Driscoll S G
Hum Pathol. 1977 Sep;8(5):529-39. doi: 10.1016/s0046-8177(77)80113-5.
Abnormal trophoblastic proliferation is the hallmark of a spectrum of lesions constituting the gestational trophoblastic neoplasms. Rapid proliferation, infiltration, vascular invasion, hematogenous dissemination, and spontaneous regression are features of both normal and neoplastic trophoblast. Trophoblastic hyperplasia without hydrops, hydatidiform mole, invasive mole, and gestational choriocarcinoma are related lesions, characterized by increasingly aberrant trophoblastic growth and worsening prognosis, if untreated. Difficulties in diagnosis may arise with respect to the normal early implantation site, the hydropic abortus, and postgestational, involuting, residual trophoblast. Histologic grading or hydatidiform moles is relevant to their prognosis and biologic behavior. Trophoblastic neoplasia may begin at any stage of pregnancy or puerperally with immediate or late and local or distant manifestations in the mother or the child. Cognizance of the capricius potential behavior of trophoblast permits successful management of its proliferative lesions, monitored by serial measurement of gonadotropin secretion.
异常的滋养层细胞增殖是构成妊娠滋养层细胞肿瘤的一系列病变的标志。快速增殖、浸润、血管侵犯、血行播散和自发消退是正常和肿瘤性滋养层细胞的特征。无水疱性滋养层细胞增生、葡萄胎、侵蚀性葡萄胎和妊娠绒毛膜癌是相关病变，其特征是滋养层细胞生长越来越异常，若不治疗，预后越来越差。对于正常的早期着床部位、水肿性流产以及产后退化的残留滋养层细胞，诊断可能会有困难。葡萄胎的组织学分级与其预后和生物学行为相关。滋养层细胞肿瘤可在妊娠的任何阶段或产后发生，在母亲或孩子身上出现即刻或延迟的局部或远处表现。认识到滋养层细胞反复无常的潜在行为，通过连续测定促性腺激素分泌进行监测，有助于成功处理其增殖性病变。
