摘要
目的研究超常胎盘部位（ＥＰＳ）反应的病理与临床特点，提出诊断标准及鉴别诊断要点。方法对１３例经病理检查诊断为ＥＰＳ的病人，采用免疫组化标记法，进行病理学特征、临床表现及预后分析。结果ＥＰＳ组织学特征为以中间型为主的滋养细胞向蜕膜及平滑肌层浸润，不破坏原有组织结构，并保留部分胎盘床特点。免疫组化标记胎盘泌乳素、上皮细胞膜抗原呈阳性或强阳性。临床表现多有产后出血，５年预后良好。结论ＥＰＳ反应属于中间型滋养细胞为主的妊娠滋养细胞疾病，可能为胎盘部位滋养细胞肿瘤的前期病变。鉴别诊断应结合组织学、免疫组化及临床表现综合判断。ＥＰＳ反应引起的产后出血值得重视。
Objectives To study the pathological and clinical features of exaggerated placental site (EPS) and to propose its diagnostic criteria and differential diagnosis. Methods The pathological features, immunohistochemical marks, clinical characteristics and prognosis of 13 cases with EPS were studied and analyzed.Results The histological feature of EPS was that trophoblasts mainly intermediate trophoblast (IT), infitrated into decidua and myometrium layers, while original histological structure was not destroyed, and placental site features remained partially. The immunohistochemical marks of EPS, HPL and EMA, were positive or strongly positive. The primary clinical presentation of EPS was postpartum hemorrhage and the prognosis was good in 5 years. Conclusions EPS is a kind of gestational trophoblastic disease primarily involving IT. It may be a preneoplastic lesion of placental site trophoblastic tumor (PSTT). Its differential diagnosis depend on combining histological, immunohistochemical findings, and clinical features. Attentions should be paid to EPS in cases with postpartum hemorrhage.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1998年第6期352-354,I010,共4页
Chinese Journal of Obstetrics and Gynecology
