妊娠滋养细胞肿瘤不良结局临床分析

目的分析妊娠滋养细胞肿瘤患者预后的影响因素。方法回顾分析了我院1993年-2006年收治的妊娠滋养细胞肿瘤患者中不良结局的4例病例，对其临床表现、诊断分期和治疗方法及死因进行分析讨论。结果4例死亡病例中3例为晚期绒癌，1例为恶性葡萄胎术后化疗后，4例患者均未能坚持规律化疗，其中1例有严重的化疗副作用，1例出现化疗耐药后接受手术治疗。4例患者最终均死于呼吸循环衰竭，确诊至死亡时间均未超过半年。结论对于妊娠滋养细胞肿瘤，除转移病灶等分期及预后评分因素外，坚持规范合理的化疗，选择合适的手术时机，减少误诊、误治的几率对改善妊娠滋养细胞肿瘤患者的预后有重要意义。

Clinical assessment of adverse outcome in gestational trophoblastic neoplasia

Objective To analyze the prognostic factors of gestational trophoblastic neoplasia.Methods We retrospectively analyzed the clinical data of the gestational trophoblastic neoplasia patients treated in our hospital between 1993 and 2006,especially the clinical manifestation,diagnostic staging,treatment, and lethal factors of 4 dead cases.Results The 4 cases included 3 cases of choriocarcinoma at late stage and 1 case of post-operative and post-chemotherapeutic invasive mole.All these 4 patients failed to adhere to regular treatment,including 1 case of severe adverse event of chemotherapy and 1 case of chemotherapy resistance followed by hysterectomy and right oophorectomy.All died of respiratory and circulatory failure. The survival period was less than half a year after diagnosis.Conclusion Besides the parameters of stag- ing and prognostic scoring system of gestational trophoblastic neoplasia,rational chemotherapy,timely surgery,and limitation of misdiagnosis and mal-treatment may help improve the prognosis of patients with gestational trophoblastic neoplasia.