Primary diffuse large B-cell lymphosarcoma of the spleen

AIM: To investigate characteristics of the course and efficacy of treatment of diffuse large B-cell lymphosarcoma (DLBL) with primary lesion of the spleen. MATERIAL AND METHODS: From 1998 to 2006, primary splenic lesion was registered in 15 of 120 patients with DLBL and affected lymph nodes (LN), spleen and Waldeyer's ring. The diagnosis was made according to WHO criteria. Of them 14 patients had splenectomy as the first stage of therapy. The operation was followed with 6 to 8 courses of CHOP-21 (8 patients), 4 courses of R-CHOP-21 and radiotherapy (one patient). One patient received 7 courses of CHOP-21 followed by splenectomy. Because of the presence of several signs of unfavourable prognosis 5 patients under 60 years were given intensive therapy: 4-6 courses of the modified program NHL-BFM-90, 2 of 5 patients received radiotherapy. RESULTS: All the patients with primary DLBL of the spleen had two and more signs of unfavourable prognosis: elevated concentration of serum LDG, size of the tumor more than 10 cm, high proliferative activity of tumor cells, B-symptoms, severe condition. Seven patients had centroblastic, 8--anaplastic variants of DLBL. Tumor cells in primary DLBL of the spleen had no specific immunophenotype. Complete remission of the disease was achieved in 9 (90%) of 10 patients treated on programs CHOP-21, R-CHOP-21, in 4 of 4 patients on the modified program NHL-BFM-90. Mean follow-up was 39.3 months (from 7 to 103 months). CONCLUSION: For primary DLBL of the spleen characteristic are long-term remissions on first line therapy according to CHOP-21 program irrespective of morphology and immunophenotype.     

Treatment of adult Berkitt-like lymphoma

AIM: To compare programs of chemotherapy used in adult Berkitt-like lymphoma (ABLL); to assess efficacy and toxicity of the protocol AblL-M-04. MATERIAL AND METHODS: 31 ABLL patients (23 males, 8 females, mean age 27 years) participated in the study performed in Hematological Research Center in 1995-2004. ABLL stage I, II, III and IV was diagnosed in 3, 5, 8 and 15 patients, respectively. 10 patients had diffuse large B-cell lymphoma. 9 patients received 2 to 6 courses of CHOP, 1 patient--6 courses of Pro-Mace-Cytabom, 11 patients with newly diagnosed ABLL and 5 pretreated with CHOP--NHL-BFM-90. The modified protocol ABLL-M-04 of intensive short-term therapy included 10 patients, 2 of them pretreated. RESULTS: Of 10 patients given CHOP or CHOP-like courses 9 were resistant to therapy, 2 died of rapid progression, 7 were converted to the program therapy. 5 patients on the protocol NHL-BFM-90 died after short-term improvement. None of them achieved remission. Of 10 patients with newly diagnosed ABLL treated according to NHL-BFM-90 protocol, remission was achieved in 4 patients, follow-up median--34 months (2-56). Six patients died: 4 of progression, 2 of chemotherapy complications. BLL-M-04 therapy was made in 9 patients: 7 patients persisted on the first remission, 2 patients died of chemotherapy complications. Overall duration of the treatment was 3-3.5 months. CONCLUSION: The protocol ABLL-M-04 seems to be more effective than a classic NHL-BFM-90, but this must be supported by more cases. CHOP therapy cannot be recommended for patients with ABLL because of poor efficacy (all the CHOP patients died).     

The modified program NHL-BFM-90 in the treatment of patients with diffuse large B-cell lymphosarcoma

AIM: To investigate efficacy of the modified protocol NHL-BFM-90 in patients with diffuse large B-cell lymphosarcoma (DLBCLS). MATERIAL AND METHODS: A total of 13 DLBCLS patients with stage II-IV of the disease with affection of lymph nodes at the disease onset (nodal lesion) and stage II with tumor size more than 10 cm (bulky disease) received first-line treatment according to the modified program NHL-BFM-90 from 2002 to 2005. The diagnosis was made by WHO criteria. RESULTS: A complete remission was achieved in 76.9% patients. Resistance to therapy was observed in the patients with bone marrow affection. The 2.5-year overall survival was 74%, 2-year event-free survival was 75% (the events were recurrence and resistance). Follow-up continued from 5 to 47 months. CONCLUSION: The efficacy of the modified protocol NHL-BFM-90 in DLBCLS patients with stage III-IV of the "nodal" disease and stage II of the "bulky" disease was high.     

