DEVELOPMENT OF POSTMOLAR TROPHOBLASTIC DISEASE AFTER PARTIAL MOLAR PREGNANCY
DEVELOPMENT OF POSTMOLAR TROPHOBLASTIC DISEASE AFTER PARTIAL MOLAR PREGNANCY
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DOI：
10.1006/gyno.1993.1028
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发表时间：
1993-02-01
影响因子：
4.7
通讯作者：
TOMODA, Y
中科院分区：
文献类型：
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作者：
GOTO, S;YAMADA, A;TOMODA, Y
我们调查了部分葡萄胎妊娠患者和侵袭性部分葡萄胎患者的临床特征。在1981年至1990年期间，爱知县滋养细胞疾病登记中心对349例部分磨牙妊娠患者进行了随访。349例部分性磨牙妊娠中10例发生侵袭性部分性葡萄胎，发生率为2.87%，显著低于同期完全性磨牙妊娠后发生侵袭性完全性葡萄胎的174例（12.34%）（P< 0.01）。没有一个病人有任何组织学证据绒毛膜癌后部分磨牙妊娠。将这10例患者的病历与174例登记的侵袭性完全性葡萄胎患者中的85例进行比较，其临床信息可以使用。侵蚀性部分性葡萄胎患者从产胎到确诊侵蚀性葡萄胎的时间小于9周（平均4.90周），侵蚀性完全性葡萄胎患者从产胎到确诊侵蚀性葡萄胎的时间为2 ~ 18周（平均8.12周），差异有显著性（P< 0.01）。10例侵袭性部分性葡萄胎患者经8个疗程（平均5.50个疗程）化疗后hCG均为阴性（<0.5mIU/ml）。疗程数与侵袭性完全性葡萄胎组相同（平均5.70个疗程）。侵袭性部分性葡萄胎患者无复发。我们的结论是，所有患者部分磨牙妊娠应随访，因为是那些完全磨牙妊娠。部分葡萄胎妊娠的患者会在相对较短的时间内发展为侵袭性部分葡萄胎，但可以达到缓解而不会复发，绒毛膜癌很少在部分葡萄胎妊娠后发展。
We investigated the clinical characteristics of patients with partial molar pregnancy and patients who developed invasive partial mole. Between 1981 and 1990, 349 patients were followed up by the Aichi prefecture trophoblastic disease registration center after partial molar pregnancy. Ten of the 349 patients with partial molar pregnancy developed invasive partial mole, an incidence (2.87%) significantly lower (P< 0.01) than that for the development of invasive complete mole (174/1410, 12.34%) following complete molar pregnancy during the same period. None of the patients had any histologic evidence of choriocarcinoma after partial molar pregnancy. The medical records of these 10 patients were compared with those of 85 of 174 registered patients with invasive complete mole, whose clinical information could be used. The interval from molar delivery to the diagnosis of invasive mole was under 9 weeks (mean, 4.90 weeks) for the patients with invasive partial mole and was significantly shorter than that for the patients with invasive complete mole, from 2 to 18 weeks (mean, 8.12 weeks) (P< 0.01). All 10 patients with invasive partial mole achieved a negative hCG level (<0.5 mIU/ml) with eight courses or less of chemotherapy (mean, 5.50 courses). The number of courses was the same as that in the invasive complete mole group (mean, 5.70 courses). None of the patients with invasive partial mole developed recurrence. We conclude that all patients with partial molar pregnancy should be followed up as are those with complete molar pregnancy. Some patients with partial molar pregnancy will develop invasive partial mole with a relatively short interval, but remission can be achieved without the recurrence and choriocarcinoma seldom develops after partial molar pregnancy.