妇科癌症与妊娠共存——文献综述

Anna Skrzypczyk-Ostaszewicz, M. Rubach
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引用次数: 17

摘要

恶性肿瘤和怀孕并存是两种完全矛盾的哲学和生物学现象同时发生的状态——新生命的发展和危及生命的绝症。最后,一名医生——实际上是整个医生团队——正面临着为两个生命而战:母亲和她未出生的孩子。妊娠期恶性疾病的发生率为0.05 ~ 0.1%。这种情况对医生来说是一个重大挑战,因为没有随机研究可以作为选择治疗方法的基础——医学知识仅仅来自病例报告、登记和观察性研究。下列癌症最常与妊娠共存:妇科肿瘤(尤其是宫颈癌和卵巢癌)、乳腺癌、淋巴系统肿瘤和黑色素瘤。以前,诊断显然是堕胎的必要性。今天,尽管不熟练的医生仍然提出了唯一的治疗选择,但终止妊娠并不是唯一的解决方案。在过去的几年中,有关癌症孕妇管理的报告和指南不断更新。本文对这些出版物中的相关信息进行了回顾和总结。
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Gynaecological cancers coexisting with pregnancy – a literature review
The coexistence of malignant tumour and pregnancy is a state of simultaneous occurrence of two completely contradictory philosophical and biological phenomena – the development of a new life and a life-threatening terminal illness. Finally, a physician – in fact the whole team of doctors – is facing the fight for two lives: of the mother and her unborn child. The incidence of malignant disease in pregnancy is 0.05 to 0.1%. This condition is a major challenge for physicians because there are no randomised studies that could be the basis to choose the therapeutic methods – the medical knowledge merely comes from case reports, registries, and observational studies. The following cancers most often coexist with pregnancy: gynaecological neoplasm (especially cervical and ovarian cancer), breast cancer, lymphatic system neoplasm, and melanoma. Formerly, the diagnosis was clearly the necessity of abortion. Today – although unskilled doctors still propose the only therapeutic option – termination of pregnancy is not the only solution. The past few years have seen the updating of reports and guidelines for the management of pregnant women with cancer. This paper is a review and summary of the information from these publications.
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