McKendrick J J, Theaker J, Mead G M
CRC Wessex Regional Medical Oncology Unit, Southampton General Hospital, Hampshire, United Kingdom.
Cancer. 1991 Feb 1;67(3):684-9. doi: 10.1002/1097-0142(19910201)67:3<684::aid-cncr2820670326>3.0.co;2-7.
Most patients with disseminated nonseminomatous germ cell tumor (NSGCT) have an excellent prognosis with modern chemotherapy, although certain subgroups with a worse prognosis have been described. One such subgroup includes patients with high serum levels of the tumor marker, human chorionic gonadotropin (HCG). Sixteen patients of 104 treated for NSGCT at the CRC Wessex Medical Oncology Unit (Southampton, UK) presented with serum HCG greater than 25,000. Most of these patients exhibited features of the "choriocarcinoma syndrome" with bulky, rapidly progressive disease; frequent pulmonary, hepatic, and central nervous system complications; and a generally poorer response to standard NSGCT chemotherapy. Histologic identification of trophoblastic tumor was not made in all patients and is not essential for the diagnosis of the syndrome; indeed, closed biopsy may be contradicted in some circumstances because of the risk of hemorrhage. The NSGCT patients with poor prognosis, including patients with the choriocarcinoma syndrome, must be clearly identified in order to improve management and, eventually, cure rates.
大多数播散性非精原细胞瘤性生殖细胞肿瘤（NSGCT）患者通过现代化疗预后良好，不过已有报道某些亚组患者预后较差。其中一个亚组包括肿瘤标志物人绒毛膜促性腺激素（HCG）血清水平高的患者。在英国南安普敦的韦塞克斯郡癌症中心结直肠癌医学肿瘤学病房接受NSGCT治疗的104例患者中，有16例患者的血清HCG大于25,000。这些患者大多表现出“绒毛膜癌综合征”的特征，即疾病体积大、进展迅速；肺部、肝脏和中枢神经系统并发症频繁；对标准NSGCT化疗的反应总体较差。并非所有患者都进行了滋养层细胞瘤的组织学鉴定，且该鉴定对综合征的诊断并非必不可少；事实上，在某些情况下，由于出血风险，闭合活检可能是禁忌的。为了改善治疗管理并最终提高治愈率，必须明确识别预后较差的NSGCT患者，包括患有绒毛膜癌综合征的患者。
