摘要 目的探讨妊娠合并浸润性子宫颈癌患者的临床特点、诊治方法及母婴结局以提高其早期诊断率、改善肿瘤临床处理有效率及胎儿结局。方法回顾性分析2010年1月至2019年12月广州医科大学附属第三医院收治的11例妊娠合并浸润性子宫颈癌患者的病例资料,总结其临床特点、处理及母儿结局。结果 (1)11例妊娠合并子宫颈癌患者诊断时,3例为中孕期,6例为晚孕期,2例为产后诊断。子宫颈癌(FIGO 2009)ⅠB1期1例,ⅠB2期以上10例。(2)11例均因阴道不规则流血为主诉就诊,其中9例5年内及妊娠期间未进行过子宫颈癌筛查。(3)中孕期诊断3例均因无保留胎儿意愿行剖宫取胎+后续子宫颈癌治疗,平均终止孕周20+6周;晚孕期(6例)及产后(2例)诊断均剖宫产终止妊娠+后续子宫颈癌治疗,平均终止孕周36周。(4)11例患者9例存活,2例死亡(均为子宫颈神经内分泌癌),中孕期终止者3例胎儿均死亡,晚孕期终止者8例胎儿均健康存活。结论妊娠合并浸润性子宫颈癌患者孕前孕期多未接受规范化子宫颈癌筛查;多在妊娠中晚期诊断;诊断时多为子宫颈癌FIGO中晚期,需重视孕前及孕期子宫颈癌筛查;中孕期胎儿结局与患者选择保留胎儿意愿密切相关;妊娠合并特殊病理类型子宫颈神经内分泌癌预后较差。 Objective infant outcomes of pregnant women with cervical cancer, in order to improve the early diagnosis rate, clinical treatment efficiency and fetal outcome.Methods treated in the third Affiliated Hospital of Guangzhou Medical University from January 2010 to December 2019,their clinical features,management and outcomes were collected and analyzed retrospectively.Results(1)Three patients were diagnosed in the second trimester,six in the third trimester of the pregnancy,and two during postpartum. There was one patient categorized as FIGO ⅠB1 and others above ⅠB2.(2)All the patients presented with irregular vaginal bleeding,nine of them had not been screened within 5 years or during pregnancy.(3)Three patients diagnosed in the second trimester terminated pregnancies by cesarean section and received standard treatment with the average week of termination of gestation being 20 weeks and 6 days,the other 8 were treated by standard treatment after cesarean section with the average week of termination of gestation being 36 weeks.(4)For all eleven patients,nine survived and two died who diagnosed with neuroendocrine cervical cancer. The 3 fetuses were dead after termination of pregnancy in second trimester,while eight children were born in the third trimester,who survived healthily.Conclusion during pregnancy are more often found in the middle and late trimester of pregnancy,mostly presenting as the middle and advanced stage of cervical cancer,and most of the patients haven’t been screened for cervical cancer during or before pregnancy,so we should pay attention to the screening of cervical cancer before and during pregnancy;the fetal outcome in the second trimester is closely related to the patient’s willingness to retain the fetus;the pregnancy women with neuroendocrine cervical cancer have poor prognosis.
机构地区 广州医科大学附属第三医院妇科
出处 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2021年第4期482-485,共4页 Chinese Journal of Practical Gynecology and Obstetrics
基金 广东省自然科学基金(2020A1515010082)。
分类号 R737.3 [医药卫生—肿瘤]
