【摘要】 目的分析滋养细胞肿瘤误诊异位妊娠患者的临床、病理特征,探讨误诊原因及诊疗策略。方法对滋养细胞肿瘤误诊为异位妊娠并经病理检查证实的7例患者的临床特点及病理资料进行回顾性分析。结果7例患者中侵蚀性葡萄胎2例,绒毛膜细胞癌5例,临床特点均表现为停经史、下腹痛和(或)异常阴道出血,血人绒毛膜促性腺激素β亚基(β-HCG)峰值为863.7~62655.00U/L,病灶位于宫角、输卵管、卵巢、阔韧带及宫颈等。结论异常的血β-HCG水平及特殊的病灶部位是本病的主要特征,低水平人绒毛膜促性腺激素(HCG)更易导致误诊,应予以重视;结合病史、体征、动态血HCG测定及影像学检查等综合考虑,才能获得本病的正确诊断。更多还原

【Abstract】 Objective To explore clinical-pathological features,misdiagnosis reasons and therapy strategy of gestational trophoblastic tumor(GTT) misdiagnosed as ectopic pregnancy.Methods The clinical datas of 7 cases with GTT misdiagnosed as ectopic pregnancy from 1995 to 2005 in the First Affiliated Hospital of Shantou University were analyzed retrospectively.Results Of the 7 cases,2 cases were invasive mole and 5 cases were choriocarcinoma.The main symptoms were cessation of menstruation,abdominal pain and abnormal vaginal bleeding.Serum β-HCG peak values were from 863.7～62655.00U/L.The lesions were cornua uteri,fallopian tube,ovary,round ligament and cervix uteri.Conclusion Lower-level β-HCG lead GTT to be misdiagnosed as ectopic pregnancy easily.The diagnosis of GTT should be made correctly in accordance with considering all diagnostic procedures,such as clinical history and examination,dynamic serum β-HCG assay and image examination,so as to avoid the misdiagnosis.更多还原