Abstract：
To investigate factors predicting postmolar gestational trophoblastic neoplasia (GTN) by combined analysis of clinical features, human chorionic gonadotropin (hCG) value, and hCG ratios.
This retrospective study enrolled patients with histopathologically proven molar pregnancy. Patients lost to follow-up before remission or developing postmolar GTN were excluded. Demographic and clinical characteristics and hCG data obtained before and after molar evacuation were collected. Area under the receiver operating characteristic curve (AUC) analysis was used to identify the hCG and hCG ratio cutoff values that predict postmolar GTN. Multivariate analysis was employed to identify independent predictors of GTN.
There were 113 complete moles, 11 partial moles, and 52 unspecified moles included in the final analysis. Of the 176 cases, 90 achieved remission and 86 developed post-molar GTN. The incidence of postmolar GTN was 48.9%, with a median time to GTN development of 5 weeks. Univariate analysis showed age, molar evacuation performed elsewhere, pre-evacuation hCG, hCG at 2nd week post-evacuation, and ratio of hCG at 2nd week post-evacuation to post-evacuation hCG significantly predict GTN. Multivariate analysis revealed an hCG value ≥ 1400 IU/L at 2nd week post-evacuation (AUC: 0.92, aOR: 6.51, 95% CI 1.28-33.16; p = 0.024) and a ratio of hCG at 2nd week post-evacuation to post-evacuation hCG of ≥ 0.02 (AUC: 0.88, aOR: 12.27, 95% CI 2.15-70.13; p = 0.005) to independently predict GTN.
An hCG value ≥ 1400 IU/L at 2nd week post-evacuation and a ratio of hCG at 2nd week post-evacuation to post-evacuation hCG of ≥ 0.02 independently and reliably predict postmolar GTN.
This retrospective study enrolled patients with histopathologically proven molar pregnancy. Patients lost to follow-up before remission or developing postmolar GTN were excluded. Demographic and clinical characteristics and hCG data obtained before and after molar evacuation were collected. Area under the receiver operating characteristic curve (AUC) analysis was used to identify the hCG and hCG ratio cutoff values that predict postmolar GTN. Multivariate analysis was employed to identify independent predictors of GTN.
There were 113 complete moles, 11 partial moles, and 52 unspecified moles included in the final analysis. Of the 176 cases, 90 achieved remission and 86 developed post-molar GTN. The incidence of postmolar GTN was 48.9%, with a median time to GTN development of 5 weeks. Univariate analysis showed age, molar evacuation performed elsewhere, pre-evacuation hCG, hCG at 2nd week post-evacuation, and ratio of hCG at 2nd week post-evacuation to post-evacuation hCG significantly predict GTN. Multivariate analysis revealed an hCG value ≥ 1400 IU/L at 2nd week post-evacuation (AUC: 0.92, aOR: 6.51, 95% CI 1.28-33.16; p = 0.024) and a ratio of hCG at 2nd week post-evacuation to post-evacuation hCG of ≥ 0.02 (AUC: 0.88, aOR: 12.27, 95% CI 2.15-70.13; p = 0.005) to independently predict GTN.
An hCG value ≥ 1400 IU/L at 2nd week post-evacuation and a ratio of hCG at 2nd week post-evacuation to post-evacuation hCG of ≥ 0.02 independently and reliably predict postmolar GTN.
摘要：
目的：结合临床特点，探讨预测磨牙后妊娠滋养细胞肿瘤（GTN）的相关因素。人绒毛膜促性腺激素（hCG）值，和HCG比率。
方法：这项回顾性研究纳入了组织病理学证实为磨牙妊娠的患者。排除在缓解或发展磨牙后GTN之前失去随访的患者。收集在磨牙疏散前后获得的人口统计学和临床特征以及hCG数据。使用接受者工作特征曲线下面积（AUC）分析来鉴定预测后磨牙GTN的hCG和hCG比率截止值。多变量分析用于确定GTN的独立预测因子。
结果：共有113个完全痣，11部分摩尔，以及最终分析中包含的52个未指定的摩尔。在176个案例中，90例获得缓解，86例出现磨牙后GTN。磨牙后GTN的发生率为48.9%,GTN发育的中位时间为5周。单因素分析显示年龄,在其他地方进行摩尔疏散，撤离前的hCG，HCG在疏散后第二周，撤离后第2周的hCG与撤离后的hCG比率显着预测GTN。多变量分析显示，撤离后第2周hCG值≥1400IU/L（AUC：0.92，aOR：6.51，95％CI1.28-33.16；p=0.024），撤离后第2周hCG与撤离后hCG的比率≥0.02（AUC：0.88，aOR：12.27，95％CI2.15-70.13；p=0.005）以独立预测GTN。
结论：撤离后第2周的hCG值≥1400IU/L，撤离后第2周的hCG与撤离后的hCG之比≥0.02独立可靠地预测后磨牙GTN。
方法：这项回顾性研究纳入了组织病理学证实为磨牙妊娠的患者。排除在缓解或发展磨牙后GTN之前失去随访的患者。收集在磨牙疏散前后获得的人口统计学和临床特征以及hCG数据。使用接受者工作特征曲线下面积（AUC）分析来鉴定预测后磨牙GTN的hCG和hCG比率截止值。多变量分析用于确定GTN的独立预测因子。
结果：共有113个完全痣，11部分摩尔，以及最终分析中包含的52个未指定的摩尔。在176个案例中，90例获得缓解，86例出现磨牙后GTN。磨牙后GTN的发生率为48.9%,GTN发育的中位时间为5周。单因素分析显示年龄,在其他地方进行摩尔疏散，撤离前的hCG，HCG在疏散后第二周，撤离后第2周的hCG与撤离后的hCG比率显着预测GTN。多变量分析显示，撤离后第2周hCG值≥1400IU/L（AUC：0.92，aOR：6.51，95％CI1.28-33.16；p=0.024），撤离后第2周hCG与撤离后hCG的比率≥0.02（AUC：0.88，aOR：12.27，95％CI2.15-70.13；p=0.005）以独立预测GTN。
结论：撤离后第2周的hCG值≥1400IU/L，撤离后第2周的hCG与撤离后的hCG之比≥0.02独立可靠地预测后磨牙GTN。
