切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2016, Vol. 05 ›› Issue (04) : 249 -253. doi: 10.3877/cma.j.issn.2095-3259.2016.04.013

所属专题: 经典病例 文献

论著

妊娠合并恶性肿瘤14例临床分析
周燕媚1, 陈敦金1,()   
  1. 1. 510150 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心
  • 收稿日期:2016-05-05 出版日期:2016-11-18
  • 通信作者: 陈敦金
  • 基金资助:
    广州市教育局协同创新重大项目(13xt04); 广州市科技惠民专项项目(2014Y2-00182); 产科重大疾病防控创新团队(2015KCXTD020)

Clinical analysis of 14 pregnant women with malignancy

Yanmei Zhou1, Dunjin Chen1,()   

  1. 1. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2016-05-05 Published:2016-11-18
  • Corresponding author: Dunjin Chen
  • About author:
    Corresponding author: Chen Dunjin, Email:
引用本文:

周燕媚, 陈敦金. 妊娠合并恶性肿瘤14例临床分析[J]. 中华产科急救电子杂志, 2016, 05(04): 249-253.

Yanmei Zhou, Dunjin Chen. Clinical analysis of 14 pregnant women with malignancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2016, 05(04): 249-253.

目的

探讨妊娠合并恶性肿瘤患者的临床特点及母儿结局。

方法

收集2009年10月至2015年12月就诊于广州医科大学附属第三医院妇产科的14例妊娠合并恶性肿瘤患者的临床资料,对患者的临床特点、孕期治疗、妊娠结局及预后进行分析。

结果

14例妊娠合并恶性肿瘤患者的肿瘤类型分别为血液系统恶性肿瘤(8例)、乳腺癌(4例)和宫颈癌(2例)。足月分娩者有5例,早产6例,1例早期人工流产,1例中孕期引产,1例孕期死亡。共分娩新生儿11例,2例乳腺癌患者于孕期接受抗癌治疗,2例新生儿为足月儿;10例患者孕期选择期待治疗,9例患者的新生儿存活,包括3例足月儿和6例早产儿。

结论

妊娠合并恶性肿瘤可导致严重的不良妊娠结局,根据病情孕期应进行合理的抗癌治疗可改善患者结局。

Objective

To investigate the clinical characteristics and the maternal-fetal outcome of pregnancy with malignancy.

Methods

A retrospective study was conducted in 14 pregnant women with malignancy. The patients were admitted to the The Third Affiliated Hospital of Guangzhou Medical University from September 2009 to December 2015. Clinical characteristics, treatment during pregnancy, pregnancy outcome and prognosis of the patients were analyzed.

Results

Among the 14 cases, 8 patients were hematologic malignancies, 4 patients were breast cancer and 2 patients were cervical cancer. As a result, 5 cases were full-term neonates, 6 cases exposed preterm birth, 1 patient performed induced abortion during the first trimester of pregnancy, 1 patient underwent labor induction during the second trimester of pregnancy, and 1patient died during pregnancy. There were 11 newborns. Two breast cancer patients received anticancer treatment, and they delivered babies at term. Ten patients chose expectant management during pregnancy and 9 neonates were born, including 3 full-term neonates and 6 preterm birth.

Conclusion

Pregnant women with malignancy can result in serious adverse pregnancy outcomes. The outcomes can be improved if reasonable anticancer treatment were performed according to the gestation.