Efficacy of therapy of different variants of anaplastic large T-cell lymphomas

AIM: To compare efficacy of NHL-BFM-90 and CHOP-like courses in the treatment of anaplastic large cell lymphoma (ALCL). MATERIAL AND METHODS: Twenty-two patients with ALCL participated in the study. The diagnosis was made basing on the findings of clinical, device, morphological, immunohistochemical and molecular-genetic examinations with application of a panel of monoclonal antibodies to CD30, ALK, CD3, CD4, CDS, CD7, CD34, CD15, CD68, CD20, CD45RO, CD45RA, Ki-67. 14 cases of 22 were negative by kinase of anaplastic lymphocytes (ALK-) and 8 were positive (ALK+). Mean age of ALK-ALCL patients was 39.6 +/- 4.1 years, of ALK+ALCL patients - 23.4 +/- 2.6 years. 14 patients were treated by the protocol NHL-BFM-90, 8 were initially treated with other schemes (CHOP, MACOP-B, BEACOPP and others). All 14 patients treated according to NHL-BFM-90 had ALCL stages III-IV with B-symptoms. 12 patients who completed treatment by the above protocol achieved complete remission after the forth course, 2 patients failed the treatment. Of 8 ALCL patients treated initially according to other schemes, a complete remission was achieved in 4 patients (2 had stage II). One of 4 patients with remission had recurrence. Four patients who had failed to achieve complete remission died of the disease progression. CONCLUSION: ALCL occurs more frequently in young and middle-aged patients. The disease has an aggressive course with rapid generalization. For such processes it is more preferable to use a modified protocol NHL-BFM-90.     

Overall results of adjuvant chemotherapy and a chemosensitivity test for osteosarcoma

Among 59 patients with long bone osteosarcoma without metastases at first diagnosis, the five-year cumulative survival rate was 51.7% following surgery and chemotherapy, and 14.4% in an historical control group. Preoperative combination chemotherapy with high-dose methotrexate, adriamycin, and vincristine was found to be effective in 60% (9/15) of the patients. Histopathological examination of the resected tumor indicated a necrosis rate of over 90%. Twenty tissue samples from 12 patients were tested for sensitivity to anticancer drugs using the human tumor clonogenic assay. Samples obtained by biopsy from four of five patients were found to be sensitive to methotrexate or cisplatin, as were five of six surgical specimens from primary lesions. Samples from pulmonary metastases, however, were either resistant or showed poor sensitivity to all anticancer agents tested. The predictability for methotrexate was 87.5% (7/8). Results indicate that combination chemotherapy improves patient survival. Further improvement in the overall prognosis may be achieved by using a reliable tumor sensitivity test to prepare an optimal chemotherapy program.     

B淋巴母细胞淋巴瘤的临床特点和采用改良BFM-90方案治疗的结果

目的 分析B淋巴母细胞淋巴瘤的临床特点和采用改良BFM-90淋巴母细胞淋巴瘤方案的治疗结果。方法 对14例B淋巴母细胞淋巴瘤患者的临床表现进行分析，与同期住院的T淋巴母细胞淋巴瘤的临床表现进行比较。并对采用改良BFM-90淋巴母细胞淋巴瘤方案治疗的疗效和不良反应进行初步分析。结果 14例B淋巴母细胞淋巴瘤患者，年龄3～18岁，经病理检查和免疫组化检测证实为B淋巴母细胞淋巴瘤。其中Ⅰ期1例，Ⅲ期2例，Ⅳ期11例。以侵犯淋巴结和皮肤和骨髓最多见，分别占71％，50％和64％。除1例早期患者采用CHOP＋HD-MTX化疗，其余13例均采用改良BFM-90淋巴母细胞淋巴瘤方案化疗，其中12例患者（92．3％）获得完全缓解，1例患者（7．7％）获得部分缓解。中位随访19．5（2～44）个月，1例部分缓解患者放弃治疗后死亡，其余13例患者目前仍存活。近期疗效好，远期疗效仍须要继续随访。主要的不良反应为骨髓抑制，但均可耐受。结论 B淋巴母细胞淋巴瘤侵犯部位多为淋巴结、骨髓和皮肤，采用改良BFM-90淋巴母细胞淋巴瘤方案治疗可改善疗效。     

