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本文综述20多年来在滋养叶肿瘤(GTN)自然病史及病生理方面研究所得之主要进展,讨论新的分期法并提出诊断处理最合理的方案。资料来源于新英格兰滋养叶疾病中心(NETDC)14年中,1,510例的诊治经验。其中葡萄胎1,001例;除外临床或随访不适当的183例;在其余326例GTN中无转移198例(61%),有转移128例(39%)。326例经治疗后缓解者308例(94%),死亡者18例(6%)。一、自然病史 GTN最常发生于葡萄胎后,亦偶见于足月产、流产或子宫外孕以后。继发于葡萄胎者含有葡萄胎或绒癌(CCA)组织,继发
This review summarizes the major advances in the study of natural and pathophysiological aspects of trophoblastic tumor (GTN) over the past 20 years, discusses new staging methods and proposes the most rational protocol for diagnosis and treatment. Data from the New England Trophoblast Disease Center (NETDC) 14 years, 1,510 cases of diagnosis and treatment experience. Among them, there were 1,001 hydatidiform moles in 183 cases, except for clinical or unsuitable follow-up; 198 cases (61%) had no metastasis in the other 326 GTN cases and 128 cases (39%) had metastasis. Thirty-six (326%) of the 326 patients who had been treated had a response rate of 308 (94%) and 18 died (6%). First, the natural history of GTN occurs most commonly in hydatidiform mole, also occasionally in full-term, abortion or after ectopic pregnancy. Secondary to hydatidiform mole containing hydatidiform mole or choriocarcinoma (CCA) tissue, secondary