tbuckley/cabot-search huggingface dataset:
Lurbinectedin (LUR) in combination with Irinotecan (IRI) in patients (pts) with advanced solid tumors: Updated results from a phase Ib-II trial.
Authors: Santiago Ponce Aix, Gregory Michael Cote, Alejandro Falcon Gonzalez, Juan Manuel Sepulveda, Elizabeth Jimenez Aguilar, Inmaculada Sanchez-Simon, Maria José Flor, Rafael Nuñez, Eva Maria Gonzalez, Monica Insa, Mariano Siguero, Martin Cullell-Young, Carmen Maria Kahatt, Ali Hassan Zeaiter, Luis G. Paz-Ares
Journal: Journal of Clinical Oncology (2020)

3514 Background: LUR is a novel agent that exerts antitumor activity through inhibition of trans-activated transcription and modulation of tumor microenvironment. Preclinical synergism/additivity in combination with IRI has been reported, thus prompting the conduct of this clinical trial. Methods: Phase Ib-II trial to evaluate escalating doses of LUR on Day (D) 1 plus a fixed dose of IRI 75 mg/m 2 on D1 and D8 every 3 weeks (q3w) in pts with advanced solid tumors (+/- G-CSF, if dose-limiting toxicities [DLTs] were neutropenia). Starting dose was LUR 1.0 m/m 2 + IRI 75 mg/m 2 . Results: 77 pts have been treated to date at 5 dose levels, 51 of them at the recommended dose (RD). Baseline characteristics of all 77 pts were: 48% females, 68% ECOG PS=1; median age 57 years (range, 19-75 years); median of 2 prior lines (range, 0−4 lines). The maximum tolerated dose (MTD) was LUR 2.4 mg/m 2 + IRI 75 mg/m 2 with G-CSF, and the RD was LUR 2.0 mg/m 2 + IRI 75 mg/m 2 with G-CSF. DLTs in Cycle 1 occurred in 2/3 evaluable pts at the MTD and 3/13 evaluable pts at the RD, and comprised omission of IRI D8 infusion due to grade (G) 3/4 neutropenia (n=3 pts) or G2-4 thrombocytopenia (n=2). At the RD (n=51), common G1/2 non-hematological toxicities were nausea, vomiting, fatigue, diarrhea, anorexia and neuropathy. G3 non-hematological toxicities (diarrhea 10%, fatigue 10%) and G3/4 hematological abnormalities (neutropenia 49%, thrombocytopenia 10%) were transient. Conclusions: The combination of LUR and IRI had acceptable tolerance, with no unexpected toxicities. Transient myelosuppression was dose-limiting. The RD is LUR 2.0 mg/m 2 on D1 + IRI 75 mg/m 2 on D1 and D8 q3w with G-CSF. Antitumor activity was observed at the RD in SCLC pts, as well as in endometrial carcinoma pts. Hints of activity were also observed in STS pts. Updated results will be presented. Clinical trial information: NCT02611024 . [Table: see text]
Pan-tumor analyses of kinase fusions detected in circulating tumor DNA (ctDNA) and concordance with paired tissue.
Authors: Jessica Kim Lee, Daniel Lieber, Russell Madison, Jon Chung, Alexa Betzig Schrock, James Creeden, Jeffrey Venstrom, Brian Michael Alexander, Mehlika Hazar-Rethinam
Journal: Journal of Clinical Oncology (2020)

