Rob L, Robová H, Pluta M, Kulovaný E, Hrehorcák M, Chmel R, Schlegerová D, Kodet R, Macek M
Gynekologicko-porodnická klinika, onkogynekologické oddĕlení, 2. LF UK Praha.
Ceska Gynekol. 2001 Jul;66(4):230-5.
To evaluate spontaneous regression curves of hCG serum positivity in patients with surgically treated molar pregnancies. Comparison of complete, partial and invasive mole. The study should result in optimalisation of follow up criteria of molar pregnancies in respect to their potential malignant change.
Retrospective comparative clinical study.
Obst. Gyn. Dpt., Oncogynecology div., 2nd Medical Faculty, FNM, Charles University Prague, Pathology Dpt., 2nd Medical Faculty, Institute of Biology and Medical Genetics.
Evaluation of spontaneous regression curves of serum hCG levels in 104 molar pregnancies. 46 patients with partial hydatiform mole, 48 patients with complete hydatiform mole, 10 patients with invasive mole. Serum hCG levels were detected by radioimunoassay (RIA) in the first period and imunochemoluminisent assay (LIA) in the second period. Regression curves of hCG positivity in particular moles were statistically evaluated by Fischer test and t-test.
There is statistically significant difference in spontaneous regression of hCG positivity in different types of molar pregnancies. Recommended criteria for gestational trofoblastic disease (GTD) diagnosis and follow up are fully applicable in clinical practice. There is exception in partial hydatiform moles, where plateau in hCG regression does not necessarily implicate chemotherapy in patient with good compliance.
Early diagnosis of GTD predominantly due to the widespread use of ultrasonography changes classical clinical features of molar pregnancies. Spontaneous regression in hCG positivity in serum is more rapid in patients with partial hydatiform mole, slower in complete hydatiform mole and invasive mole. There is no significant change in malignant potential regarding early detection and treatment.
评估手术治疗的葡萄胎患者血清hCG阳性的自然消退曲线。比较完全性、部分性和侵袭性葡萄胎。该研究应能优化葡萄胎潜在恶变的随访标准。
回顾性比较临床研究。
布拉格查理大学医学院第二医学系妇产科、肿瘤妇科，病理学系，生物学与医学遗传学研究所。
评估104例葡萄胎患者血清hCG水平的自然消退曲线。46例部分性葡萄胎患者，48例完全性葡萄胎患者，10例侵袭性葡萄胎患者。第一阶段采用放射免疫分析法（RIA）检测血清hCG水平，第二阶段采用免疫化学发光分析法（LIA）检测。通过Fischer检验和t检验对特定葡萄胎中hCG阳性的消退曲线进行统计学评估。
不同类型葡萄胎中hCG阳性的自然消退存在统计学显著差异。推荐的妊娠滋养细胞疾病（GTD）诊断和随访标准在临床实践中完全适用。部分性葡萄胎存在例外情况，即hCG消退出现平台期时，对于依从性良好的患者不一定需要化疗。
由于超声检查的广泛应用，GTD的早期诊断改变了葡萄胎的经典临床特征。部分性葡萄胎患者血清中hCG阳性的自然消退更快，完全性葡萄胎和侵袭性葡萄胎患者较慢。早期检测和治疗对恶性潜能无显著影响。
