Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis.
Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis.
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DOI：
10.1186/s12884-018-1678-4
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发表时间：
2018-02-08
影响因子：
3.1
通讯作者：
Ikeda T
中科院分区：
文献类型：
--
作者：
Sekine M;Kobayashi Y;Tabata T;Sudo T;Nishimura R;Matsuo K;Grubbs BH;Enomoto T;Ikeda T
怀孕期间的恶性肿瘤已成为发达国家孕产妇死亡的一个重要原因，这可能是由于怀孕人口年龄较大和年轻女性宫颈癌的增加所致。我们的目标是调查日本妊娠期间恶性肿瘤的临床情况，并利用这些信息来确定早期检测和治疗的机会。我们向日本 1508 家二级或三级医院提供了一份调查问卷。我们回顾了2008年1月至12月期间妊娠期恶性肿瘤病例的临床特征。从回复的760个机构中，我们获得了227个独特病例的临床信息。调查问卷提供了临床信息，包括疾病部位、妊娠结局以及疾病的检测方式。最常见的恶性肿瘤是宫颈癌（n = 162，71.4%），其次是卵巢癌（n = 16，7.0%）和乳腺癌（n = 15，6.6%）。白血病(n = 7, 3.1%)、结肠癌(n = 5, 2.2%)、胃癌(n = 5, 2.2%)、恶性淋巴瘤(n = 4, 1.8%)、甲状腺癌(n = 3, 1.3%)、脑癌(n = 3,其余病例分别为子宫内膜癌（n = 2，0.9%）、头颈癌（n = 2，0.9%）、子宫内膜癌（n = 2，0.9%）。总体而言，妇科恶性肿瘤占本研究中诊断的妊娠相关恶性肿瘤的 79.3%（95% 置信区间 74.0–84.6）。大多数宫颈癌（162 例中的 149 例 (92.0%)）是在妊娠早期通过巴氏涂片 (Papanicolaou) 诊断的。 10例（62.5%）卵巢癌病例是在产前检查或初次妊娠诊断时通过超声检查确诊的。在 14 种乳腺癌中，只有一种 (7.1%) 通过乳腺筛查确诊。从这项研究中，我们重申了从孕早期开始进行产前检查对于妊娠期间妇科癌症的检测具有明显而显着的益处。相反，怀孕期间乳腺癌的检测效果较差，这表明需要新的策略来早期识别这种疾病。
Malignancy during pregnancy has become a significant cause of maternal death in developed countries, likely due to both an older pregnant population, and increases of cervical cancer in younger women. Our aim is to investigate the clinical aspects of malignancy during pregnancy in Japan and to use this information to identify opportunities for earlier detection and treatment. We provided a questionnaire to 1508 secondary or tertiary care hospitals in Japan. We reviewed the clinical characteristics of cases with malignancy during pregnancy for the period of January to December, 2008. From the 760 institutions which responded, we obtained clinical information for 227 unique cases. The questionnaire provided clinical information, including disease site, pregnancy outcome and how the disease was detected. The most common type of malignancy was cervical cancer (n = 162, 71.4%) followed by ovarian (n = 16, 7.0%) and breast cancer (n = 15, 6.6%). Leukemia (n = 7, 3.1%), colon cancer (n = 5, 2.2%), gastric cancer (n = 5, 2.2%), malignant lymphoma (n = 4, 1.8%), thyroid cancer (n = 3, 1.3%), brain cancer (n = 3, 1.3%), endometrial cancer (n = 2, 0.9%), and head and neck cancer (n = 2, 0.9%) accounted for the remaining cases. Overall, gynecological malignancies accounted for 79.3% (95% confidence interval 74.0–84.6) of pregnancy associated malignancies diagnosed in the present study. The majority of cervical cancers, 149 (92.0%) of 162, were diagnosed by a Pap (Papanicolaou) smear during early gestation. Ten (62.5%) of the ovarian cancer cases were diagnosed by ultrasonography during a prenatal checkup or at the time of initial pregnancy diagnosis. Out of 14 breast cancers, only one (7.1%) was diagnosed by screening breast exam. From this study, we reaffirm the clear and significant benefits of prenatal checkups starting at an early gestational age for the detection of gynecological cancers during pregnancy. Conversely, breast cancer detection during pregnancy was poor, suggesting new strategies for early identification of this disease are required.
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影响因子：
45.3
作者：
Stensheim, Hanne;Moller, Bjorn;Fossa, Sophie D.
通讯作者：
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影响因子：
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