Mizejewski Gerald J
Tumori. 2014 Nov-Dec;100(6):581-9. doi: 10.1700/1778.19254.
Cancer during pregnancy, referred to as gestational cancer (GC), is infrequent but can occur in 1.0% of pregnant women. Hepatocellular carcinoma (HCC) is often lethal and is the fifth most common cancer worldwide, while breast adenocarcinoma (breast cancer) is the most common cancer seen during pregnancy. Liver and breast carcinomas are two examples of cancer types that present challenges to the obstetrician due to late and/or delayed diagnosis during pregnancy. Delays in diagnosis limit choices available to physicians regarding surgery, radiation, and chemotherapy. In view of such clinical situations, a role for maternal serum and placental biomarker (MSPB) screening results contributing to cancer diagnosis should be recognized; overlooking such data in GC could result from a lack of knowledge and understanding of MSPB biology, chemistry, and physiology. In this report, obstetricians and perinatologists seeking a diagnosis are urged to take advantage of available results from MSPB screening programs obtained from first- and second-trimester patient data. Using liver and breast cancer as examples, the present review and commentary seeks to demonstrate that MSPB levels, profiles, patterns, and cellular responses could provide foundational data in planning invasive or noninvasive methods and procedures (biopsy, imaging, scans, surgery) to attain a diagnosis as soon as possible in pregnancy. Finally, MSPB epidemiological and cancer risk studies could aid in providing baseline information for decisions regarding GC diagnosis from knowledge of their proposed roles in reducing lifetime risk of malignancies such as breast cancer.
孕期癌症，称为妊娠期癌症（GC），虽不常见，但在1.0%的孕妇中可能发生。肝细胞癌（HCC）往往致命，是全球第五大常见癌症，而乳腺腺癌（乳腺癌）是孕期最常见的癌症。肝癌和乳腺癌是两种癌症类型的例子，由于孕期诊断延迟和/或延误，给产科医生带来了挑战。诊断延迟限制了医生在手术、放疗和化疗方面的选择。鉴于这种临床情况，应认识到母体血清和胎盘生物标志物（MSPB）筛查结果对癌症诊断的作用；在GC中忽视这些数据可能是由于对MSPB生物学、化学和生理学缺乏了解。在本报告中，敦促寻求诊断的产科医生和围产医学专家利用从孕早期和孕中期患者数据中获得的MSPB筛查项目的现有结果。以肝癌和乳腺癌为例，本综述和评论旨在表明，MSPB水平、概况、模式和细胞反应可为规划侵入性或非侵入性方法及程序（活检、成像、扫描、手术）提供基础数据，以便在孕期尽快获得诊断。最后，MSPB流行病学和癌症风险研究有助于从其在降低乳腺癌等恶性肿瘤终生风险方面的拟议作用的知识中，为GC诊断决策提供基线信息。