3517 Background: Oncogenic kinase gene fusions are targetable with approved and investigational therapies and can also emerge as acquired resistance (AR) to targeted therapy. To understand the clinical validity of liquid biopsy comprehensive genomic profiling (CGP) to detect kinase fusions, we compared patient-matched plasma and tissue-based CGP. Methods: Hybrid capture-based CGP was performed on 28,743 plasma and 325,131 tumor tissue samples in the course of clinical care. Complete exonic regions of 13 kinases involved in oncogenic fusions plus select introns in ALK, EGFR, FGFR2/3, PDGFRA, RET, and ROS1 were sequenced to capture fusions with well characterized breakpoints. ctDNA fraction was estimated by maximum somatic allele frequency (MSAF). Results: 86% of cases had detectable ctDNA in plasma (MSAF &gt; 0). Kinase fusions were detected in 2.1% of ctDNA cases (478/23,294) and were most prevalent in patients (pts) with bladder cancer (4.5%), non-small cell lung cancer (NSCLC) (4.3%), and cholangiocarcinoma (3.9%). The most commonly rearranged kinases were ALK (60%, 162/271) and RET (19%, 51/271) in NSCLC, FGFR2 (85%, 11/13) in cholangiocarcinoma, and FGFR3 (88%, 7/8) in bladder cancer. ALK fusions were detected in 26% (54/207) of fusion+ non-NSCLC cases. Paired tissue and ctDNA samples where ≥1 sample harbored a kinase fusion were available for 147 pts; median time between sample collection was 150 days (interquartile range: 444 days). Positive percent agreement (PPA) to tissue and liquid biopsies was 76% and 80%. Median MSAF in concordant and discordant ctDNA samples was 2.3% and 0.41% (p = 0.04) and median time between specimen collection for concordant and discordant pairs was 110 and 344 days (p = 0.04). PPA to tissue and liquid was 86% and 88% for pairs collected &lt; 60 days apart (n = 53), versus 70% and 74% for pairs collected &gt; 60 days apart. 6 pts with paired samples all collected &gt; 196 days apart (median 593 days) had initial tissue samples with EGFR driver mutations and had an acquired kinase fusion (4 ALK, 1 FGFR2, 1 FGFR3) in the 2nd ctDNA sample, likely representing AR. Conclusions: Kinase gene fusions identified by tissue-based CGP were detected by liquid biopsy CGP in 85% of temporally-matched plasma samples. Kinase fusion detection by liquid biopsy CGP is feasible and had high PPA to tissue-based CGP. Subsequent sampling by liquid biopsy identified acquired fusions in EGFR driver positive cases consistent with known mechanisms of resistance to EGFR inhibitors suggesting utility of liquid biopsy at progression to identify targetable mechanisms of AR.
心尖肥厚型心肌病的临床特点及诊断
Authors: 周磊, 黄霞, 张维平, 赵有生, 章慧洁
Journal: BMJ (2006)

以心电图、超声心动图、核素心肌显像及左心室造影等方法诊断29例心尖肥厚型心肌病. 结果提示心电图胸导联T波深倒伴有ST段压低和R波电压增高者,除外高血压病后,应高度怀疑心尖肥厚型心肌病,超声心动图检查可确诊本病.对诊断困难者应进一步检查核素心肌显像、心脏核磁共振或冠状动脉与左室造影以确诊。
Clinical utility of 18F-FDG-PET/CT in staging localized breast cancer prior to initiating preoperative systemic therapy.
Authors: Heidi Ko, Yaser Baghdadi, Charito Love, Joseph A. Sparano
Journal: Journal of Clinical Oncology (2020)

563 Background: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET/CT) is recommended as an optional study in current National Comprehensive Cancer Network (NCCN) guidelines after computerized tomography and bone scan (CTBS) in patients with stage IIA-IIIC breast cancer. We evaluated our experience with use of PET/CT in this setting prior to beginning primary systemic therapy (PST) before planned surgery. Methods: We performed medical record abstractions to identify all adult female patients with clinical stage IIA to IIIC breast cancer diagnosed at Montefiore Medical Center from January 1, 2014 to January 1, 2019 who underwent PET/CT. We calculated the proportion of patients upstaged after PET/CT, stratified by their initial clinical stages and use of PST, and examined the cost and radiation exposure associated with PET/CT compared with CTBS. Results: 227 patients with 230 breast cancers (bilateral disease in 3) met the study inclusion criteria. PET/CT was the only staging done in 195 patients (86%); 32 patients had PET/CT based on suspicious findings from prior CTBS. Among these 195 patients with 196 breast cancers (bilateral disease in 1) that had PET/CT as the only staging done, the overall upstaging rate for regional nodal and/or distant metastasis was 37% (73/196), including 24% for stage IIA (9/38), 39% for IIB (31/79), 54% for IIIA (22/41), 27% for IIIB (8/30), and 37% for IIIC (3/8). The overall upstaging rate to stage IV was 14% (27/196), including 0% for stage IIA, 13% for IIB (10/79), 22% for IIIA (9/41), 17% for IIIB (5/30), and 37% for IIIC (3/8). The sensitivity and specificity of PET/CT in detecting distant metastasis was 100% and 94%, respectively. Our institution's total Medicare reimbursement rate of PET/CT is $1604.37 whereas CTBS is $1679.94. Radiation dose for PET/CT is 14 mSv whereas CTBS is 21 mSv. Conclusions: Approximately 37% of patients with clinical stage IIA-IIIC breast cancer who underwent PET/CT prior to PST showed more extensive disease, including 23% with more extensive regional nodal metastases and 14% with distant metastasis. Given the high detection rate, comparable cost, lower radiation dose and greater convenience, PET/CT should be considered as an alternative to CTBS rather than “optional” after CTBS, especially in patients who require an efficient and expeditious work up prior to initiating PST.
Room temperature water infusion during colonoscopy insertion induces rectosigmoid colon mucus production
Authors: Ahmed El Rahyel, Connor D. McWhinney, Nasim Parsa, Rachel E. Lahr, Krishna C. Vemulapalli, Douglas K. Rex
Journal: Endoscopy (2020)

