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目的探讨妊娠滋养细胞肿瘤的临床特点、治疗方法及转归。方法妊娠滋养细胞肿瘤患者105例,年龄18-54岁;绒癌34例,侵蚀性葡萄胎71例。根据预后评分的低危或高危分别选择单药或联合化疗3-11个疗程,部分患者辅以介入治疗。19例接受了全子宫切除术。结果 105例中,单纯化疗及化疗联合手术患者完全缓解94例(89.5%)。其中,86例单纯化疗患者完全缓解78例(90.7%),19例化疗联合手术完全缓解16例(84.2%)。不同FIGO分期患者的完全缓解率:Ⅰ期完全缓解率100.0%(62/62),Ⅱ期完全缓解率100.0%(23/23);Ⅲ期完全缓解率53.3%(8/15),Ⅳ期完全缓解率25.0%(1/5)。结论早期诊断和及时化疗,有手术指征者联合手术,可使妊娠滋养细胞肿瘤获得满意的治疗效果。
Objective To investigate the clinical features, treatment and outcome of gestational trophoblastic tumor. Methods 105 cases of gestational trophoblastic tumor patients, aged 18-54 years; choriocarcinoma in 34 cases, 71 cases of invasive hydatidiform mole. According to the prognostic score of low-risk or high risk were selected single-agent or combination chemotherapy 3-11 courses, some patients supplemented by interventional therapy. Nineteen patients underwent total hysterectomy. Results In 105 cases, 94 cases (89.5%) were completely relieved by chemotherapy alone and chemotherapy combined surgery. Among them, 78 cases (90.7%) were completely relieved in 86 patients with chemotherapy alone, and 16 cases (84.2%) were completely relieved in 19 cases treated with chemotherapy. The complete response rate was 100.0% (62/62) in stage Ⅰ, 100.0% (23/23) in stage Ⅱ, and 53.3% (8/15) in stage Ⅲ. The complete response rate The complete remission rate was 25.0% (1/5). Conclusions Early diagnosis and timely chemotherapy, surgical indications combined surgery can make gestational trophoblastic tumor obtain satisfactory therapeutic effect.