Köhler Christhardt, Oppelt Peter, Favero Giovanni, Morgenstern Bernd, Runnebaum Ingo, Tsunoda Audrey, Schmittel Alexander, Schneider Achim, Mueller Michael, Marnitz Simone
Department of Advanced Gynecologic Surgery and Oncology, Asklepios Hospital Hamburg, Hamburg, Germany.
Department of Gynecology and Obstetrics, Women and Children Hospital Linz; and Medical Faculty of Johannes Kepler University Linz, Linz, Austria.
Am J Obstet Gynecol. 2015 Aug;213(2):206.e1-5. doi: 10.1016/j.ajog.2015.02.022. Epub 2015 Feb 27.
Cervical cancer is the most common solid cancer diagnosed in pregnancy. Platinum is an active drug in the treatment of patients with cervical cancer. In the second and third trimesters, platinum is used to prevent cancer progression until fetal maturity is reached. However, knowledge about the transplacental passage of platinum is very limited.
Between May 2008 and June 2014, platinum-based neoadjuvant chemotherapy was applied to 21 consecutive patients with cervical cancer diagnosed in their second trimester. At the time of delivery by cesarean delivery, synchronous samples from maternal blood, umbilical cord blood, and amniotic fluid were taken and analyzed for platinum concentrations.
The mean week of gestation at cancer diagnosis was 17 (13-23). On average 3 (range, 2-4) cycles of chemotherapy were applied. Cesarean deliveries were carried out between 30.4 and 36.5 weeks of gestation. Twenty-two healthy babies without renal, hepatic, auditory, or hematopoietic impairment were delivered. Platinum concentrations in umbilical cord blood and amniotic fluid were 23-65% and 11-42% of the maternal blood, respectively.
This series on in vivo measurement of platinum concentrations in the fetomaternal compartment observed that because of consistently lower platinum values in the fetoplacental unit, a placental filtration mechanism of platinum may be assumed.
宫颈癌是孕期最常见的实体癌。铂是治疗宫颈癌患者的一种有效药物。在妊娠中期和晚期，铂用于预防癌症进展直至胎儿成熟。然而，关于铂经胎盘转运的知识非常有限。
2008年5月至2014年6月期间，对21例在妊娠中期确诊的宫颈癌患者连续应用铂类新辅助化疗。剖宫产分娩时，采集母体血液、脐带血和羊水的同步样本，并分析铂浓度。
癌症诊断时的平均孕周为17（13 - 23）周。平均应用3（范围2 - 4）个化疗周期。剖宫产在妊娠30.4至36.5周之间进行。分娩出22名健康婴儿，无肾脏、肝脏、听觉或造血功能损害。脐带血和羊水中的铂浓度分别为母体血液的23% - 65%和11% - 42%。
该系列关于母胎体内铂浓度的体内测量观察到，由于胎盘 - 胎儿单位中的铂值持续较低，可能存在铂的胎盘过滤机制。
