Mousavi Azam Sadat, Karimi Samieh, Modarres Gilani Mitra, Akhavan Setareh, Rezayof Elahe
Gynecology Oncology, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Hormozgan Fertility & Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas 7914964157, Iran.
ISRN Obstet Gynecol. 2014 Mar 24;2014:494695. doi: 10.1155/2014/494695. eCollection 2014.
β -human chorionic gonadotropin (HCG) level is not a reliable marker for early identification of persistent gestational trophoblastic neoplasia (GTN) after evacuation of hydatidiform mole. Thus, this study was conducted to evaluate β -HCG regression after evacuation as a predictive factor of malignant GTN in complete molar pregnancy. Methods. In this cross-sectional study, we evaluated a total of 260 patients with complete molar pregnancy. Sixteen of the 260 patients were excluded. Serum levels of HCG were measured in all patients before treatment and after evacuation. HCG level was measured weekly until it reached a level lower than 5 mIU/mL. Results. The only predictors of persistent GTN are HCG levels one and two weeks after evacuation. The cut-off point for the preevacuation HCG level was 6000 mIU/mL (area under the curve, AUC, 0.58; sensitivity, 38.53%; specificity, 77.4%), whereas cut-off points for HCG levels one and two weeks after evacuation were 6288 mIU/mL (AUC, 0.63; sensitivity, 50.46%; specificity, 77.0%) and 801 mIU/mL (AUC, 0.80; sensitivity, 79.82%; specificity, 71.64%), respectively. Conclusion. The rate of decrease of HCG level at two weeks after surgical evacuation is the most reliable and strongest predictive factor for the progression of molar pregnancies to persistent GTN.
β-人绒毛膜促性腺激素（HCG）水平并非葡萄胎清宫术后早期识别持续性妊娠滋养细胞肿瘤（GTN）的可靠标志物。因此，本研究旨在评估清宫术后β-HCG的下降情况，作为完全性葡萄胎妊娠中恶性GTN的预测因素。方法。在这项横断面研究中，我们共评估了260例完全性葡萄胎妊娠患者。260例患者中有16例被排除。在所有患者治疗前和清宫术后均检测血清HCG水平。每周测量HCG水平，直至其降至低于5 mIU/mL。结果。持续性GTN的唯一预测因素是清宫术后1周和2周时的HCG水平。清宫术前HCG水平的截断点为6000 mIU/mL（曲线下面积，AUC，0.58；敏感性，38.53%；特异性，77.4%），而清宫术后1周和2周时HCG水平的截断点分别为6288 mIU/mL（AUC，0.63；敏感性，50.46%；特异性，77.0%）和801 mIU/mL（AUC，0.80；敏感性，79.82%；特异性，71.64%）。结论。手术清宫术后2周时HCG水平的下降速率是葡萄胎妊娠进展为持续性GTN最可靠、最强有力的预测因素。
