융모 종양에 관한 임상적 고찰

Abstract

[한글]

[영문]

This study was undertaken for the clinical analysis and evaluation on the women with trophobalstec tumors who were admitted and treated at the Yonsei University Medical Center from Jan. 1, 1961 to June 30, 1972.

A total of 187 cases were seen with the following distribution; Hydatidiform mole 94, Chorioadenoma destruens 17, and choriocarcinoma 76. The following features were the results of this study.

1. Hydatidiform mole occurred approximately once in every 186 pregnancies and 161 deliveries, chorieadenoma destruens once in every 1028 pregnacies and 889 deliveries, choriocarcinoma once in every 230 pregnancies and 199 deliveries, respectively.

2. While the rate of normal intrauterine pregnancy declines markedly after the age of 40, the occurrence of the trophoblastic tumor after this age bicame remarkably increased. It was note worthy that the incidence of choriocarcinoma increased in proportion to the gravidity.

3. Among the patients with choriocarcinoma, 71 per cent of patient had lung metastasis, 21 per cent vagina, 8 percent brain, and 4 per cent G-I tract.

4. In cases of choriocarcinoma, 33 per cent of cases occur after hydatidiform mole, 30 per cent term pregnancies, 30 per cent after abortion.

5. Forty seven per cent of the patient with hydatidiform more were managed by D & E, hysterectomy was dome in 41 per cent of the patient with chorioadenoma destruens, and 53 per cent of the patient with choriocarcinoma were manage by chemotherapy with Methotrexate alone or Methotrexate and Actinomycin-D.

6. In the patient with chorioadenoma destruens, remission rat was 76 per cent. In patients with choriocarcinoma, remission rate was51 per cent, mortality rate was 26 per cent and recurrence rate was 12 per cent respectively. In the cases of choriocarcinoma the earlier the treatment, the better the result. Among the patient with remission after chemotherapy. most of them had at least 3 kurs of therpapy, and the patient with multiple metastasis showed very poor remission rate compared with those without metas.