Gestational choriocarcinoma.

General & diagnostic pathology Pub Date : 1997-11-01
R N Baergen
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Abstract

The malignant transformation of trophoblast is interesting to contemplate, as trophoblast normally behaves in a manner that is interpreted as indicative of malignancy. First of all, trophoblasts show "controlled invasion" at the placental site as part of the normal process of implantation. Secondly, it is estimated that 100,000 syncytiotrophoblastic cells are deported to the maternal circulation daily and these are commonly identified in the pulmonary circulation of pregnant women (38). These trophoblastic cells do not ordinarily produce disease and presumably are rejected by the mother, unlike true metastases. When trophoblastic malignancy does develop, however, the trophoblast continues to invade and grow without limit, eventually metastasizing and ultimately leading to death. Choriocarcinoma is, therefore, unique in that it represents a malignant transformation of a tissue that inherently has "invasive" and "metastatic" properties. It is also the only tumor which contains DNA foreign to the host, as it is derived from a conception which contains paternal genetic material. Thus, choriocarcinoma is a complex neoplasm, and to study it, one must study and understand graft rejection, immunologic mechanisms and a multitude of genetic concepts in addition to the mechanisms of invasion and metastasis.

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妊娠期绒毛膜癌。
滋养细胞的恶性转化是一种有趣的思考,因为滋养细胞的正常行为方式被解释为恶性肿瘤的指示。首先,作为正常着床过程的一部分,滋养细胞在胎盘部位表现出“有控制的侵袭”。其次,据估计,每天有100,000个合胞滋养细胞被排出到母体循环中,这些细胞通常存在于孕妇的肺循环中(38)。与真正的转移不同,这些滋养细胞通常不会产生疾病,可能会被母体排斥。然而,当滋养细胞恶性肿瘤发展时,滋养细胞继续侵袭并无限制地生长,最终转移并最终导致死亡。因此,绒毛膜癌的独特之处在于它代表了一种组织的恶性转化,其本质上具有“侵袭性”和“转移性”特征。它也是唯一一种含有宿主外来DNA的肿瘤,因为它来源于含有父系遗传物质的受孕。因此,绒毛膜癌是一种复杂的肿瘤,为了研究它,除了研究其侵袭和转移的机制外,还必须研究和理解移植物排斥反应、免疫机制和大量的遗传学概念。
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