10例上皮样滋养细胞肿瘤的临床诊治分析

摘要

目的 研究上皮样滋养细胞肿瘤(ETT)的临床特征与治疗方式. 方法 回顾性分析2010年7月至201 7年8月北京协和医院收治的10例ETT患者的临床病理资料、治疗方式及预后情况. 结果 10例患者中有9例表现为异常阴道出血,血β-HCG的范围为0～3 303 U/L.5例为Ⅰ期,2例为Ⅱ期,3例为Ⅲ期.2例Ⅰ期患者直接行子宫切除术;其余8例患者接受了3～9个疗程的多药联合化疗,平均(5.6±2.1)疗程,其中6例患者行子宫切除,1例患者行直肠旁腹膜肿物切除,1例行阴道病灶切除.9例获得完全缓解,1例患者病情缓解后复发. 结论 ETT是一类罕见的中间型滋养细胞肿瘤,临床表现不特异,明确诊断依赖于手术病理及免疫组化.手术是最重要的治疗手段.%Objective:To investigate the clinical features and treatments in patients with epithelioid trophoblastic tumor(ETT).Methods:The data including clinic pathologic characteristics,treatments and prognosis of 10 patients with ETT in Peking Union Medical College Hospital from July 2010 to August 2017 were analyzed retrospectively.Results:Nine patients showed abnormal vaginal bleeding.Their serum β-HCG ranged from 0 to 3 303 U/L.Five patients were in stage Ⅰ,2 patients in stage Ⅱ,and 3 patients in stage Ⅲ.Two patients underwent hysterectomy without chemotherapy.Other 8 patients were treated with multimodality treatment(combined with surgery and chemotherapy);6 patients of them underwent hysterectomy,1 patient underwent para rectal peritoneal mass excision and 1 patient underwent vaginal lesion excision.Nine patients achieved complete remission(CR),and 1 patient had relapse after CR.Conclusions:ETT is a rare intermediate trophoblastic tumor.The clinical manifestation is non-specific,and its diagnosis depends on surgical pathology and immunohistochemistry.Surgery is the most important treatment.