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[关于磨牙后区患者的随访期(作者译)]

[On the follow up period of postmolar patient (author's transl)].

作者信息

Hando T, Maruyama S, Watanabe S, Hirogami T, Obata N, Kanazawa K, Takeuchi S

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1982 Mar;34(3):287-91.

PMID:7069243
Abstract

We discussed how long should postmole patients be followed up by the analysis of 44 cases of postmolar invasive mole and 14 cases of postmolar choriocarcinoma treated in our hospital between 1971 and 1979. All of the invasive mole have been detected before their urinary hCG titer fell below normal pituitary LH level and by the 5 th month after the termination of molar pregnancy. While only 2 cases out of 14 cases of postmolar choriocarcinoma have been detected before their urinary hCG titer fell below LH level and by the 5 th postmole month. The other 12 cases of choriocarcinoma were diagnosed later than the 6 th postmole month. The longest interval between termination of mole and diagnosis of postmolar choriocarcinoma was 7 years and 2 months, the interval of which was also the longest among all of the postmolar choriocarcinoma registered to the Committee of Registration for Trophoblastic Disease in Japan Society of Obstetrics and Gynecology in 1974 through 1978. Therefore from the empirical point of view, the postmole patient should be followed up to 7 years and 2 months at the shortest. Besides almost all of the secondary sequelae after mole which were detected before urinary hCG titer fell below LH level were actually invasive mole (44 cases). Choriocarcinoma (2 cases) in this stage was exceptional (2 cases/46 cases = 4.4%). On the other hand, once the molar patient showed normal LH level in their urinary hCG determination, the secondary sequela was invariably choriocarcinoma. This way of discriminating invasive mole from choriocarcinoma is the key in the management of postmolar patient.

摘要

通过对我院1971年至1979年间治疗的44例侵蚀性葡萄胎和14例绒毛膜癌患者进行分析,我们探讨了葡萄胎后患者应随访多长时间。所有侵蚀性葡萄胎均在尿hCG滴度降至正常垂体LH水平之前,以及葡萄胎妊娠终止后第5个月时被检测到。而14例绒毛膜癌患者中,只有2例在尿hCG滴度降至LH水平之前,以及葡萄胎后第5个月时被检测到。其他12例绒毛膜癌患者在葡萄胎后第6个月以后才被诊断出来。葡萄胎终止与绒毛膜癌诊断之间的最长间隔为7年零2个月,在1974年至1978年向日本妇产科学会滋养细胞疾病登记委员会登记的所有葡萄胎后绒毛膜癌病例中,这一间隔也是最长的。因此,从经验角度来看,葡萄胎后患者最短应随访7年零2个月。此外,几乎所有在尿hCG滴度降至LH水平之前被检测到的葡萄胎后继发后遗症实际上都是侵蚀性葡萄胎(44例)。在此阶段的绒毛膜癌(2例)是例外情况(2例/46例 = 4.4%)。另一方面,一旦葡萄胎患者尿hCG测定显示LH水平正常,继发后遗症则总是绒毛膜癌。这种区分侵蚀性葡萄胎和绒毛膜癌的方法是管理葡萄胎后患者的关键。

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