Abstract Background Water filling during colonoscopy improves several colonoscopy outcomes. We evaluated an anecdotal observation that room temperature water filling during colonoscope insertion results in mucus production in the left colon, which may impair mucosal visualization during withdrawal. Methods We performed 55 colonoscopies with either water or saline filling during insertion, and video recorded the examinations. Three blinded observers scored the amount of mucus visible on the video recordings. Results 29 patients had water filling and 26 patients had saline filling during insertion. Demographic features, procedure indications, volume of infused fluid, and insertion time to the cecum were similar in the two groups. All three blinded observers rated the mucus as greater after water filling than after saline (median 3 out of 5 vs. 1 out of 5; P &lt; 0.001), with a kappa value for interobserver agreement of 0.364 (P &lt; 0.001). Conclusion Room temperature water filling is associated with mucus production by the rectosigmoid colon, requiring additional cleansing during withdrawal.
丙戊酸钠脑病一例
Authors: 唐永亮, 杨咏波, 黄玉杰, 那世杰, 王斌
Journal: BMJ (2011)

患者女性,43岁,于2009年11月16日在南京鼓楼医院神经外科行右侧大脑中动脉动脉瘤夹闭及血肿清除术,术后当天予丙戊酸钠注射液1.2g/d泵入预防癫痫.第3天患者意识由昏迷转为清醒,偏瘫的左侧肢体活动较前增多.第7天四肢肌力Ⅴ级,肌张力正常,双侧病理征(-),为更换口服抗癫痫药物,增加苯妥英钠0.1 g,3次/d口服.第10天突然昏迷,呼之不应,双侧瞳孔等大等圆,直径2.0 mm,对光反射灵敏,颈软,右侧肢体肌张力正常,有自主活动,左侧肢体肌张力低,疼痛刺激有关节轻微活动,左侧巴宾斯基征(+),无发热、抽搐、呕吐.查肾功能、电解质均正常。
Efficacy of itopride combined with alpha-lipoic acid for patients with diabetic gastroparesis
Authors: Gang Ma, Weijie Dai, Wei Yan
Journal: BMJ (2015)

Objective
To evaluate the efficacy of itopride hydrochloride combined with alpha-lipoic acid in treatment of diabetic gastroparesis.


Methods
One hundred and ten patients with diabetic gastroparesis were randomly assigned to two groups. Sixty patients received α-lipoic acid plus itopride (α-lipoic acid 0.6 g intravenously for 14 d plus itopride 50 mg orally t. i.d), and 50 cases received oral itopride only.The clinical symptoms including postprandial abdominal fullness, belching, acid reflux, anorexia, nausea and vomiting were observed; the gastric emptying rate was tested, and plasma motilin and serum ganstrin levels were measured groups, before and after two weeks of treatment.


Results
The clinical symptom scores of combination therapy group (4.62±3.46 vs. 12.26±3.43) and control groups (5.43±3.65 vs. 12.31±3.37) were improved after treatment. The overall effective rate of combination group was 91.6% and that of itopride therapy group was 78.0% (χ2=4.098, P<0.05). Gastric emptying rate of combination group [(76.9±9.7)% vs. (37.3±10.2) %] was increased more markedly than that of itopride group[(57.2±10.4)% vs. (36.8±11.2)%] (t=10.221, P<0.05). Plasma motilin and serum ganstrin levels in combination group [(640.2±64.4)ng/L vs. (554.0±67.6)ng/L, (152.6±20.3)ng/L vs. (96.8±22.2)ng/L] were reduced more markedly than those in itopride group [(636.3±66.4)ng/L vs. (589.4±48.3)ng/L, (153.5±19.4)ng/L vs. (120.9±19.7)ng/L] respectively (t=3.100, 5.959, all P<0.05).