141例儿童急性髓系白血病的疗效及预后相关因素分析

目的评价初治儿童急性髓系白血病(AML)的疗效及探讨除急性早幼粒细胞白血病(APL)外的 AML 的预后相关因素。方法 141例18岁以下 AML 患者分成 APL 组(A 组,51例)和除APL 外的 AML 组(B 组,90例)进行回顾性研究分析。采用 Kaplan-Meier 曲线评估患者的无事件生存(EFS)率、无病生存(DFS)率和总生存(OS)率,Cox 回归模型评估预后因素。结果 B 组1个疗程完全缓解(CR)率为54.4%(49例),总缓解率为76.7%。5年累积 EFS 率、DFS 率和 OS 率分别为(28.4±9.0)%、(28.39±8.96)%和(35.5±6.3)%;A 组5年累积 EFS 率、DFS 率和 OS 率分别为(81.5±5.7)%、(94.3±4.0)%和(81.4±5.7)%:全部141例 AML 患儿5年累积 DFS 率和5年累积OS 率分别为(56.9±6.3)%和(53.3±4.8)%。B 组病例经多因素分析表明,初诊时骨髓白血病细胞比例较高和≥2个疗程达 CR 以及巩固治疗6个疗程以下是影响患者预后的危险因素(P 值均<0.05)。结论儿童 APL 预后良好。其他儿童 AML 中,初诊时骨髓原始细胞比例低和1个疗程达CR 以及巩固治疗6个疗程以上者预后较优;儿童 M_(2h)/t(8;21)与除 APL 以外的其他亚型相比没有显示预后良好的趋势;降低复发是改善儿童 AML 预后的关键。     

HLH-2004方案治疗继发性噬血细胞性淋巴组织细胞增多症10例临床分析

本研究旨在探讨HLH-2004方案在继发性噬血细胞性淋巴组织细胞增多症（secondary hemophagocytic lymphohistiocytosis,sHLH）患者中的临床疗效。对我科10例行HLH-2004方案化疗的sHLH患者进行回顾性分析。结果表明,化疗中7例患者有临床反应,3例患者无反应。5例sHLH患者未完成8周初始治疗,其中4例死亡,1例因严重药物副反应改用CHOP方案,治疗4个疗程后获疾病缓解。5例患者完成初始治疗,3例获疾病缓解,2例疾病控制不佳。3例缓解患者中,1例死于疾病复发,另2例维持缓解;2例控制不佳的患者中,1例死亡,另1例出院后获疾病缓解。结论：感染相关的HLH（IAHS）患者予HLH-2004方案化疗联合有效抗感染治疗后缓解率高,而EB病毒相关的HLH（EBV-HLH）或淋巴瘤相关的HLH（LAHS）患者缓解率低、缓解后易复发。     

预激诱导治疗急性髓细胞性白血病临床分析

目的:探讨预激诱导治疗对急性髓细胞白血病(AML)的临床疗效及毒副作用。方法:将AML43例分为2组。常规化疗组17例,均为用经典方案诱导化疗2疗程以上未获完全缓解或首次完全缓解6个月内复发者;男7例,女10例,平均年龄43(17~65)岁。预激方案治疗组26例,其中14例为用经典方案诱导化疗2疗程以上未获完全缓解或首次完全缓解6个月内复发者,6例为MDS转化型,1例为继发性AML,5例为低增生性AML;男8例,女18例,平均年龄50.5(19~72)岁,60岁以上者有8例。主要方案:常规化疗方案(AA方案):阿克拉霉素(Acla)20 mg/d第1~5天,阿糖胞苷(Arac-C)150~200 mg/d第1~7天;预激方案(CAG方案):粒细胞集落刺激因子(G-CSF)150μg/d(与化疗同时进行,共10~14 d),Arac-C 30 mg/d,q12 h(共10~14 d),Acla 20 mg/d(第1、3、5、7、9天),WBC>30×109/L时停用G-CSF,治疗中出现骨髓Ⅳ度抑制时停止治疗。结果:常规化疗组,完全缓解(CR)4例,部分缓解(PR)3例,无效(NR)10例,有效率41.1%。预激方案治疗组,第1疗程后获CR 16例,PR 4例,NR 6例;PR中2例进行了第2疗程的预激治疗达CR,2例放弃治疗,有效率76.9%;8例老年白血病患者中CR 5例、PR 1例、NR 2例;5例低增生性白血病患者均获CR;CR后给予常规剂量强化治疗,除1例死于严重感染外其余均处于缓解状态。两组治疗有效率比较,预激方案治疗组明显高于常规化疗组。预激方案治疗组中有1例出现Ⅳ度骨髓抑制达1月,其余患者均能很好耐受。结论:G-CSF预激诱导治疗方案对难治及复发性AML患者具有良好的效果,且对老年AML及低增生AML同样具有较高的缓解率,是一种安全、有效的治疗方案。     

Dose-related increases in cerebrospinal fluid concentrations of methotrexate in a postoperative patient with glioblastoma.

