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首页> 外文期刊>Journal of Gynecologic Oncology >The management of hydatidiform mole with lung nodule: a retrospective analysis in 53 patients
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The management of hydatidiform mole with lung nodule: a retrospective analysis in 53 patients

机译：葡萄胎结节性葡萄胎的治疗：53例回顾性分析

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Objective To investigate the significance of lung nodule in hydatidiform mole, we retrospectively compared the clinical outcomes of those patients treated with different strategies. Methods The patients were divided into three groups: chemotherapy immediately once lung nodule was detected (group 1, n=17), delayed chemotherapy until human chorionic gonadotrophin (hCG) level met the diagnostic criteria for gestational trophoblastic neoplasia (GTN) (group 2, n=18), and hCG surveillance alone until hCG level was normalized spontaneously (group 3, n=18). The clinical parameters of these patients were collected and analyzed. Results Totally 53 (4.0%) patients were included from 1,323 cases with molar pregnancy during past 16 years. Among them, the diameters of lung nodules were 0.3–2.5 cm. Chemotherapy cycles for achieving hCG normalization and the failure rate of first-line chemotherapy in group 1 were significantly increased than that in group 2 (5 vs. 3 cycles, p=0.000, 58.8% vs. 11.1%, p=0.005). The hCG level of all 18 cases in group 3 was normalized spontaneously within 6 months. Of those, lung nodules of 9 patients disappeared spontaneously, accounting for 25% (9/36) of patients who initially selected observation. The proportion of single nodule in group 3 was significantly higher than that in group 2 (10/18 vs. 2/18, p=0.012). Conclusion Our results suggest that lung nodule alone is not an adequate indication of chemotherapy in molar pregnancy. hCG surveillance is safe for patients with lung nodule, especially with single nodule, as long as their hCG levels do not meet International Federation of Gynecology and Obstetrics diagnostic criteria for GTN.
机译：目的回顾性分析葡萄胎结节状葡萄胎中肺结节的意义，回顾性比较采用不同策略治疗的患者的临床结局。方法将患者分为三组：一旦发现肺结节立即进行化学治疗（第1组，n = 17），延迟化疗直至人绒毛膜促性腺激素（hCG）水平达到妊娠滋养细胞瘤形成（GTN）的诊断标准（第2组）。 n = 18），并单独进行hCG监测，直至自发地将hCG水平标准化（第3组，n = 18）。收集并分析这些患者的临床参数。结果在过去16年中，共有1,323例磨牙妊娠患者中包括53例（4.0％）。其中，肺结节直径为0.3-2.5 cm。与第2组相比，第1组中实现hCG正常化的化学疗法周期和一线化疗的失败率显着增加（5 vs. 3周期，p = 0.000，58.8％vs. 11.1％，p = 0.005）。第三组所有18例患者的hCG水平在6个月内自发恢复正常。其中，9例患者的肺结节自发消失，占最初选择观察的患者的25％（9/36）。第3组的单个结节比例明显高于第2组（10/18 vs. 2/18，p = 0.012）。结论我们的结果表明，仅磨牙结节不足以解决磨牙妊娠中的化疗。只要其hCG水平不符合国际妇产科联合会（GTN）诊断标准，hCG监测对于肺结节，尤其是单结节的患者是安全的。

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