表1 14例妊娠合并恶性肿瘤患者的临床特点、孕期治疗和结局
例序 年龄(岁) 恶性肿瘤类型及病情 诊断时间 抗癌治疗方案 分娩方式 妊娠结局 患者结局 新生儿结局
1 30 乳癌根治术及化疗后复发并感染 孕31周诊断癌症复发 产后治疗 剖宫产 早产 存活 低出生体重儿,新生儿黄疸
2 27 右乳腺癌根治术及化疗后复发并远处转移 孕16周诊断癌症复发 产后治疗 顺产 早产 存活 低出生体重儿,新生儿黄疸,心肌损害
3 31 左乳腺癌 12 于孕20周行手术治疗和化疗 剖宫产 足月分娩 存活 先心病:卵圆孔未闭,新生儿黄疸,心肌损害
4 32 左侧乳腺浸润癌 28 于孕28周行左乳腺癌切除术 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
5 31 宫颈癌 31 产后治疗 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
6 27 宫颈癌 产后1个月 产后治疗 剖宫产 早产 存活 新生儿感染,黄疸,动脉导管未闭,胃肠功能紊乱,贫血
7 29 急性白血病 33 产后治疗 剖宫产 早产 存活 心肌损害,黄疸
8 26 急性白血病 28 产后治疗 剖宫产 早产 存活 新生儿呼吸窘迫综合征,感染,心肌损害,混合性酸中毒,贫血,黄疸
9 25 急性白血病 31 产后治疗 剖宫产 早产 产后1年内死亡 新生儿呼吸窘迫综合征,暂时性凝血功能障碍,寒冷损伤综合征,黄疸
10 31 慢性白血病 28 产后治疗 顺产 足月分娩 存活 存活,未发现新生儿并发症
11 34 慢性白血病 38 产后治疗 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
12 28 急性白血病 8 化疗 人工流产 存活 不存活
13 29 急性白血病 18周 化疗 引产 存活 不存活
14 35 急性白血病 14 期待治疗 孕22周死亡 不存活
[1]
Pavlidis N. Cancer and pregnancy: what should we know about the management with systemic treatment of pregnant women with cancer? [J]. Eur J Cancer, 2011, 47(3):S348-S352.
[2]
Lee YY, Roberts CL, Dobbins T, et al. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study [J]. BJOG, 2012, 119(13):1572-1582.
[3]
Pavlidis NA. Coexistence of pregnancy and malignancy [J]. Oncologist, 2002, 7(4):279-287.
[4]
Stensheim H, Møller B, van Dijk T, et al. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study [J]. J Clin Oncol, 2009, 27(1):45-51.
[5]
Lee YY, Roberts CL, Young J, et al. Using hospital discharge data to identify incident pregnancy-associated cancers: a validation study [J]. BMC Pregnancy and Childbirth, 2013, 13(1):37.
[6]
Plante M, Renaud MC, Francois H, et al. Vaginal radical trachelectomy: an on cologically safe ferility-preserving surgery. An updated series of 72 cases and review of literature[J]. Gynecol Oncol, 2004, 94(3):614-623.
[7]
Kizer NT, Powell MA. Surgery in the pregnant patient [J]. Clin Obstet Gynecol, 2011, 54(4):633-641.
[8]
Cardonick E, Dougherty R, Grana G, et al. Breast cancer during pregnancy: Maternal and fetal outcomes [J]. Cancer J, 2010, 16(1):76-82.
[9]
Mazonakis M, Varveris H, Damilakis J, et al. Radiation dose to conceptus resulting from tangential breast irradiation [J]. Int J Radiat Oncol Biol Phys, 2003, 55(2):386-391.
[10]
Doll DC, Ringenberg QS, Yarbro JW. Antineoplastic agents and pregnancy [J]. Semin Oncol, 1989, 16:337-346.
[11]
Mir O, Berveiller P, Rouzier R, et al. Chemotherapy for breast cancer during pregnancy: Is epirubicin safe? [J]. Ann Oncol, 2008, 19(10):1814-1815.
[12]
Zagouri F, Sergentanis TN, Chrysikos D, et al. Platinum derivatives during pregnancy in cervical cancer: a systematic review and meta-analysis [J]. Obstet Gynecol, 2013, 121(2):337-343.