OBJECTIVE: To investigate the postoperative pharmacokinetics of methotrexate in the plasma and cerebrospinal fluid (CSF) in the space created by tumor removal of a patient with glioblastoma during hyperosmotic disruption of the blood-brain barrier (BBB) and intraarterial chemotherapy with a stepwise increase in the methotrexate dosage. CASE SUMMARY: A 30-year-old Japanese woman with glioblastoma received four courses of hyperosmotic disruption of the BBB and intraarterial chemotherapy with a combination of peplomycin, vindesine, nimustine, pirarubicin, and methotrexate. The patient was initially administered mannitol; anticancer drugs were then infused into the left internal carotid artery. Following the first, second, third, and fourth courses of treatment, methotrexate 350, 700, 1000, and 1500 mg, respectively, were administered for 30 minutes. Samples of blood and CSF from the space created by tumor removal were obtained. Methotrexate concentrations were measured by fluorescence polarization immunoassay and the pharmacokinetic parameters of methotrexate in plasma and CSF were estimated. RESULTS: The plasma concentration of methotrexate peaked at the end of drug infusion, then decreased in a biexponential decay manner during the remainder of the treatment period. The CSF concentration of methotrexate in the space created by tumor removal peaked two hours after drug administration, then monoexponentially decreased. Although the maximal CSF concentration of methotrexate in the space created by tumor removal was lower than that in the plasma, the CSF concentration of methotrexate in the space created by tumor removal exceeded that in the plasma six hours after drug infusion. The half-life of methotrexate in the CSF exceeded that in the plasma. The AUC for the plasma and CSF methotrexate concentration increased parallel with the methotrexate dosage. The mean CSF AUC of methotrexate was 59.4% of that found in plasma. CONCLUSIONS: The CSF AUC of methotrexate in the space created by tumor removal increased parallel with the methotrexate dosage during hyperosmotic disruption of the BBB and intraarterial chemotherapy.     

Use of Mabtera (rituximab) in treating patients with refractory courses of B-cell lymphoma,along with high-dose chemotherapy and autologous transplantation of hematopoietic stem cells

AIM: To study efficacy of rituximab in patients with resistant B-cell lymphoma on high-dose chemotherapy. MATERIAL AND METHODS: From September 2000 to April 2002 we studied efficacy and tolerance of rituximab at different stages of high-dose chemotherapy. The treatment was given to 10 patients with histologically verified CD20+ non-Hodgkin's lymphoma: diffuse large-cell (n = 4), Berkitt's (n = 2), follicular (n = 3), mantle-cell (n = 1). Five patients with diffuse large-cell lymphoma and Berkitt's lymphoma had a primary resistant course of the disease, one patient with diffuse large-cell lymphoma had a refractory recurrence. Follicular and mantle-cell lymphomas were characterized by a resistant course and large tumor masses. The patients received 1-2 courses of induction chemotherapy with dexa-BEAM with collection of peripheral stem cells followed by high-dose chemotherapy (BEAM-9, CBV + mitoxantron-1) with transplantation of autologous stem blood cells. Rituximab infusion (375 mg/m2) was conducted before the collection of the stem cells, prior to high-dose chemotherapy and in posttransplantation period after recovery of hemopoiesis. RESULTS: 4 patients achieved complete remission, 3-partial remission, 2 had progression and 1-stabilization. In mean follow-up 11 (2-20) months 7 of 10 patients were alive, overall survival being 15 +/- 2.4 months (95% confidence interval 10-19.7), median was not reached. 5 patients are in complete remission: 2 of them without further treatment, 3-after progression and repeat therapy including rituximab and interferon-alpha or rotuximab and CHOP chemotherapy. CONCLUSION: The addition of rituximab can improve the results of high-dose chemotherapy of patients with non-Hodgkin's lymphoma resistant to standard doses of cytostatics. Repeat use of this drug can be effective in some patients with progression after high-dose chemotherapy with rituximab.     

