Intermediate trophoblastic tumor: the clinical analysis of 62 cases and prognostic factors
Intermediate trophoblastic tumor: the clinical analysis of 62 cases and prognostic factors
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DOI：
10.1007/s00404-018-05037-0
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发表时间：
2019-05-01
影响因子：
2.6
通讯作者：
Zhang, Yumin
中科院分区：
文献类型：
--
作者：
Zhang, Ying;Zhang, Shiqian;Zhang, Yumin
目的分析2005年1月至2016年12月山东大学齐鲁医院收治的12例中间型滋养细胞肿瘤（ITT）的临床特点。此外，从2010年1月至2016年12月期间的MEDLINE和CBM数据库中选择了50例病例。结果胎盘部位滋养细胞肿瘤（PSTT）42例，上皮样滋养细胞肿瘤（ETT）19例，混合型（PSTT + ETT）1例。PSTT与ETT在年龄、前孕类型、主诉、血清hCG峰值、FIGO分期及预后方面无显著性差异。但ETT组从怀孕到发病的时间较PSTT组长（P = 0.01）。FIGO分期与血清hCG水平无关（P = 0.263）。62例均行手术治疗，7例保留生育能力。15例有高危因素者未行辅助化疗。单因素分析结果显示，年龄<40岁、血清hCG峰值<1000IU/L、治疗不规范与患者生存率相关，而多因素分析结果显示，年龄对ITT患者生存率影响显著（P = 0.018）。血清-hCG不能反映ITT的进展。年龄40岁是ITT的独立高危因素。
PurposeThe aim is to analyze the clinical characteristics of intermediate trophoblastic tumor (ITT).Methods12 cases diagnosed at Qilu Hospital of Shandong University from January 2005 to December 2016 were investigated. Additionally, 50 cases were selected from MEDLINE and CBM databases between January 2010 and December 2016. The clinical data extracted from those aforementioned 62 cases were analyzed.ResultsThere were 42 cases with placental site trophoblastic tumor (PSTT), 19 cases with epithelioid trophoblastic tumor (ETT), and 1 case with mixed type (PSTT and ETT). No significant differences were found between PSTT and ETT in terms of age, type of antecedent pregnancy, main complaints, serum -hCG peak, FIGO stage or prognosis. However, the interval between antecedent pregnancy and the onset was longer in ETT than in PSTT (P=0.01). FIGO stage was irrelevant to serum -hCG (P=0.263). All 62 cases underwent surgeries and seven cases preserved fertility. Fifteen cases with high risk factors were not treated with adjuvant chemotherapy. Univariate analysis results showed that age 40years, serum -hCG peak 1000IU/L and nonstandard treatment were associated with poor survival, but only age remained significant on multivariate analysis for ITT (P=0.018).ConclusionPSTT and ETT have similar clinical characteristics generally. Serum -hCG can not reflect the progress of ITT. Age 40years is the independent high risk factor for ITT.