妊娠期恶性肿瘤58例临床分析

Analysis of 58 pregnant women complicated with malignant tumor

目的:总结妊娠期恶性肿瘤病例的临床特征及诊治经验。方法:回顾性分析2002年1月至2012年6月中国医科大学附属盛京医院诊断及治疗的58例妊娠期恶性肿瘤患者的临床资料。结果:我院10余年共收治妊娠期恶性肿瘤患者58例,院内检出率为0.95/1000次分娩。其中宫颈癌24例,血液恶性肿瘤11例,卵巢癌8例,乳腺癌5例,消化道恶性肿瘤5例,神经系统肿瘤2例,肝癌、侵袭性纤维肿瘤及滑膜肉瘤各1例。所有病例均经活检或手术病理证实为恶性。妊娠期治疗5例,终止妊娠时联合根治术14例,终止妊娠后治疗32例,终止妊娠后放弃治疗4例,3例仅终止妊娠后失访。随访5天-100个月,死亡16例,失访8例。新生儿出生23例(剖宫产21例,阴式分娩2例),随访至今死亡2例,失访4例,余17例新生儿存活至今(5个月-7岁),无畸形,无发育不良及罹患恶性肿瘤。结论:妊娠期生殖系统恶性肿瘤发现时期别较早,系统治疗后母儿预后均较好;妊娠期非生殖系统恶性肿瘤,发现时期别偏晚,预后差,早期发现是关键。

Objective： To investigate the clinical characteristics, treatment of malignant tumor in pregnancy. Methods ： A retrospective analysis was conducted on the clinical data of 58 women with malignant tumor in pregnancy between January 2002 and June 2012. Results： The incidence of malignant tumor in pregnancy was 0.95/1000 deliveries in the past 10 years. The most frequently encountered cancer types were cervical cancer （n = 24） ,hematologic malignancies （ n = 10）, and ovarian cancer （ n = 8 ）. Treatment was initiated during pregnancy in 5 patients, during delivery in 14 patients and postpartum in 32 patients. 16 patients were dead during a follow - up of 5 days to 100 months,and 4 were lost. Totally,23 neonates were born,2 were dead,4 were lost and the rest 17 babies are healthy. Conclusion ： Gynaecological malignancies during pregnancy are mostly in early stage ,optimistic outcome can be expected for both mother and infants. Women,who suffered from non -gynaecological malignancies, had poor prognosis, for the late stage of the tumor. The early diagnosis should be emphasized particularly to them.