Treatment of leukemias and lymphomas with interferons: III. Trial treatment of meningeal localizations of acute leukemia and non-Hodgkin's lymphomas with beta interferon administered by the intrathecal route

Six patients with pure meningeal relapse of acute lymphoblastic leukemia (ALL) (5 patients) or leukemic lymphosarcoma (LS) (non Hodgkin's lymphoma) (NHL) (1 patient) were treated with intrathecal (I.T.) human fibroblastic interferon (IF beta), one vial (1.3 million units) every other day or every day up to remission or failure. Tolerance was excellent in all six patients with no local or general side effects. 5 patients had no improvement of their meningeal blast infiltrations after 5 to 8 injections and were given IT chemotherapy. The sixth patient achieved a complete remission (CR) after 11 injections, and was maintained in CR for eleven months under systemic and IT chemotherapy. IF cannot be proposed as standard treatment for meningeal leukemia, but we may be able to select a population of patients in which it could be indicated. Its combination with methotrexate and arabinoside cytosine, the two agents used IT which are S-dependent, has to be studied for a possible potentiation. Moreover, its good tolerance would permit its use in severe meningeal viral diseases.     

伴t（1；3）（p34；p21）急性淋巴细胞白血病的临床和实验室研究

目的 探讨伴t （1;3）（p34;p21）的恶性血液病的临床及实验室特征。方法 骨髓细胞培养24 h后按常规方法 制备染色体,用RHG显带技术进行细胞遗传学分析。结果 1例B细胞急性淋巴细胞白血病（B-ALL）患者其核型分析结果 有t （1;3）（p34;p21）的异常,临床和血液学改变符合B-ALL诊断,患者化疗后获得完全缓解。结论 伴t （1;3）（p34;p21）急性淋巴细胞白血病可能是一个独立的临床病理遗传学类型。     

Synchronous programmed intensive therapy of patients with severe rheumatoid arthritis

AIM: To evaluate efficiency and safety of intensive treatment program (synchroneous plasmapheresis, large-dose methotrexate and methypred) for patients with severe rheumatoid arthritis (RA). MATERIAL AND METHODS: 45 patients with highly active and progressive RA, systemic symptoms, corticosteroid dependence who had intolerance to standard therapy or had not responded to it were divided into 2 comparable groups. 25 patients of group 1 for a month got 6 plasmapheresis procedures with synchroneous intravenous injection of 40 mg of methotrexate and 250 mg of methypred. 20 patients of group 2 received pulse therapy with methypred (3 g) and methotrexate (200 mg). The intensive therapy was followed in all the patients with methotrexate in a dose 10-20 mg/week. RESULTS: One, six and twelve months after treatment patients of group 1 demonstrated a decrease in RA clinical activity and inflammation. In a year remission by ACR criteria was achieved in one-third of the patients. CONCLUSION: The sychroneous program of intensive therapy is highly effective in RA patients with vasculitis, ineffective standard therapy and corticosteroid dependence.     

原始NK细胞白血病一例报告--附文献复习

目的 提高对原始自然杀伤(NK)细胞白血病的认识，特别是侵袭性表现。方法 报道l例原始NK细胞白血病及其治疗经过，并进行献复习。结果 经联合化疗及脊髓节段性放疗，外周血及骨髓达缓解但髓外浸润无明显改善。结论 原始NK细胞白血病易发生髓外浸润，且治疗反应差、预后不良。     

联合三氧化二砷序贯治疗急性早幼粒细胞白血病临床观察

目的:观察三氧化二砷(As2O3)序贯治疗急性早幼粒细胞白血病(acute promyelocytic leuk-emia,APL)的疗效.方法:8例初发APL患者经维A酸诱导缓解后,再予DA方案(柔红霉素、阿糖胞苷)、维A酸和As2O3序贯巩固强化治疗3年,观察持续缓解时间及As2O3的不良反应.结果:8例中,7例随访4～42个月,1例失访.随访的7例均处于完全缓解中,中数缓解时间为17个月.随访超过24个月者3例,仍持续缓解,持续缓解时间最长者已达42个月.此疗法不良反应轻.结论:联合As2O3序贯治疗APL,疗效良好,有望延长APL患者的持续缓解时间及无病生存时间.     

