女性生殖道恶性中胚叶混合瘤(29例临床资料分析)

女性生殖道恶性中胚叶混合瘤发病率低，恶性程度高。上海医科大学妇产科医院1965年～1993年共收治20例生殖道恶性中胚叶混合瘤，其中子宫20例，宫颈2例，卵巢6例，输卵管1例。占同期妇科住院患者的0．3‰、妇科肿瘤患者的5．9‰；。本病的临床表现主要有：阴道流血水（74．4％）、腹痛（27．6％）。在术前诊断中诊断性刮它对有阴道流血水的病例有一定帮助，确诊率为71％，而对拉他病例则意义不大。本病预后较差，29例中2年内死亡者12例。生存时间超过5年者7例。发生在子宫的恶性中胚叶混合瘤可能较发生在其他部位的预后好。五年存活率在较广泛的手术切除者比单纯全宫加双附件切除者要高。化疗对本病的治疗效果尚不肯定，但术后长期用以铂剂为主的联合化疗可得到明显缓解或完全缓解。临床分期与本病预后尚不明显。影响本病预后的可能因素有：1．手术治疗是否彻底。2术后是否加用以铂剂为主的联合化疗。3临床分期。

The Malignant Mixed Mesodermal Tumors of Female Genital Tract (Clinical Analysis of 29 Cases)

Although the incidence of the malignant mixed mesodermal tumor in female genital tract is low. the malignancy is of high grade. 29 cases of the malignant mixed mesodermal tumors of the female genital tract in the Gynecological and Obstetrical Hospital of Shanghai Medical University were presented in this paper from 1965 to 1 993,of them, 20 cases from endometrium, 2 from cervix, 6 from ovary, 1 from fallopian tube- They occupied about 0. 3 % of all patients hospitalized in gynecological department, and about 5. 9 %. of all gynecological oncological patients during the same period in the hospital. The clinical manifestations were vagina bloody disoharge (74. 4% ) and aboominal pain (27. 6 % ). Diag nostic curettage is helptul to diagnosis for the patients with vagina bloedy discharge preoperativeIy, the success rate is 71 %. But it was insignificance in the patients without these symptoms. The prognosis of the tumor was poor, which 12 of 29 patients died within two years, only 7 of 29 patients lived more than five years. The prognosis of the malignant mixed rnesoclermal tumor of uterus may be better than the tumor of other fernale genital organs. The survival rate of five years is higher in patients after a complete surgery than those af-ter hyserectomy and bisalpingo-oophorectomy only. The effectiveness of chemotherapy is uncertain, but the use of the combined chemotherapy of the long-term, mainly in DDP, may lead to complete or partial remission.