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黑色素瘤与妊娠

Melanoma and pregnancy.

作者信息

Driscoll M S, Grant-Kels J M

机构信息

Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

出版信息

G Ital Dermatol Venereol. 2008 Aug;143(4):251-7.

Abstract

Herein we analyze three important issues concerning melanoma and pregnancy: 1) While initial case reports and case series predicted a grim prognosis for the woman diagnosed with melanoma during pregnancy, we summarize more recent controlled studies that suggest that pregnancy has no effect on survival in women diagnosed with localized cutaneous melanoma. 2) We review the prognosis for the fetus when a woman is diagnosed with melanoma during pregnancy. While melanoma is the most common malignancy to metastasize to the placenta, metastatic melanoma to the fetus appears to be a rare event. 3) How do we answer questions about future pregnancies and hormonal therapy when counseling women who have been diagnosed with melanoma during pregnancy or the childbearing years? Will future pregnancies worsen prognosis? Based on limited data, pregnancies subsequent to a diagnosis of localized melanoma do not appear to impact prognosis. Are oral contraceptive pills or hormonal replacement therapy contraindicated in these women? Strong epidemiologic evidence suggests that exposure to oral contraceptive pills do not increase the risk for melanoma. Although only a small number of studies have addressed the risk of hormone replacement therapy, the reports demonstrate that this also does not appear to enhance the risk for developing melanoma.

摘要

在此,我们分析了有关黑色素瘤与妊娠的三个重要问题:1)虽然最初的病例报告和病例系列预测,孕期被诊断为黑色素瘤的女性预后不佳,但我们总结了更多近期的对照研究,这些研究表明,妊娠对被诊断为局限性皮肤黑色素瘤的女性的生存没有影响。2)我们回顾了女性在孕期被诊断为黑色素瘤时胎儿的预后情况。虽然黑色素瘤是最常见的转移至胎盘的恶性肿瘤,但黑色素瘤转移至胎儿似乎是罕见事件。3)当为孕期或育龄期被诊断为黑色素瘤的女性提供咨询时,我们如何回答有关未来妊娠和激素治疗的问题?未来妊娠会使预后恶化吗?基于有限的数据,诊断为局限性黑色素瘤后的妊娠似乎不会影响预后。这些女性禁用口服避孕药或激素替代疗法吗?有力的流行病学证据表明,服用口服避孕药不会增加患黑色素瘤的风险。虽然只有少数研究探讨了激素替代疗法的风险,但报告表明,这似乎也不会增加患黑色素瘤的风险。

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