CAJ | 학술논문

目的：探讨胎盘部位滋养细胞肿瘤患者的临床诊疗过程。方法选择2000年1月至2013年8月杭州师范大学附属医院妇产科收治的4例胎盘部位滋养细胞肿瘤患者临床资料进行研究。结果胎盘部位滋养细胞肿瘤发病率占同期滋养细胞疾病的2．0％。患者平均年龄30．5岁，其中3例前次妊娠为足月妊娠，距前次妊娠平均时间为12．8个月，诊断时血人绒毛膜促性腺激素（ hCG）平均54．3 IU／L。4例患者中3例采取子宫全切手术治疗，另1例在子宫全切后辅以EMA-CO 方案化疗1个疗程。4例患者均存活，随访至今无复发。结论胎盘部位滋养细胞肿瘤发病率低，多继发于足月妊娠，血hCG水平低，治疗首选子宫全切术，对于存在高危因素的患者应在手术基础上联合化疗。
목적：탐토태반부위자양세포종류환자적림상진료과정。방법선택2000년1월지2013년8월항주사범대학부속의원부산과수치적4례태반부위자양세포종류환자림상자료진행연구。결과태반부위자양세포종류발병솔점동기자양세포질병적2．0％。환자평균년령30．5세，기중3례전차임신위족월임신，거전차임신평균시간위12．8개월，진단시혈인융모막촉성선격소（ hCG）평균54．3 IU／L。4례환자중3례채취자궁전절수술치료，령1례재자궁전절후보이EMA-CO 방안화료1개료정。4례환자균존활，수방지금무복발。결론태반부위자양세포종류발병솔저，다계발우족월임신，혈hCG수평저，치료수선자궁전절술，대우존재고위인소적환자응재수술기출상연합화료。
Objective To investigate the clinical diagnosis and treatment of placental site trophoblastic tumor ( PSTT) .Methods Analysis was conducted on the clinical data of 4 patients with PSTT admitted in gynecology and obstetrics department of the Affiliated Hospital of Hangzhou Normal University during the period of January 2000 to August 2013.Results The incidence of PSTT accounted for 2.0% of gestational trophoblastic disease at the same period .The mean age of these 4 patients was 30.5 years old.Previous pregnancy was full term in 3 cases.The mean interval from previous pregnancy to the diagnosis was 12.8 months.The mean level of human chorionic gonadotropin ( hCG) was 53.4 IU/L.Three of four patients were cured by hysterectomy , and the other one was cured by hysterectomy and one course of EMA-CO chemotherapy.The 4 patients were alive up to now with no recurrence .Conclusion PSTT is rare, and most previous pregnancy is full term.The level of hCG is low .Hysterectomy is the primary choice of treatment .Chemotherapy should be given to the high-risk cases based on hysterectomy .