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2例妊娠相关乳腺癌患者的病例报道及相关文献复习
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| 篇名： | 2例妊娠相关乳腺癌患者的病例报道及相关文献复习 |
| TITLE： | Case Reports of Two Patients with Pregnancy-associated Breast Cancer and Related Literature Review |
| 摘要： | 目的：为妊娠相关乳腺癌（PABC）的早期诊断和治疗方案的选择提供参考。方法：对我院2例PABC患者的疾病特征、治疗过程和预后情况等进行分析；检索PubMed数据库中1986年1月－2019年4月发表的相关文献，纳入标题、关键词或摘要中包括“Breastcancerandpregnancy”“Pregnancy-associatedbreastcancer”“Breastcancerduringpregnancy”“Breastcarcinomaduringpreg-nancy”“Casereports”等的病例报告，排除不符合PABC定义的病例报告，对其中患者的基本资料、肿瘤临床特征、药物治疗方案、母胎/婴预后等信息进行汇总及描述性统计分析。结果与结论：我院2例患者均于哺乳期确诊，经新辅助化疗和手术切除后，预后良好。通过文献检索与筛选获得共36篇病例报告，共45例患者（39例患者在妊娠期间确诊，6例患者在哺乳期间确诊）的临床资料。排除未报道相关信息的病例后，35.0％（14/40）的病例应用了新辅助化疗AC方案（多柔比星+环磷酰胺）；59.5％（22/37）的病例进行了择期剖腹产手术，37.8％（14/37）的病例经阴道分娩，1例终止妊娠；患者存活率为80.8％（21/26），婴儿平均出生体质量为2407g（1015～3830g）。分别有6例和9例患者在妊娠期和产后使用了紫杉烷类药物。PABC化疗方案的确定应综合考虑多方因素，需要全面权衡母亲及婴儿的受益风险，尽量避免在妊娠早期进行化疗，尤其要兼顾化疗对胎儿的影响。化疗方案仍以蒽环类药物为主导，可在此基础上制订个体化方案，且使用紫杉醇类药物时应充分权衡利弊并进行严密监测。 |
| ABSTRACT： | OBJECTIVE：To provide reference for the early diagnosis and selection of treatment regimens of pregnancy- associated breast cancer （PABC）. METHODS ：The disease characteristics ，treatment process and prognosis of 2 cases of PABC were analyzed in our hospital. The relevant literature published from Jan. 1986 to Apr. 2019 in PubMed database was retrieved. The case reports that the title ，keywords or abstracts involved “Breast cancer and pregnancy ”“Pregnancy-associated breast cancer ” “Breast cancer during pregnancy ”“Breast carcinoma during pregnancy ”“Case reports ”were included. Cases which didn ’t meet the definition of PABC were excluded. The general information ，tumor clinical characteristics ，drug treatment plan ，maternal/fetal prognosis and other information of patients were extracted for summary and descriptive statistical analysis. RESULTS & CONCLUSIONS：Two patients were both diagnosed during lactation. The prognosis was good after neoadjuvant chemotherapy and surgical resection. A total of 36 case reports were obtained through literature search and screening ，as well asclinical data of 45 patients（39 diagnosed during pregnancy and 6 diagnosed during lactation ）.Neoadjuvant chemotherapy AC regimen （doxorubicin+ cyclophosphamide）was used in 35.0％（14/40）of cases after excluding the cases without relevant information ；elective caesarean section was performed in 59.5％（22/37）of cases ，37.8％（14/37）of cases were delivered ，and 1 case chose to terminate pregnancy；survival rate of patients was 80.8％（21/26），and the average weight of newborns was 2 407 g（1 015-3 830 g）. Six patients each received taxanes during pregnancy and 9 patients during postpartum. The determination of chemotherapy for PABC should comprehensively consider a variety of factors. It is necessary to comprehensively weigh the benefit risks of the mother and child，try to avoid chemotherapy in early pregnancy ，and especially consider the impact of chemotherapy on the fetus. The chemotherapy regimen is still dominated by anthracyclines. Based on this ，an individualized regimen is formulated and close monitoring should be performed when using paclitaxel. |
| 期刊： | 2020年第31卷第08期 |
| 作者： | 金司爻，赵志刚，霍记平 |
| AUTHORS： | JIN Siyao，ZHAO Zhigang ，HUO Jiping |
| 关键字： | 妊娠相关乳腺癌；病例报道；文献综述；新辅助化疗；化疗相关不良反应；预后 |
| KEYWORDS： | Pregnancy-associated breast cancer ；Case report ；Literature review ；Neoadjuvant chemotherapy ；Chemotherapy- |
| 阅读数： | 336 次 |
| 本月下载数： | 4 次 |
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