原发部位不明的低分化(或未分化)癌,给临床肿瘤医生提出种种难题。因为没有一定的病理组织学特征,又不知其原发部位,所以通常搞不清这类肿瘤的性质,不能根据已确认的肿瘤资料进行治疗。自1979年以来,有报道提及这类肿瘤可能是尚未认识的性腺以外的胚细胞肿瘤或“不典型性畸胎瘤”对联合化疗有效,有的获得完全缓解和长时间生存。作者根据对为数不多的病人的初步观察,提出几条特征,这些特征可能有助于检出这类病人中对(以顺铂为主的)联合化疗有效者。这些特征包括:年龄小于50岁,肿瘤主要累及中线结构(纵隔、腹膜后)、肺(多结节型)或淋巴结;血清人绒毛膜促性腺激素(或甲胎蛋白)水平升高;临床证据表明肿瘤生长迅速,对以前的放疗或化疗很有效。作者将这组特征称为“性腺外胚细胞癌综合征”。本文报道71例原发部位不明的转移性低分化癌患者的临床特征和预后特点。这71例中,男59例,女12例,年龄17～70 Undifferentiated, poorly differentiated (or undifferentiated) cancers present various challenges to clinical oncologists. Because there is no definite pathological histological feature and unknown origin, it is often impossible to understand the nature of these tumors and it is not possible to treat them based on confirmed tumor data. Since 1979, it has been reported that such tumors may be unrecognized germ cell tumors other than gonadal or “atypical teratomas” that are effective for combination chemotherapy, and some may achieve complete remission and prolonged survival. Based on preliminary observations of a small number of patients, the authors propose several features that may be useful in the detection of cisplatin-based combination chemotherapy in these patients. These characteristics include: age less than 50 years old, tumors involving mainly midline structures (mediastinum, retroperitoneum), lungs (multiple nodular), or lymph nodes; elevated levels of serum human chorionic gonadotropin (or alpha-fetoprotein); clinical evidence It shows that the tumor grows rapidly and is effective for previous radiotherapy or chemotherapy. The authors refer to this group of characteristics as “gonadal blastoma syndrome.” This article reports the clinical features and prognostic characteristics of 71 patients with metastatic poorly differentiated carcinoma of unexplained primary sites. Of these 71 cases, 59 were males and 12 were females, aged 17 to 70.