低危型妊娠滋养细胞肿瘤血β-HCG下降时间的影响因素分析  

Prognostic Factors Associated with HCG Regression Time in Postmolar Gestational Trophoblastic Neoplasia Patients

作　　者：朱烨[1] 周璘[1] 雷月[1] 周晓美[1] 苏亦平[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院,江苏南京210004

出　　处：《实用妇产科杂志》2016年第11期834-838,共5页Journal of Practical Obstetrics and Gynecology

基　　金：江苏省妇幼保健科研项目(编号:F201211);南京市科技发展项目(编号:201503049)

摘　　要：目的:探讨葡萄胎后低危型妊娠滋养细胞肿瘤(GTN)患者血β-人绒毛膜促性腺激素(β-HCG)下降时间与临床影响因素的相关性。方法:选取南京医科大学附属南京市妇幼保健院2007年1月至2014年9月期间继发于葡萄胎后低危型GTN患者50例。通过单因素和多因素分析方法分析年龄、既往葡萄胎妊娠史、葡萄胎清宫术后的组织病理学诊断、GTN确诊前的持续时间(葡萄胎清宫术后至确诊GTN的时间)、有无转移性病灶、治疗前血β-HCG水平、FIGO评分、一线化疗方案与血β-HCG下降时间的相关性。结果:血β-HCG下降时间平均(34.2±19.3)天。多因素分析表明完全性葡萄胎(HR 1.446)、GTN确诊前的持续时间<12周(HR 1.775)、有转移性病灶(HR 1.228)、治疗前血β-HCG水平高(HR 1.468)与血β-HCG下降时间相关。FIGO评分与血β-HCG下降时间的线性分析表明,FIGO评分每增加1分,血β-HCG下降时间平均增加7天。结论:完全性葡萄胎、治疗前血β-HCG水平高、确诊GTN前的持续时间小于12周及转移性病灶的存在是延长葡萄胎后低危型GTN患者血β-HCG下降时间的影响因素。Objective：Identify the clinical factors associated with human chorionic gonadotropin（HCG） regression time among women with postmolar GTN. Methods：Collected 50 patients from January 2007 to September 2014 diagnosed with low-risk postmolar GTN according to FIGO 2000 criteria. Associations between patient＇s age, HCG regression time, history of prior mole, histologic evidence, persistence time, presence of metastatic disease,FIGO score, HCG levels before treatment, chemotherapy protocols were investigated with univariate and multivariate analyses. Results：The mean HCG regression time was（34.2 ±19.3） days. The complete molar histology（ HR 1. 446） ,metastatic disease（ HR 1. 228） ,the persistence time（ HR 1. 775） and high HCG levels pretreatment（ HR 1. 468） were associated with HCG regression time. There was a linear relationship between FIGO score and HCG regression time. Each 1-point increment in FIGO score was associated with an average -7day increase in HCG regression time. Conclusions： Histologic evidence of complete hydatidiformmole, HCG levels pretreatment the presence of metastatic disease, persistence time less than 12 weeks before the diagnosis of postmolar GTN were independent factors associated with hCG regression time in postmolar GTN.

关 键 词：低危型妊娠滋养细胞肿瘤 人绒毛膜促性腺激素 下降时间 临床因素 化疗 

分 类 号：R737.3[医药卫生—肿瘤]