妊娠滋养细胞肿瘤肺转移患者的疗效分析

The analysis on efficacy of patients of gestational trophoblastic neoplasia with pulmonary metastases

目的评价妊娠滋养细胞肿瘤(gestational trophoblastic neoplasia,GTN)肺转移患者的治疗效果。方法对2000年1月至2012年1月郑州大学第一附属医院妇产科收治的妊娠滋养细胞肿瘤肺转移患者179例进行回顾性分析,将患者分为初诊组73例、耐药组69例和复发组37例,对其血清β-绒毛膜促性腺激素(human chorionic,gonadotropin,hCG)值和肺部转移灶情况进行对比分析。结果初诊组的完全缓解率、完全缓解平均所需化疗疗程及复发率明显优于耐药组和复发组(P<0.05);耐药组和复发组中血β-hCG正常但肺部转移灶未消失患者的病情进展率明显高于初诊组(P<0.05)。结论初诊肺转移患者经规范化疗后完全治愈率高,血β-hCG正常肺部转移灶未消失的情况下,复发和耐药患者病情稳定性相对较差,而初诊组肺部转移灶多可自行消失。既往出现耐药的复发患者再次治疗的效果较差,需进一步探讨有效可行的治疗方法。

Objective To investigate the treatment of efficacy of patients of gestational trophoblastic neoplasia （GTN）with pulmonary metastases. Methods A retrospective analysis of 179 GTN patients with pulmonary metastases in The First Affiliated Hospital of Zhengzhou University during January 2000 to January 2012 was carried out. The cases were divided into first - diagnosed group（73 cases）,drug - resist group（69 cases）and recurrent group（37 cases）. The β - human chorionic gonadotrophin（ hCG）titer and pulmonary lesion（ s）were compared statistically between the three groups. Results The complete remission rates,the average course of chemotherapy and recurrence rate in first - diagnosed group were prior to the other two groups（P〈 0. 05）. The disease progress rate of patients whose β - hCG were normal but pulmonary metastases were still exist in drug - resist group and recurrent group were significantly higher than first - diagnosed group（ P〈 0. 05）. Conclusion The first - diagnosed GTN patients with pulmonary metastases have a high completely cure rate after standardized chemotherapy. When the β -hCG is normal but pulmonary metastases are still exist,recurrent and drug - resistant patients have poor outcomes, while the first - diagnosed patients have a high rate of pulmonary metastases disappearing. The recurrent drug -resistant patients have poor outcomes in retreatment,whose treatment need further discuss.