Conclusion
For patients with diabetic gastroparesis, α-lipoic acid and itopride combination therapy can significantly improve symptoms and gastric emptying rate, decrease motlin and gastrin levels; and the efficacy of combination therapy is better than that of itopride monotherapy.


Key words: 
Diabetes mellitus; Gastroparesis; Tiapride; Thioctic acid
Australasian Gastrointestinal Trials Group (AGITG) CONTROL NET Study: Phase II study evaluating the activity of <sup>177</sup>Lu-Octreotate peptide receptor radionuclide therapy (LuTate PRRT) and capecitabine, temozolomide CAPTEM)—First results for pancreas and updated midgut neuroendocrine tumors (pNETS, mNETS).
Authors: Nick Pavlakis, David Turner Ransom, David Wyld, Katrin Marie Sjoquist, Rebecca Asher, Val Gebski, Kate Wilson, Andrew Ddembe Kiberu, Matthew E. Burge, William Macdonald, Paul Roach, David A. Pattison, Patrick Butler, Timothy Jay Price, Michael Michael, Benjamin James Lawrence, Dale L. Bailey, Simone Leyden, John Raymond Zalcberg, J. Harvey Turner
Journal: Journal of Clinical Oncology (2020)

4608 Background: CAPTEM is an accepted regimen for patients (pts) with advanced pNETs. Single agent 177 Lu-Octreotate PRRT is now a standard of care for progressive WHO Grade (G) 1/2 mNETs. High activity was seen with LuTate/CAPTEM in a single arm Phase I/II trial. This study was undertaken to determine the relative activity of adding CAPTEM to LuTate PRRT in pts with mNETs and pNETs. Methods: Non-comparative randomised open label parallel group phase II trial with 2:1 randomisation to PRRT/CAPTEM (experimental arm) vs. PRRT (mNETs control) and CAPTEM (pNETS control). PRRT/CAPTEM: 7.8GBq LuTate day(D) 10, 8 weekly (wkly) x 4, with b.i.d. oral CAP 750mg/m 2 D1-14 &amp; TEM 75mg/m 2 D10-14, 8 wkly x 4; PRRT: 8 wkly x 4; CAPTEM 8 wkly x 4. Primary endpoint: Progression free survival (PFS). mNETS- at 15 months (mo) assuming 15mo PFS 66.4% in control arm, aiming for PFS ³ 80%; pNETS- at 12mo assuming 12mo PFS 60% in control arm, aiming for PFS ³ 75%. Secondary endpoints: Objective tumour response rate (complete or partial) (OTRR), clinical benefit rate (OTRR, stable disease) (CBR), toxicity, quality of life. Results: 75 pts enrolled (Dec 2015 – Nov 2018): mNETs 33 PRRT/CAPTEM and 14 PRRT; pNETS 19 PRRT/CAPTEM and 9 CAPTEM. mNETS: Median follow-up 35mo; 15mo PFS was 90% (95% CI: 73-97%) v 92% (95% CI: 57-99%); OTRR 31% vs 15%; and CBR 97% vs 92% for PRRT/CAPTEM v PRRT respectively. Treatment related adverse events (AEs): 24/32 PRRT/CAPTEM pts had at least one G3 event (75%) vs 5/13 (38%, PRRT); and 4/32 pts at least one G4 event (13%) v 1/13 (8%) respectively, mostly haematologic (haem). Only one patient failed to complete therapy (PRRT/CAPTEM). pNETS: Median follow-up 34mo; 12mo PFS was 76% (95% CI: 48-90%) v 67% (95% CI: 28-88%); OTRR 68% vs 33%; and CBR 100% vs 100% for PRRT/CAPTEM v CAPTEM respectively. Treatment related AEs: 5/18 PRRT/CAPTEM pts had at least one G3 event (28%) vs 3/9 (33%) CAPTEM; 3/18 pts at least one G4 event (17%) v 1/9 (11%) respectively. Conclusions: CAPTEM/PRRT is active, meeting its target landmark PFS for CAPTEM/PRRT (12mo pNETs; 15mo mNETs) with numerically greater OTRR in both pNETs and mNETs, but with more haem toxicity in mNETs. As activity was high in both control arms longer follow up is required to determine if the relative activity of PRRT/CAPTEM is sufficient to warrant Phase III evaluation. Clinical trial information: ACTRN12615000909527 .
Association of Mental Health Treatment With Outcomes for US Veterans Diagnosed With Non–Small Cell Lung Cancer
Authors: Jacob E. Berchuck, Craig S. Meyer, Ning Zhang, Caroline M. Berchuck, Neil N. Trivedi, Beth Cohen, Sunny Wang
Journal: JAMA Oncology (2020)

