作者投稿
专家审稿
编辑办公
邮件订阅
RSS
-
摘要:目的 探讨中间型滋养细胞肿瘤(intermediate trophoblastic tumors, ITTs)保留生育功能治疗的方法并分析其结局。方法 对1999年1月至2010年3月在本院行保留生育功能治疗的6例ITTs进行回顾性分析。结果 诊刮有效2例、化疗敏感2例、开腹子宫病灶切除术有效3例。3例病理大体类型为结节息肉型ITTs, 行诊刮+联合化疗有效; 3例肿块型ITTs, 行开腹子宫病灶切除术+联合化疗±诊刮有效。平均随诊35个月, 均获得完全缓解(completeremis-sion, CR), 月经均恢复正常, 随访至今无复发。3例有足月生产史者未再妊娠, 3例未生产者至今尚未妊娠。结论 ITTs患者年龄 < 35岁(强烈要求保留生育功能), 病变局限于子宫, 且除外子宫多发病灶(病理弥漫浸润型)行保留生育功能的治疗是安全可行的。Abstract:Objective To investigate the methodologies of fertility sparing therapy in treating intermediate trophoblastic tumors (ITTs) and analyze their outcomes.Methods The clinical data of 6 patients with ITTs who underwent fertility sparing therapy in our department from January 1999 to March 2010 were retrospectively analyzed.Results Serum β-hCG of two patients returned normal after treated by dilation and curettage. Serum β-hCG of two patients returned normal after two courses of combined chemotherapy. Three patients were cured after open uterine tumor resection and combined chemotherapy. The gross pathology of three ITTS were polypoid, which were controlled by combined chemotherapy following dilation and curettage. Two of three patients with nodular masses type were cured by a multi-modality treatments that combined dilation and curettage with chemotherapy, followed by open uterine tumor resection (the other one did not undergo dilation and curettage). The average follow-up time was 35 months. All patients experienced complete remission (CR). Menstruation returned normal in all patients. No recurrence was noted during follow-up. No one had been pregnant.Conclusions Fertility sparing therapy is safe and feasible for ITTs patients under the following conditions:younger than 35 years and having a strong wish to get pregnant in future; the tumor is localized in uterus; and multifocal disease (the diffuse infiltrative type) has been excluded.
-
Keywords:
- intermediate trophoblastic tumors /
- fertility conservation /
- therapy
-
2010年经国家食品药品监督管理局(SFDA)批准的振动声桥正式进入我国。2010年5月, 北京协和医院、北京同仁医院和解放军总医院为国内首批引进该项新技术的医院。
北京协和医院耳鼻喉科为1名有多年双耳感音神经性听力下降的老年患者进行了振动声桥植入手术, 术后6周进行开机调试, 结果与其之前佩戴的传统助听器相比, 听力水平明显改善。振动声桥是一种与传统助听器不同的人工听力技术。传统助听器将采集到的声音信号放大后, 经耳道传入鼓膜; 振动声桥则是将声信号转化为电信号, 传递给经手术植入中耳腔的磁传感器, 由该传感器带动听骨振动, 从而将声信号传入内耳, 提高听力。和传统助听器相比, 振动声桥佩戴更为舒适, 外耳道内不放置元件, 可以避免耳胀和耳道皮肤反应, 也没有高调哮鸣声, 对真实声音的还原度较好, 较适合于中频和高频听力下降的患者。另外, 通过特定的术式, 还能用于治疗传统助听器所不适合的传导性和混合性听力下降, 这种新的治疗方法为广大患者带来了福音。
(北京协和医院耳鼻喉科 查 洋)
-
[1] Zhao J, Xiang Y, Wan XR, et al. Clinical and pathologic. characteristics and prognosis of placental site trophoblastic tumor [J]. J Reprod Med, 2006, 51: 939-944. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=c575bb06dac35b02deb16e3e21294dcd
[2] Baergen RN, Rutgers JL, Young RH, et al. Placental site trophoblastic tumor: a study of 55 cases and review of the literature emphasizing factors of prognostic signifcance[J]. Gynecol Oncol, 2006, 100:511-520. DOI: 10.1016/j.ygyno.2005.08.058
[3] Palmer JE, Macdonald M, Wells M, et al. Epithelioid trophoblastic tumor: a review of the literature[J]. J Reprod Med, 2008, 53: 465-475. http://cn.bing.com/academic/profile?id=684565ef2e7a2b038ad48eaae4282f6b&encoded=0&v=paper_preview&mkt=zh-cn
[4] Schmid P, Nagai Y, Agarwal R, et al. Prognostic markers and long-term outcome of placental-site trophoblastic tumours: a retrospective observational study[J]. Lancet, 2009, 374: 48-55. DOI: 10.1016/S0140-6736(09)60618-8
[5] Kim SJ. Placental site trophoblastic tumour[J]. Best Pract Res Clin Obstet Gynaecol, 2003, 17: 969 -984. DOI: 10.1016/S1521-6934(03)00095-6
[6] Leiserowitz GS, Webb MJ. Treatment of placental site trophoblastic tumor with hysterotomy and uterine reconstruction [J]. Obstet Gynecol, 1996, 88: 696-699. DOI: 10.1016/0029-7844(96)00124-X
[7] Tsuji Y, Tsubamoto H, Hori M, et al. Case of PSTT treated with chemotherapy fllowed by open uterine tumor resection to preserve fertility[J]. Gynecol Oncol, 2002, 87: 303-307. DOI: 10.1006/gyno.2002.6827
[8] Machtinger R, Gotlieb WH, Korach J, et al. Placental site trophoblastic tumor: outcome of five cases including fertility preserving management[J]. Gynecol Oncol, 2005, 96: 56-61. DOI: 10.1016/j.ygyno.2004.08.049
[9] Numnum TM, Kilgore LC, Conner MG, et al. Fertility sparing therapy in a patient with placental site trophoblastic tumor: a case report[J]. Gyecol Oncol, 2006, 103: 1141-1143. http://cn.bing.com/academic/profile?id=254c1367460a59fb8d13b4af25998def&encoded=0&v=paper_preview&mkt=zh-cn
[10] Liszka L, Wilk M, Wodolazski A, et al. Successful treatment of placental site trophoblastic tumor in twin pregnancy without hysterectomy[J]. Tumori, 2009, 95: 108-111. DOI: 10.1177/030089160909500120
[11] Peffer PE, Sebire N, Lindsay I, et al. Fertility-sparing partial hysterectomy for placental-site trophoblastic tumour[J]. Lancet Oncol, 2007, 8: 744-746. DOI: 10.1016/S1470-2045(07)70243-7
[12] Piura B, Rabinovich A, Meirovitz M, et al. Placental site trophoblastic tumor: report of four cases and review of literature[J]. Int J Gynecol Cancer, 2007, 17: 258-262. DOI: 10.1111/j.1525-1438.2006.00774.x
[13] Ajithkumar TV, Abraham EK, Rejnishkumar R, et al. Placental site trophoblastic tumor[J]. Obstet Gynecol Surv, 2003, 58: 484-488. http://cn.bing.com/academic/profile?id=c229b2f155f71f9a6a072277deafd507&encoded=0&v=paper_preview&mkt=zh-cn
[14] Swisher E, Drescher CW. Metastatic placental site trophoblastic tumor: long-term remission in a patient treated with EMA/CO chemotherapy[J]. Gynecol Oncol, 1998, 68: 62-65. DOI: 10.1006/gyno.1997.4888
下载: 
计量
- 文章访问数: 315
- HTML全文浏览量: 101
- PDF下载量: 15
