3-11个疗程,部分患者辅以介入治疗。19例接受了全子宫切除术。结果 105例中,单纯化疗及化疗联合手术患者完全缓解94例(89.5%)。其中,86例单纯化疗患者完全缓解78例(90.7%),19例化疗联合手术完全缓解16例(84.2%)。不同FIGO分期患者的完全缓解率:Ⅰ期完全缓解率100.0%(62/62),Ⅱ期完全缓解率100.0%(23/23);Ⅲ期完全缓解率53.3%(8/15),Ⅳ期完全缓解率25.0%(1/5)。结论早期诊断和及时化疗,有手术指征者联合手术,可使妊娠滋养细胞肿瘤获得满意的治疗效果。

Objective To analyze the clinical characteristics, treatment and prognosis of gestational trophoblastic tumor（GTT）. Methods Clinical data of 105 patients, aged 18-54 years old, with GTT were retrospectively analyzed, of whom 71 cases were invasive mole and 34 cases were choriocarcinoma. All patients received chemotherapy, single drug chemotherapy or combined chemotherapy for 3 to 11 cycles according to the prognostic scores. Some patients received uterine artery embolization and 19 patients underwent total hysterectomy. Results The complete remission rate was 89.5%, which was 90. 7% in patients receiving chemotherapy only, and 84.2% in those receiving chemotherapy combined with operation. According to FICA） staging, the complete remission rate was 100% in patients with stage I , 100% withstage Ⅱ ,54% with stage Ⅲ and 25% with stage IV. Conclusion Satisfactory outcomes of treating GTT may be achieved by early diagnosis, timely chemotheraov and ooeration when there were indications.