Qian Xue-Qian, Chen Li-Li, Li Bao-Hua, Cheng Xiao-Dong, Wan Xiao-Yun
Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Obstet Gynaecol Res. 2016 Jun;42(6):694-700. doi: 10.1111/jog.12953. Epub 2016 Feb 24.
The aim of this study was to investigate a series of patients with sustained low-level elevated human chorionic gonadotrophin (hCG) and explore the management of these patients.
A total of 47 patients with persistent low levels of hCG were selected for analysis between January 2002 and January 2014 at the Women's Hospital of Zhejiang University, Hangzhou, China. Data were retrospectively reviewed for patient characteristics, therapeutic strategies, and follow-ups. We compared the characteristics of patients who were and were not eventually considered to have malignancies.
Among the 47 patients, 17 with persistent low-level elevated hCG and no detectable lesions were considered to have no active malignancy. Fifteen of the 17 patients had hCG levels that returned to normal range by the end of follow-up, while the remaining two did not. The other 30 patients were eventually diagnosed as having active malignancies due to detected lesions or increasing elevation of hCG. A large proportion of these patients were diagnosed with placental site trophoblastic tumor or epithelioid trophoblastic tumor.
For patients with persistent low-level elevated hCG, frequent follow-up rather than any therapy is recommended. Treatment was considered effective and safe once diagnosis of active malignancy was confirmed.
本研究旨在调查一系列人绒毛膜促性腺激素（hCG）持续低水平升高的患者，并探讨这些患者的管理方法。
2002年1月至2014年1月期间，在中国杭州的浙江大学医学院附属妇产科医院选取了47例hCG持续低水平的患者进行分析。对患者的特征、治疗策略和随访情况进行回顾性数据审查。我们比较了最终被认为患有恶性肿瘤和未患恶性肿瘤的患者的特征。
在这47例患者中，17例hCG持续低水平升高且未检测到病变的患者被认为没有活动性恶性肿瘤。17例患者中有15例在随访结束时hCG水平恢复到正常范围，而其余2例未恢复。另外30例患者最终因检测到病变或hCG升高而被诊断为患有活动性恶性肿瘤。这些患者中很大一部分被诊断为胎盘部位滋养细胞肿瘤或上皮样滋养细胞肿瘤。
对于hCG持续低水平升高的患者，建议进行频繁随访而非任何治疗。一旦确诊为活动性恶性肿瘤，治疗被认为是有效且安全的。
