Lurain J R, Brewer J I, Torok E E, Halpern B
Am J Obstet Gynecol. 1983 Mar 1;145(5):591-5. doi: 10.1016/0002-9378(83)91202-4.
From 1962 to 1978, 738 patients with hydatidiform mole were referred to the John I. Brewer Trophoblastic Disease Center of Northwestern University for follow-up and human chorionic gonadotropin (hCG) testing after evacuation. There was spontaneous regression of trophoblastic disease in 596 (80.8%) of the 738 patients. Of these 596 patients, regression occurred in 11 (1.8%) by day 10 after evacuation, in 124 (20.8%) between days 11 and 30, in 255 (42.8%) between days 31 and 60, and in 206 (34.6%) between days 61 and 170. Treatment with chemotherapeutic agents was required in 142 (19.2%) of the 738 patients; 125 (16.9%) of these had invasive mole (107 nonmetastatic and 18 metastatic) and 17 (2.3%) had choriocarcinoma (13 nonmetastatic and four metastatic). All 596 patients whose hCG titers declined spontaneously to normal levels have remained well and free of disease. All 142 treated patients experienced permanent remission. Thus, all 738 patients are well and free of disease 4 to 18 years after evacuation of the hydatidiform mole. The follow-up regimen described in this report furnishes information on natural history of molar pregnancies after evacuation and provides an excellent means by which all patients can be safely managed following termination of a hydatidiform mole.
1962年至1978年期间，738例葡萄胎患者被转诊至西北大学约翰·I·布鲁尔滋养细胞疾病中心，以便在清宫术后进行随访及人绒毛膜促性腺激素（hCG）检测。738例患者中有596例（80.8%）的滋养细胞疾病出现自发消退。在这596例患者中，清宫术后第10天内有11例（1.8%）出现消退，第11至30天有124例（20.8%），第31至60天有255例（42.8%），第61至170天有206例（34.6%）。738例患者中有142例（19.2%）需要接受化疗药物治疗；其中125例（16.9%）患有侵蚀性葡萄胎（107例无转移，18例有转移），17例（2.3%）患有绒毛膜癌（13例无转移，4例有转移）。所有hCG滴度自发下降至正常水平的596例患者均保持良好且无疾病。所有142例接受治疗的患者均实现永久缓解。因此，所有738例患者在葡萄胎清宫术后4至18年都保持良好且无疾病。本报告中描述的随访方案提供了清宫术后葡萄胎妊娠自然史的信息，并提供了一种在葡萄胎终止后安全管理所有患者的极佳方法。
