Feng Xuan, Wei Zhi, Zhang Sai, Du Yan, Zhao Hongbo
Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.
Front Oncol. 2019 Nov 28;9:937. doi: 10.3389/fonc.2019.00937. eCollection 2019.
Placental site trophoblastic tumor (PSTT) is a rare type of gestational trophoblastic disease originating from the intermediate trophoblast. Compared with hydatidiform mole, invasive hydatidiform mole and choriocarcinoma, the diagnosis of PSTT is more complicated and lacks specific and sensitive tumor markers. Most PSTT patients demonstrate malignant potential, and the primary treatment of PSTT is hysterectomy. However, metastasis occasionally occurs and even causes death in a small number of PSTT patients. Most PSTT patients are young women hence fertility preservation is an important consideration. The major obstacle for PSTT patient prognosis is chemotherapy resistance. However, the current understanding of the pathogenesis of PSTT and clinical treatment remains elusive. In this review, we summarized the research progress of PSTT in recent years from three aspects: mechanism, clinical presentation, and treatment and prognosis. Well-conducted multi-center studies with sufficient sample sizes are of great importance to better examine the pathological progress and evaluate the prognosis of PSTT patients, so as to develop prevention and early detection programs, as well as novel treatment strategies, and finally improve prognosis for PSTT patients.
胎盘部位滋养细胞肿瘤(PSTT)是一种罕见的妊娠滋养细胞疾病,起源于中间型滋养细胞。与葡萄胎、侵蚀性葡萄胎和绒毛膜癌相比,PSTT的诊断更为复杂,且缺乏特异性和敏感性高的肿瘤标志物。大多数PSTT患者具有恶性潜能,PSTT的主要治疗方法是子宫切除术。然而,少数PSTT患者偶尔会发生转移甚至导致死亡。大多数PSTT患者为年轻女性,因此保留生育功能是一个重要的考虑因素。PSTT患者预后的主要障碍是化疗耐药。然而,目前对PSTT发病机制和临床治疗的认识仍不清楚。在这篇综述中,我们从机制、临床表现、治疗及预后三个方面总结了近年来PSTT的研究进展。开展样本量充足的多中心研究对于更好地研究PSTT的病理进展、评估患者预后、制定预防和早期检测方案以及新的治疗策略、最终改善PSTT患者的预后具有重要意义。