不同HCG水平妊娠滋养细胞肿瘤的临床特征和治疗分析

Characteristics of gestational trophoblastic neoplasia with different levels of human chorionic gonadotropin

目的探讨不同人绒毛膜促性腺激素(HCG)水平妊娠滋养细胞肿瘤患者的临床特点与治疗措施。方法收集56例妊娠滋养细胞肿瘤患者的资料,根据入院时血清HCG值分为低水平组(27例)和高水平组(29例),比较两组患者在发病时间、临床表现、临床分期及治疗疗效等方面的差异。结果两组患者诊断GTN距末次妊娠时间差异有统计学意义(P<0.05)。低水平组患者出现阴道流血症状的概率明显高于高水平组,差异有统计学意义(P<0.05)。两组患者临床分期的差异有统计学意义(P<0.05),预后评分差异无统计学意义(P>0.05)。高水平组患者肺转移率明显高于低水平组,差异有统计学意义(P<0.05)。两组患者化疗时耐药发生率的差异无统计学意义(P>0.05),但高水平组患者平均疗程长于低水平组,差异有统计学意义(P<0.05)。结论不同水平的GTN患者在临床特征及治疗时间上存在一定的差异,但只要选择合理的化疗方案,必要时辅以手术治疗,均可获得良好的治疗效果。

Objective To review the clinical characteristics and treatment of gestational trophoblastic neopiasia （GTN） with different levels of human chorionic gonadotropin （HCG）. Methods Fifty six patients with GTN were enrolled in the study, including 27 cases with low HCG level and 29 cases with high HCG levels. The onset, manifestations, stage and clinical efficacy were compared between two groups. Results The interval between antecedent pregnancies and GTN had statistically significant differences between the patients with different levels of HCG （P〈0.05）. The incidence of vaginal bleeding in patients with low HCG levels was higher than that in patients with high HCG levels （P〈0.05）. There was significant difference in distribution of GTN stages between two groups （P〈0.05）, while there was no difference in prognosis score between two groups （P 〉0.05）. There was also significant difference in the incidence of lung metastasis between two groups （P〈0.05）. There was no difference in drug resistance between two groups （P 〉0.05）, but patients with high HCG levels required more courses of chemotherapy than those with low HCG levels （P〈0.05）. Conclusion There are some differences in clinical features and treatment for GTN patients with different levels of HCG, but all patients can obtain satisfactory outcomes if they receive appropriate chemotherapy and surgical treatment.