胎盘部位滋养细胞肿瘤4例病例分析

目的 探讨胎盘部位滋养细胞肿瘤患者的临床诊疗过程。方法 选择2000年1月至2013年8月杭州师范大学附属医院妇产科收治的4例胎盘部位滋养细胞肿瘤患者临床资料进行研究。结果 胎盘部位滋养细胞肿瘤发病率占同期滋养细胞疾病的2．0％。患者平均年龄30．5岁，其中3例前次妊娠为足月妊娠，距前次妊娠平均时间为12．8个月，诊断时血人绒毛膜促性腺激素（ hCG）平均54．3 IU／L。4例患者中3例采取子宫全切手术治疗，另1例在子宫全切后辅以EMA-CO 方案化疗1个疗程。4例患者均存活，随访至今无复发。结论 胎盘部位滋养细胞肿瘤发病率低，多继发于足月妊娠，血hCG水平低，治疗首选子宫全切术，对于存在高危因素的患者应在手术基础上联合化疗。

Placental site trophoblastic tumor:A study of 4 cases

Objective To investigate the clinical diagnosis and treatment of placental site trophoblastic tumor （ PSTT） .Methods Analysis was conducted on the clinical data of 4 patients with PSTT admitted in gynecology and obstetrics department of the Affiliated Hospital of Hangzhou Normal University during the period of January 2000 to August 2013.Results The incidence of PSTT accounted for 2.0% of gestational trophoblastic disease at the same period .The mean age of these 4 patients was 30.5 years old.Previous pregnancy was full term in 3 cases.The mean interval from previous pregnancy to the diagnosis was 12.8 months.The mean level of human chorionic gonadotropin （ hCG） was 53.4 IU/L.Three of four patients were cured by hysterectomy , and the other one was cured by hysterectomy and one course of EMA-CO chemotherapy.The 4 patients were alive up to now with no recurrence .Conclusion PSTT is rare, and most previous pregnancy is full term.The level of hCG is low .Hysterectomy is the primary choice of treatment .Chemotherapy should be given to the high-risk cases based on hysterectomy .