急性髓系白血病完全缓解后治疗周期的初步探讨

目的 探讨急性髓系白血病（AML）诱导缓解后的适宜治疗周期。方法 治疗并随访观察我院7年收治的原发、补治AML191例,采用SPSS软件分析所得数据。结果 191例原发初治AML采用HA、DA、AA、HAD方案分组诱导化疗,完全缓解（CR）率81．4％,其1－2个疗程CR率89．9％。144例可分析生存期的CR患者中位无病生存（DFS）9．6个月,3年实际DFS率为21．6％,5年DFS预计为12．9％,CR后巩固强化治疗＜6个疗程者中位DFS为7．1个月,3年DFS率为11．4％,5年DFS率为6．3％,治疗≥6个疗程者中位DFS为35．3个月,3年DFS率为43．2％,5年DFS率为27．0％,二者差异具有显著性。其中治疗≥8个疗程者中位DFS为48．8个月,3年DFS率为57．9％,5年DFS率为31．6％,略高于治疗≥6个疗程的全部病例,但差异无统计学意义。结论 AML CR后标准剂量化疗巩固强化至少应6个疗程,以8个疗程以上为宜。建议AML的治疗至少维持1年左右。     

儿童白血病运用HD-MTX化疗临床护理路径的应用探讨

【目的】探讨临床护理路径（CP）在综合治疗、护理白血病患几应用大剂量甲氨蝶呤（HD-MTX）化疗的临床意义和效果,规范该类患儿在治疗过程中的护理行为。【方法】将28例急性淋巴细胞白血病（ALL）患儿,运用HD-MTX化疗共104个疗程,按入院次序的前后分为试验组和对照组,每组52例次,试验组应用临床路径管理,对照组按照常规的工作模式管理,比较两组患儿的平均住院日、住院费用、感染发生率、化疗药物的毒副作用所致并发症、病人满意度。【结果】试验组患儿的平均住院日、医疗费用、感染发生率、化疗药物不良反应发生率显著少于对照组（P〈O．05）。【结论】ALL运用HD-MTX化疗时应用CP管理,是深化临床优质护理服务内涵一条切实可行的有效途径。     

卵巢上皮癌TCI化疗方案的疗效研究及远期预后探讨

目的探讨TCI联合化疗方案对于卵巢上皮癌的疗效及远期预后。方法 2000年2月~2010年12月在本院进行规范治疗的卵巢上皮癌158例,运用TCI治疗方案为88例,其化疗方案为TP和/或CAP和/或IAP（简称TCI方案）;对照组治疗70例,方案选择为PC（环磷酰胺与顺铂）,比较两组的临床缓解情况、毒性反应及远期预后,并且对TCI组进行COX系统回归因素分析。结果 TCI治疗组总体缓解率明显高于对照组,毒性反应方面TCI治疗组的血液系统及神经系统不良反应均显著低于PC组,胃肠道不良反应与心血管系统反应则无显著差异;TCI组5年平均生存率为31.2%,病理分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期中位生存时间分别是79、56、22、18个月,残留灶小于2 cm者和治疗次数大于6次者远期预后明显好与相对应者。结论 TCI化疗方案显著优于PC方案,且不良反应相对较少,但胃肠道反应应引起重视,在预后各种因素方面病理分期、术后残留及疗程多少均具有一定相关意义。     

宫颈胎盘部位滋养细胞肿瘤一例并文献复习

目的通过对1例原发于宫颈的胎盘部位滋养细胞肿瘤(PSTT)的资料及相关文献的复习,全面介绍胎盘部位滋养细胞肿瘤的临床特征、病理特点、治疗方式及预后。方法对收治1例罕见原发于宫颈部位的PSTT的临床病理资料进行分析,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等文献数据库进行文献复习。结果该例原发于宫颈部位的PSTT患者术后化学疗法后,目前情况良好,已随访3年,无复发及转移征象。2011年9月1日前,CNKI数据库共报道300余例PSTT病例,PubMed数据库共160余例,其中有2例原发于宫颈部位的PSTT。原发于宫颈部位的PSTT罕见,易误诊,往往需要宫颈活组织检查或宫颈搔刮才能确诊。结论原发于宫颈部位的PSTT的预后是否遵循PSTT尚需收集更多的病例证实。PSTT因其发病率低,临床表现多无特异性,通常需要通过诊断性刮宫、活组织检查甚至术后病理检查才能确诊。PSTT首选的治疗方式为手术,多数患者病灶清除后可治愈,对有高危因素的患者术后宜选择依托泊苷+甲氨蝶呤+放线菌素D+环磷酰胺+长春新碱(EMA-CO)方案或依托泊苷+甲氨蝶呤+放线菌素D+依托泊苷+顺铂(EMA-EP)方案进行化学治疗,以期改善预后。