[13]
Amant F, Loibl S, Neven P, et al. Breast cancer in pregnancy [J]. Lancet, 2012, 379(9815):570-579.
[14]
Cai WB, Zhang Y, Cheng R, et al. Dual inhibition of plasminogen kringle 5 on angiogenesis and chemotaxis suppresses tumor metastasis by targeting HIF-1a pathway [J]. PLoS One, 2012, 7(12):e53152.
[15]
Zoccarato G, Romagnolo C, Ghiotto C, et al. High frequency of premature births in concomitant pregnancy and cancer [J]. J Clin Oncol, 2010, 28:e12020.
[16]
Fruscio R, Villa A, Chiari S, et al. Delivery delay with neoadjuvant chemotherapy for cervical cancer patients during pregnancy: a series of nine cases and literature review [J]. Gynecol Oncol, 2012, 126(2):192-197.
[17]
Ali SA, Gupta S, Sehgal R, et al. Survival outcomes in pregnancy associated breast cancer: a retrospective case control study [J]. Breast J, 2012, 18(2):139-144.
[18]
Tretli S, Kvalheim G, Thoresen S, et al. Survival of breast cancer patients diagnosed during pregnancy or lactation [J]. Br J Cancer, 1988, 58:382-384.
[1] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[2] 居晓庆, 金蕴洁, 王晓燕. 剖宫产术后瘢痕子宫患者再次妊娠阴道分娩发生子宫破裂的影响因素分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 575-581.
[3] 陈甜甜, 王晓东, 余海燕. 双胎妊娠合并Gitelman综合征孕妇的妊娠结局及文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 559-568.
[4] 杨皓媛, 龚杰, 邹青伟, 阮航. 哮喘孕妇的母婴不良妊娠结局研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 522-529.
[5] 周梦玲, 薛志伟, 周淑. 妊娠合并子宫肌瘤的孕期变化及其与不良妊娠结局的关系[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 611-615.
[6] 陈莉, 雷雪芹, 段炼, 曾悦, 何国琳. 影响2次剖宫产术后阴道试产产妇试产成功因素及妊娠结局分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 287-294.
[7] 陈樱, 陈艳莉. 高龄孕妇心率变异性原因及围产结局分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 295-301.
[8] 冯丹艳, 曹晓辉, 史玉霞. 血清脂联素与胎盘亮氨酸氨肽酶对妊娠期糖尿病患者妊娠结局的影响[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 302-308.
[9] 任国华, 杜晓晓, 洪善玲, 邵帅. 妊娠期高血压并发急性肾损伤患者血清白细胞介素-22、硫化氢及护骨素水平的变化与意义[J]. 中华肾病研究电子杂志, 2023, 12(03): 150-155.
[10] 张郁妍, 胡滨, 张伟红, 徐楣, 朱慧, 羊馨玥, 刘海玲. 妊娠中期心血管超声参数与肝功能的相关性及对不良妊娠结局的预测价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 499-504.
[11] 王欣, 刘琳, 闻哲嘉, 刘春玲, 张弘, 吕芳. 妊娠前应激暴露对小鼠后续妊娠的影响[J]. 中华临床医师杂志(电子版), 2023, 17(04): 431-437.
[12] 吴晓翔, 杨波, 李景漩, 张凤玲, 郭桂辉, 郑少培. 脐动脉超声检查联合NLR、sFlt-1/PLGF对妊娠高血压综合征患者不良妊娠结局的预测价值[J]. 中华临床医师杂志(电子版), 2023, 17(03): 266-271.
[13] 张丽姿, 陈敦金. 胎盘植入性疾病的不良结局及远期影响[J]. 中华产科急救电子杂志, 2023, 12(03): 155-158.
[14] 郑晓芳, 魏宋荃, 黄真轩, 吴文诗, 李桂民, 张红霞, 江庆萍, 陈敦金, 余琳. 子痫前期合并胎儿生长受限的妊娠结局及胎盘病理改变的研究[J]. 中华产科急救电子杂志, 2023, 12(02): 85-92.
[15] 李群颖, 郑丽婷, 于燕. 妇科手术史患者妊娠期子宫破裂临床研究[J]. 中华产科急救电子杂志, 2023, 12(02): 98-102.
阅读次数
全文


摘要