摘要
目的探讨妊娠期宫颈癌的临床特点及治疗方法,以期早期发现并改善患者临床结局。方法回顾性分析2003年12月至2016年12月暨南大学附属第一医院收治的9例妊娠期宫颈癌患者的临床资料及随访结果。结果 9例患者中,孕前1年内均未行宫颈癌筛查。2例于孕早期发现(ⅡA期1例,ⅡB期1例),2例为孕中晚期发现(ⅠB期1例,Ⅳ期1例),产后发现5例(ⅠB期2例,ⅡB期1例,Ⅲ期1例,Ⅳ期1例)。1例ⅠB期患者延期治疗外,余患者均于诊断后采取综合性治疗。7例鳞状细胞癌(中分化3例,低分化4例),1例小细胞癌,1例黏液腺癌。6例ⅡB期及更早期患者除2例失访,随访至今,余患者均存活。Ⅲ期及更晚期患者3例,均于孕中期后发现,其中1例为小细胞癌,2例为低分化鳞状细胞癌,随访至今均死亡,平均生存时间(13±4.5)个月。结论妊娠期宫颈癌患者早发现、早治疗可改善患者临床结局,因此妊娠期应重视宫颈癌筛查。妊娠期宫颈癌应根据患者意愿、临床期别采取综合治疗方案。
Objective To analyze the clinical characteristics and treatment of cervical cancer during pregnancy, aiming at the early detection and improvement of clinical outcomes. Methods A retrospective analysis was conducted on the clinical data of 9 women with cervical cancer in pregnancy, who admitted to the First Affiliated Hospital of Jinan University from December 2003 to December 2016. Results Among the 9 cases of cervical cancer, who were not screened for cervical cancer within 1 year before pregnancy, 2 cases were found in early pregnancy（1 in stage ⅡA, 1 in stage ⅡB）, 2 cases（1 in stage ⅠB, 1 in stage Ⅳ） in late pregnancy, 5 cases in post-partum（2 in stage ⅠB, 1 in stage ⅡB,1 in stage Ⅲ, 1 in stage Ⅳ）; one patient with stage ⅠB delayed treatment, and the remaining patients took comprehensive treatment after diagnosis. Pathological results indicated 7 cases of squamous cell carcinoma, of which 3 cases were moderately differentiated, 4 cases were poorly differentiated, 1 case was small cell carcinoma, and 1 case was mucinous adenocarcinoma. Among the 6 patients with ⅠB-ⅡB stage, except 2 cases who were lost to follow-up, the remaining patients survived until the follow-up period. Three patients of stage Ⅲ-Ⅳ were found after the second trimester, of which one was small cell carcinoma and two were poorly differentiated squamous cell carcinomas. All three patients died after follow-up, and the average survival time was（13±4.5） months. Conclusion Early detection of cervical cancer during pregnancy can improve the clinical outcome of patients, so cervical cancer screening should be emphasized during pregnancy. Formulating the treatment of cervical cancer during pregnancy should be based on the patient＇s wishes, clinical stages and tumor type.
作者
郑艳红
罗新
ZHENG Yan-hong;LUO Xin(Department of Gynaecology and Obstetrics,the First Affiliated Hospital of Jinan University,Guangzhou 510630,Guangdong,CHINA)
出处
《海南医学》
CAS
2018年第16期2332-2334,共3页
Hainan Medical Journal
关键词
妊娠
宫颈癌
筛查
治疗
Pregnancy
Cervical cancer
Screening
Treatment
