Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
Abdom Radiol (NY). 2023 May;48(5):1605-1611. doi: 10.1007/s00261-023-03809-0. Epub 2023 Jan 27.
Pregnancy-associated cancer (PAC) occurs in approximately 1 in 1000 pregnancies, and the incidence is expected to rise due to delayed childbearing (Silverstein et al. in JCO Oncol Pract 16:545-557, 2020; Woitek et al. in ESMO Open 1:e000017, 2016). Diagnosis and management of PACs are challenging and diagnosis is often delayed as symptoms may overlap with physiologic changes of pregnancy (Jha et al. in RadioGraphics 42:220005, 2022). These patients are best cared for by a multidisciplinary healthcare team composed of experts (Silverstein et al. in JCO Oncol Pract 16:545-557, 2020). Management of these patients must balance optimal maternal care with potentially harmful fetal effects. This involves honest, forthright, and sometimes difficult discussions between the care team and the patient throughout the entirety of care. Radiologists play a significant role in timely cancer diagnosis, staging and follow-up during and after pregnancy, accurate determination of gestational age, and in assessing fetal growth and well-being throughout pregnancy.
妊娠相关癌症(PAC)在大约每 1000 次妊娠中发生 1 次,由于生育年龄推迟,其发病率预计将会上升(Silverstein 等人,在 JCO Oncol Pract 16:545-557,2020;Woitek 等人,在 ESMO Open 1:e000017,2016)。PAC 的诊断和管理具有挑战性,且诊断往往被延误,因为症状可能与妊娠的生理变化相重叠(Jha 等人,在 RadioGraphics 42:220005,2022)。这些患者最好由多学科医疗团队的专家进行治疗(Silverstein 等人,在 JCO Oncol Pract 16:545-557,2020)。这些患者的管理必须在最佳的母婴护理与胎儿潜在有害影响之间取得平衡。这需要护理团队与患者在整个护理过程中进行坦诚、直率,有时甚至是困难的讨论。放射科医生在妊娠期间和妊娠后及时进行癌症诊断、分期和随访、准确确定胎龄以及评估胎儿生长和健康方面发挥着重要作用。