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世界核心医学期刊文摘（妇产科学分册） 2006年第6期2卷 53-54页

作者： baergen r.n. rutgers J.L. Young r.H. 吕涛 new York Presbyterian Hospital Weill Cornell Medical Center 520 East 70th Street Starr 1002 New York NY 10021 United States

Objective. The placental site trophoblastic tumor is a rare form of gestational trophoblastic disease. Fifteen percent of reported cases have been fatal, but predicting behavior in individual patients has been challenging. Methods. The clinical, gross and histopathological features of 55 cases and 180 cases in the literature were analyzed for their effect on survival and in relation to tumor stage. results. The 55 patients in our series were 20 to 62 (average 32) years of age. The tumors occurred on an average of 34 months after the last known gestation. 84% were stage I, 2% stage II, 5% stage III, and 9% stage IV. Serum levels of human chorionic gonadotropin (hCG)were elevated (average 691 mIU/ml) in 77% of the cases. The tumors were on average 5 cm in greatest dimension and were composed microscopically of infiltrative sheets of intermediate (extravillous) trophoblastic cells. The mitotic rate r.n.ed from 0 to 20 (average 5.0) per 10 high power fields. The follow- up interval averaged 4.6 years. Eight patients (15% ) died from metastatic tumor, and nine additional patients had metastases or a recurr.n.e but were alive at last contact. The most common metastatic sites were the lungs, liver, and vagina. Conclusions. Significant factors associated with adverse survival in the present series were age over 35 years (P = 0.025), interval since the last pregnancy of over 2 years (P = 0.014), deep myometrial invasion (P = 0.006), stage III or IV (P 1000 mIU/ml (P = 0.034), extensive coagulative necrosis (P = 0.024), high mitotic rate (P = 0.005), and the presence of cells with clear cytoplasm (P nly stage and clear cytoplasm were independent predictors of overall survival, while stage and age were the only independent predictors of time to recurr.n.e or disease- free survival. In the literature, factors associated with survival were stage (P nterval from preceding pregnancy of over 2 years (P = 0.029), previous term pr

关键词：滋养细胞肿瘤病例分析预后因素胎盘附着文献回顾人绒毛促性腺激素滋养细胞疾病平均年龄组织病理学临床表现

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