妇科常见恶性肿瘤保留生育功能的研究进展

doi:10.12280/gjfckx.20210573

摘要/Abstract

摘要：

妇科常见的恶性肿瘤包括宫颈癌、子宫内膜癌和卵巢癌,虽在治疗上已取得很多进展,但常规的治疗手段多涉及子宫切除。对于仍有妊娠需求的女性,需要在保证安全的前提下,最大程度地满足患者的生育需求。现阶段对于保留生育功能的治疗方式已有很多研究,出现了较多新的方法和手段,在疾病评估上也愈加完善。宫颈癌早期可选择宫颈锥切术、单纯宫颈切除术和根治性宫颈切除术;子宫内膜癌保留生育功能治疗非标准治疗,在严格筛选下可有激素治疗或联合先行宫腔镜下病灶切除术;卵巢癌中的早期低风险患者可选择保留生育功能的患侧附件切除或肿瘤剔除术。综述常见妇科恶性肿瘤保留生育功能治疗的适应证、治疗方式、治疗效果和存在问题等,以期为临床治疗提供思路和帮助。

关键词: 保留生育能力, 宫颈肿瘤, 子宫内膜肿瘤, 卵巢肿瘤, 预后

Abstract:

Common malignant tumors in gynecology include cervical cancer, endometrial cancer and ovarian cancer. Although many advances have been made in treatment, conventional treatments mostly involve hysterectomy. For women who still need pregnancy, it is necessary to meet the patient′s fertility needs to the greatest extent under the premise of ensuring safety. There have been many researches on preserving fertility, and more new methods have emerged, and disease assessment has become more and more perfect. Cervical conization, simple trachelectomy and radical trachelectomy can be selected for early cervical cancer. Fertility-sparing treatment for endometrial cancer isn′t the standard treatment, and hormone therapy or combined with hysteroscopic lesion resection can be given under strict selection. Early low-risk patients with ovarian cancer can choose to preserve the fertility of the affected side appendage resection or tumor rejection. This article intends to summarize and analyze the indications, treatment methods, treatment effects, and existing problems of common gynecological malignant tumors with fertility preservation treatment, hoping to provide ideas and help for clinical treatment.

Key words: Fertility preservation, Uterine cervical neoplasms, Endometrial neoplasms, Ovarian neoplasms, Prognosis

李承尧, 李圃. 妇科常见恶性肿瘤保留生育功能的研究进展[J]. 国际妇产科学杂志, 2022, 49(2): 196-201.

LI Cheng-yao, LI Pu. Research Progress of Common Gynecological Malignant Tumors to Preserve Fertility[J]. Journal of International Obstetrics and Gynecology, 2022, 49(2): 196-201.

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