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妊娠合并肺癌 3 例并文献复习

Three cases of lung cancer in pregnancy and literature review.

机构信息

Department of Gynecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2020 Jul;9(4):1928-1936. doi: 10.21037/apm-20-999. Epub 2020 Jul 9.

Abstract

BACKGROUND

The incidence of tumors during pregnancy is 1ntscomprising 0.07-0.1% of all malignant tumors. Lung cancer during pregnancy is rare, but it is the second leading cause of cancer-attributed mortality in women of childbearing age. This article reports 3 cases of lung cancer in pregnant women and reviews the relevant literature, to explore the diagnosis, treatment, and prognosis of women with lung cancer during pregnancy.

METHODS

The clinical and pathological data of 3 pregnant women with lung cancer who were treated at our hospital were retrospectively analyzed, and the relevant literature was reviewed.

RESULTS

The three patients with lung cancer during pregnancy were all under 40 years old, and the gestational weeks of diagnosis were 20, 22 and 36 weeks, respectively. Two of the women were clinical stage IV and 1 was clinical stage III, all of which constitute advanced lung cancer. Pathological types are adenocarcinoma, small cell neuroendocrine carcinoma, and adenocarcinoma with neuroendocrine carcinoma respectively. Two patients were diagnosed during the second trimester and had mid-term induction of labor. After lung cancer surgery in other hospitals, they were died at 4 and 7 months after diagnosis. The remaining patient, who was diagnosed at 36 gestational week underwent cesarean section at 37 weeks. The patient received chemoradiotherapy, and was still alive at 19 months postpartum follow-up.

CONCLUSIONS

Lung cancer during pregnancy is rare in clinic. For those who repeatedly experience respiratory symptoms during pregnancy, imaging examinations should be performed promptly, and biopsies should be taken if necessary to obtain early diagnosis. Pregnancy with lung cancer carries high risk and has a poor overall prognosis. Platinum-based combination chemotherapy is safe in the second and third trimesters.

摘要

背景

妊娠期肿瘤的发病率为 1/10000,占所有恶性肿瘤的 0.07-0.1%。妊娠期肺癌少见,但它是育龄妇女癌症相关死亡的第二大原因。本文报道了 3 例妊娠期肺癌病例,并复习相关文献,探讨妊娠期女性肺癌的诊断、治疗及预后。

方法

回顾性分析我院收治的 3 例妊娠期肺癌患者的临床和病理资料,并复习相关文献。

结果

3 例妊娠期肺癌患者均小于 40 岁,诊断时孕周分别为 20、22 和 36 周。2 例为临床Ⅳ期,1 例为临床Ⅲ期,均为晚期肺癌。病理类型分别为腺癌、小细胞神经内分泌癌和腺癌伴神经内分泌癌。2 例患者在孕中期诊断,行中期引产,在其他医院行肺癌手术后分别于诊断后 4 个月和 7 个月死亡。另 1 例患者在孕 36 周诊断,孕 37 周行剖宫产术。该患者接受了放化疗,在产后 19 个月随访时仍存活。

结论

妊娠期肺癌临床罕见。对于那些在妊娠期反复出现呼吸系统症状的患者,应及时进行影像学检查,如果需要,应进行活检以获得早期诊断。妊娠期肺癌风险高,总体预后差。铂类联合化疗在妊娠中晚期是安全的。

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