胎盘部位滋养细胞肿瘤的病例资料分析

Analysis of clinical data of placental site trophoblastic tumor

目的分析胎盘部位滋养细胞肿瘤的临床特征、病理学特点、治疗及预后。方法分析西安交通大学第一附属医院收治的1例胎盘部位滋养细胞肿瘤患者的临床资料,并以"胎盘部位滋养细胞肿瘤"为主题词查阅中国知网(CNKI)及PubMed等数据库进行文献复习。结果该患者继发于足月妊娠女婴后,持续阴道排液8月,接受了全子宫切除术,术后病理回报:胎盘部位滋养细胞肿瘤伴血管浸润,遂接受了7次化疗(2次联合化疗,5次EMA-CO方案化疗)。随访14个月未发现复发或转移的征象。结论胎盘部位滋养细胞肿瘤发病率低、临床表现缺乏特异性,确诊常依靠组织病理学检查。其首选的治疗方式为手术,有高危因素者术后宜选择EMA-CO或EMA-EP方案进行化疗。

Objective To analyze the clinical characteristics, pathological features, treatment and prognosis of placental site trophoblastic tumor （PSTT）. Methods Medical record of one case of PSTT admitted in the First Affiliated Hospital of Xi＇ an Jiaotong University was analyzed, and PSTT was taken as mesh to review literatures searched in CNKI and PubMed. Results The patient was secondary to full-term female baby birth, manifesting persist vaginal discharge for 8 months. The case accepted total hysterectomy. The postoperative pathological results revealed PSTT accompanied with vascular invasion. So the patient underwent seven cycles of chemotherapies （2 cycles of combined chemotherapy and 5 cycles of EMA-CO regimen）. There were no symptoms of recurrence or metastasis during the 14 months of follow-up. Conclusion Its low morbidity and the heterogeneity of clinical manifestations lead to the fact that the definite diagnosis is made based on the pathological features in conjunction with immunohistochemistry. Its optimal treatment is surgery. For patients with high risk factors, chemotherapy with the regimen of EMA-CO or EMA-EP is suitable.