<h3>Importance</h3> Preexisting mental health disorders (MHDs) are associated with increased mortality in people diagnosed with cancer, yet few data exist on the efficacy of interventions to mitigate this disparity. <h3>Objective</h3> To evaluate the association of participation in mental health treatment programs (MHTPs), housing support programs, or employment support programs with stage at cancer diagnosis, receipt of stage-appropriate treatment, and mortality among patients with a preexisting MHD. <h3>Design, Setting, and Participants</h3> This retrospective, population-based cohort study included 55 315 veterans in the Veterans Affairs Central Cancer Registry (VACCR) who had newly diagnosed non–small cell lung cancer (NSCLC) from September 30, 2000, to December 31, 2011. Data were analyzed from January 15, 2017, to March 17, 2020. <h3>Exposures</h3> Mental health disorders, including schizophrenia, bipolar disorder, depressive disorder, posttraumatic stress disorder, and substance use disorder. <h3>Main Outcomes and Measures</h3> Stage at cancer diagnosis, receipt of stage-appropriate cancer treatment, all-cause mortality, and lung cancer–specific mortality. <h3>Results</h3> Of 55 315 veterans with a new diagnosis of NSCLC included in the analysis (98.1% men; mean [SD] age, 68.1 [9.8] years), 18 229 had a preexisting MHD, among whom participation in MHTPs was associated with a lower likelihood of being diagnosed in a late stage (odds ratio [OR], 0.62; 95% CI, 0.58-0.66;<i>P</i> &lt; .001), a higher likelihood of receiving stage-appropriate treatment (OR, 1.55; 95% CI, 1.26-1.89;<i>P</i> &lt; .001), lower all-cause mortality (adjusted hazard ratio [AHR], 0.74; 95% CI, 0.72-0.77;<i>P</i> &lt; .001), and lower lung cancer–specific mortality (AHR, 0.77; 95% CI, 0.74-0.80;<i>P</i> &lt; .001). Likewise, participation in housing and employment support programs was associated with similar improvements in all outcomes described above. <h3>Conclusions and Relevance</h3> In veterans with preexisting MHDs diagnosed with NSCLC, participation in MHTPs and housing and employment support programs was associated with improved lung cancer–related outcomes. This study might be the first to demonstrate significant improvement in cancer mortality for patients with MHDs who participate in MHTPs, housing support programs, or employment support programs. This work supports substantial literature that investment in mental health and social needs can improve health outcomes and highlights the importance of further research to identify, evaluate, and implement interventions to improve outcomes for patients with MHDs who are diagnosed with cancer.
Health seeking behavior and related factors among hypertensive and diabetic patients contracting medical service in Fangzhuang community health service center
Authors: Wenjuan Gao, Ying Wang, Caiying Ge, Xuejuan Wei, Min Kong, Hongyan Jia, Xiaoling Guo, Xinying Liu, Hao Wu
Journal: BMJ (2018)

Objective
To investigate the health-seeking behavior and related factors among hypertensive and diabetic patients contracting medical service in Beijing Fangzhuang Community Health Service Center.


Methods
By using stratified random sampling method, 830 contracted hypertensive and diabetic patients were selected in the study. A face to face questionnaire survey was conducted in Fangzhuang Community Health Service Center from November 2016 to January 2017. Total 800 questionnaires were completed, and the medical behavior and influencing factors of patients were analyzed.


Results
The first-contact rate of community for hypertensive and diabetic patients was 73.0%(584/800). The reasons for choosing community service were: near home (86.3%, 690/800), shorter waiting time (71.4%, 571/800) and trust in doctors (50.3%, 402/800); while the reasons for not choosing community service were less drug varieties (76.1%, 609/800), poor facilities (32.1%, 257/800) and lower technical level (11.4%, 91/800). Its influencing factors were: frequent need of accompanying for visit (χ2=5.719, P=0.012), family income (χ2=4.540, P=0.021), awareness of service scopes(χ2=64.668, P=0.000), purpose of service(χ2=19.234, P=0.000), frequency of doctor contact(χ2=9.367, P=0.001), the awareness of referral(χ2=5.736, P=0.011).


