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1956年以前,滋养细胞肿瘤病人的预后很差。近20多年来,由于对本病的恶变因素有了进一步认识,检查、追踪及监测方法也有很大的进展,这些均有利于滋养细胞肿瘤的诊断及治疗,特别是对恶性葡萄胎(以下简称恶葡)及绒毛膜癌(以下简称绒癌)的预防起了很大的作用。本文仅就近几年来滋养细胞肿瘤的恶变因素、预后、预防性治疗、染色体、免疫学以及超微结构方面的进展,作一综合报道。一、葡萄胎的恶变因素葡萄胎的恶变率国内外报道不同,约0.7～20%。国内夏氏报道为14.5%,朱氏等为14%,傅氏为4.36%。一般认为恶变与年龄、子宫大于妊娠月份、人体绒毛膜促性腺激素(hCG或HCG)滴度、子宫增长速度、发病到葡萄胎排出的时间等有关。夏氏特别指出,刮宫时以小葡萄为主时则恶变可能性大。傅氏提出,滋养细胞高度增生者恶变率可达14.89%,
Before 1956, the prognosis of patients with trophoblastic tumors was poor. In the recent 20 years, due to the further understanding of the malignant factors of the disease, there has been great progress in the methods of examination, tracking and monitoring, which are conducive to the diagnosis and treatment of trophoblastic tumors, especially for malignant mole (hereinafter referred to as Ebola) and choriocarcinoma (hereinafter referred to as choriocarcinoma) played a significant role in prevention. This article only in recent years to nodule malignant tumor cells, prognosis, prophylactic treatment, chromosome, immunology and ultrastructure of the progress made a comprehensive report. First, hydatidiform mole malignant variable hydatidiform mole malignant rate of different reports at home and abroad, about 0.7 to 20%. Domestic Xia reported 14.5%, Zhu and other 14%, Fu 4.36%. Generally believed that malignant and age, the uterus is greater than the month of pregnancy, human chorionic gonadotropin (hCG or HCG) titer, the rate of uterine growth, the incidence of mole discharge time and so on. In particular, Xia Shi pointed out that the curettage of small grapes when the main possibility of malignant transformation. Fu proposed that highly malignant trophoblastic hyperplasia rate of up to 14.89%