目的 初步探讨上皮样滋养细胞肿瘤(ETT)的临床特点及其诊治策略.方法 回顾性分析2005年6月-2007年8月在浙江大学医学院附属妇产科医院收治的6例ETT患者的临床资料.结果 本组6例患者均经手术后病理检查确诊,年龄27～46岁.其中5例表现为阴道流血;前次妊娠情况:1例为葡萄胎,2例为早孕行人工流产术,3例为足月分娩;前次妊娠距诊断的时间间隔为15～48个月;治疗前血人绒毛膜促性腺激素水平为46～121 147 IU/L.子宫有病灶者6例;子宫外有转移灶者4例,其中肺转移3例,肝、胰腺转移各1例.治疗方式均为手术结合化疗,其中行子宫全切除术者6例,肺叶切除术者1例.治疗后1例复发,拒绝治疗并失访;1例继续治疗中;4例治疗后随访期内(9～19个月)未复发.结论 ETT患者术前诊断极为困难,一般为术后依据病理检查方能确诊,手术是治疗ETT的主要手段,化疗在ETT治疗中的作用尚不明确.%Objective To evaluate the clinical characteristics of epithelioid trophoblastic tumor (ETT).Methods Six cases of ETT treated in Women's Hospital,School of Medicine,Zhejiang University from 2005 to 2007 were retrospectively analyzed,together with a literature review.Results Six cases of ETT were diagnosed pathologically after surgery.The age of patients ranged from 27 to 46 years.The most common presentation was abnormal vaginal bleeding(5/6).The preceding gestational events were hydatidiform mole in 1 case,abortion in 2 cases,and term delivery in 3 cases.The interval between the preceding gestation and the diagnosis of ETT ranged from 15-48 months.The serum human chorionic gonadotropin(hCG)level was 46-121 147 IU/L.Four cases presented with metastasis,including lung metastasis in all of the 4 cases,liver metastasis in 1 case,and pancreas metastasis in another 1 case.The main therapies were surgery combined with chemotherapy.All of the 6 cases received total abdominal hysterectomy.and 1 case also had lung lobectomy.One ease had a recurrence but refused any treatment again,and was lost to follow up;the therapy of 1 case unfinished;another 4 cases were without evidence of disease 9 to 19 months after surgery.Condusions The confirmation of ETF diagnosis is difficult before surgery.Surgical management is mostly recommended in ETT. The role of chemotherapy in ETT is not clear yet.
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