Ngu Siew-Fei, Chan Karen K L
Department of Obstetrics and Gynecology, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR.
Curr Obstet Gynecol Rep. 2014 Jan 4;3(1):84-90. doi: 10.1007/s13669-013-0071-6. eCollection 2014.
Gestational trophoblastic neoplasia (GTN) is highly chemosensitive and has a high cure rate. Since the introduction of chemotherapy, reliable measurement of human chorionic gonadotropin (hCG) levels, and individualised risk-based therapy into the management of GTN, almost all low-risk and more than 80 % of high-risk GTN cases are curable. However, approximately 25 % of high-risk GTN developed resistance to chemotherapy or relapsed after completion of initial therapy, which often necessitate salvage combination chemotherapy. On the other end of the spectrum, a proportion of patients with gestational trophoblastic disease (GTD) have persistently low levels of hCG, without clinical or radiological evidence of disease, a condition called quiescent GTD. Recently, measurement of hyperglycosylated hCG has been proposed for the management of patients with quiescent GTD. Although representing a small proportion of GTD cases, the management of patients with chemoresistant and quiescent GTD often poses challenges to medical practitioners.
妊娠滋养细胞肿瘤（GTN）对化疗高度敏感，治愈率高。自化疗引入、人绒毛膜促性腺激素（hCG）水平的可靠测定以及基于个体风险的治疗方法应用于GTN的管理以来，几乎所有低风险和80%以上的高风险GTN病例都可治愈。然而，约25%的高风险GTN会对化疗产生耐药性或在初始治疗完成后复发，这通常需要进行挽救性联合化疗。另一方面，一部分妊娠滋养细胞疾病（GTD）患者的hCG水平持续较低，且无疾病的临床或影像学证据，这种情况称为静止期GTD。最近，有人提出测定高糖基化hCG用于静止期GTD患者的管理。尽管化疗耐药和静止期GTD患者仅占GTD病例的一小部分，但对其管理往往给医生带来挑战。
