妊娠期宫颈原位腺癌的管理。
Management of cervical adenocarcinoma in situ during pregnancy.
作者信息
Lacour Robin A, Garner Elizabeth I O, Molpus Kelly L, Ashfaq Raheela, Schorge John O
机构信息
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75390-9032, USA.
出版信息
Am J Obstet Gynecol. 2005 May;192(5):1449-51. doi: 10.1016/j.ajog.2004.12.079.
OBJECTIVE
Adenocarcinoma in situ (AIS) is a precursor of invasive disease that is being more frequently diagnosed during the reproductive years. Few reports have described the treatment of this condition in gravid women. The purpose of this study was to review our collective experience managing cervical AIS during pregnancy.
STUDY DESIGN
Retrospective medical record review of all women diagnosed with AIS during pregnancy from 1995 to 2004 at 3 academic institutions.
RESULTS
Eleven women with a median age of 32 years were identified. Five who received a diagnosis in the early second trimester underwent uncomplicated cold knife conization (CKC) at 14 to 19 weeks' gestation. Six patients underwent postpartum CKC. All 11 women delivered at term. One patient undergoing postpartum CKC required radical hysterectomy for stage IB1 cervical adenocarcinoma. Four subsequent pregnancies occurred among patients having fertility-sparing surgery.
CONCLUSION
Management of cervical AIS during pregnancy by early second trimester CKC is safe for mother and fetus.
目的
原位腺癌（AIS）是浸润性疾病的前驱病变，在育龄期诊断更为频繁。很少有报告描述妊娠女性中这种疾病的治疗情况。本研究的目的是回顾我们在孕期管理宫颈原位腺癌的总体经验。
研究设计
对1995年至2004年期间在3家学术机构诊断为孕期原位腺癌的所有女性进行回顾性病历审查。
结果
确定了11名女性，中位年龄为32岁。5名在孕中期早期确诊的患者在妊娠14至19周时接受了无并发症的冷刀锥切术（CKC）。6名患者在产后接受了冷刀锥切术。所有11名女性均足月分娩。1名接受产后冷刀锥切术的患者因IB1期宫颈腺癌需要行根治性子宫切除术。保留生育功能手术的患者中有4例随后怀孕。
结论
孕中期早期行冷刀锥切术治疗孕期宫颈原位腺癌对母亲和胎儿是安全的。
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