Conclusion
The community health service centers should take the advantage of easy access, short waiting time and patients′ trust, at the same time should improve the service conditions and quality, so as to increase the first-contact rate for patients contracting medical service.


Key words: 
Hypertension; Diabetes mellitus; Community health centers; Contract services
Concealed late-life depression: reorganization and management
Authors: Xinyu Sun
Journal: BMJ (2018)

老年期抑郁障碍是老年人中常见的精神心理障碍，严重影响老年人身心健康和生命质量。临床表现上具有抑郁体验不鲜明、焦虑疑病色彩突出、合并躯体疾病及躯体症状较多见、认知损害常见等一些不典型特征，造成识别和诊断困难，治疗处理中兼顾老年期生理心理特点影响，药物治疗和心理治疗并重，基础支持治疗和生物物理治疗也不容忽视，还要关注整体医疗服务和疾病预防。
Evaluation of a computational decision support system for molecularly targeted treatment planning by the clinical outcome data of the randomized trial SHIVA01.
Authors: Anna Dirner, Robert Doczi, Peter Filotas, Barbara Vodicska, Edit Varkondi, Dora Tihanyi, Célia Dupain, Nicolas Servant, Maud Kamal, Csilla Hegedűs, Richárd Schwab, Christophe Le Tourneau, Istvan T. Valyi-Nagy, István Peták
Journal: Journal of Clinical Oncology (2020)

3642 Background: Precision oncology requires the identification of individual molecular pathomechanisms to find optimal personalized treatment strategies for every cancer patient. Incorporation of complex molecular information into routine clinical practice remains a significant challenge due to the lack of a reproducible, standardized process of clinical decision making. Methods: To provide a standardized process for molecular interpretation, we develop a precision oncology decision support system, the Realtime Oncology Molecular Treatment Calculator (MTC). MTC is a rule-based medical knowledge engine that dynamically aggregates and ranks relevant scientific and clinical evidence using currently 26,000 evidence-based associations and reproducible algorithm scoring of drivers, molecular targets to match molecular alterations to efficient therapies. To validate this novel method and system, we used data of the SHIVA01 trial of molecularly targeted therapy (Lancet Oncol 2015 16:1324-34). Molecular profiles of participants were uploaded to MTC and aggregated evidence level (AEL) values of associated targeted treatments were calculated, including those used in the SHIVA01 trial. Results: The MTC output provided a prioritized list of drugs associated with the driver alterations in the patient molecular profile, where ranking is based on AEL values. Of 113 patients who received targeted therapy with available clinical best response data, disease control was experienced in 63 cases (PR: 5, SD: 58), while disease progression occurred in 50 cases. The average AEL score for the therapies applied was significantly higher in the responsive group than in the non-responsive group (1512 and 614, respectively (p = 0.049)). In 94 cases, drugs other than those used for therapy were ranked higher by the MTC. The average AEL difference between the top-ranked and the used drugs was in an inverse correlation with clinical response, i.e. smaller differences associated with a better outcome. Conclusions: Results indicate that the aggregation of evidence-based tumor-driver-target-drug associations using standardized mathematical algorithms of this computational tool is a promising novel approach to improve clinical decisions in precision oncology. Further validation based on the results of other targeted clinical trials and real-life data using more detailed molecular profiles is warranted to explore the full clinical potential of this novel medical solution.
腹腔镜下行子宫瘢痕妊娠病灶切除加修补术七例分析
Authors: 许学先, 洪莉, 李彦博, 匡军秀
Journal: BMJ (2011)

随着剖宫产率的升高,剖宫产术后子宫瘢痕妊娠(cesareanscar pregnancy,CSP)的发生率也呈逐年增高的趋势.CSP是一种特殊而高度危险的异位妊娠[1],严重者可造成子宫破裂和不可控制的大出血.如能早期诊断、处理及时得当,则能减少并发症,成功保留生育能力.Ash等[2]根据瘢痕处受精卵种植的深浅及生长方向将CSP分为2型,即深植入瘢痕缺陷处,向膀胱及腹腔凸出生长型(外凸型)和向子宫颈、峡部或腔内生长型,并认为外凸型CSP的危险性更大.现对7例外凸型CSP患者施行腹腔镜下子宫瘢痕妊娠病灶切除加修补术获得成功,现报道如下。