妇科恶性肿瘤与其他恶性肿瘤同样存在肿瘤内异质性,主要表现在原发灶及转移灶的抗原性、免疫性、激素受体、代谢性、基因改变、生长速度及对化学药物反应等方面的差异,尤其是药物治疗反应方面存在异质性及耐药产生等。提示临床上肿瘤化疗模式应采用序贯化疗,有望减少化疗耐药,提高疗效,并减少毒副反应;在肿瘤病理诊断中,进行多点取材,克服取样误差;在随访中也应考虑肿瘤内异质性,进行多种标志物联合测定。 Gynecologic malignancies have the same heterogeneity as other malignant tumors, mainly in the aspects of antigenicity, immunity, hormone receptor, metabolism, gene change, growth rate and response to chemical drugs in primary and metastatic lesions Of the differences, especially in the heterogeneity of drug treatment response and drug resistance. Prompt clinical chemotherapy model should be used sequential chemotherapy, chemotherapy is expected to reduce resistance and improve efficacy, and reduce toxicity; in tumor pathology diagnosis, multi-point sampling to overcome sampling error; should also be considered in the follow-up of the tumor Heterogeneity, combined with a variety of markers.