Combined analysis of clinical features, human chorionic gonadotropin (hCG) value, and hCG ratios for early prediction of postmolar gestational trophoblastic neoplasia
Issued Date
2023-04-01
Resource Type
ISSN
09320067
eISSN
14320711
Scopus ID
2-s2.0-85138267693
Pubmed ID
36116082
Journal Title
Archives of Gynecology and Obstetrics
Volume
307
Issue
4
Start Page
1145
End Page
1154
Rights Holder(s)
SCOPUS
Bibliographic Citation
Archives of Gynecology and Obstetrics Vol.307 No.4 (2023) , 1145-1154
Suggested Citation
Rakprasit C., Ruengkhachorn I., Therasakvichya S., Inthasorn P., Achariyapota V., Kuljarasnont S., Khemworapong K., Jareemit N. Combined analysis of clinical features, human chorionic gonadotropin (hCG) value, and hCG ratios for early prediction of postmolar gestational trophoblastic neoplasia. Archives of Gynecology and Obstetrics Vol.307 No.4 (2023) , 1145-1154. 1154. doi:10.1007/s00404-022-06785-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82666
Title
Combined analysis of clinical features, human chorionic gonadotropin (hCG) value, and hCG ratios for early prediction of postmolar gestational trophoblastic neoplasia
Author's Affiliation
Other Contributor(s)
Abstract
Purpose: To investigate factors predicting postmolar gestational trophoblastic neoplasia (GTN) by combined analysis of clinical features, human chorionic gonadotropin (hCG) value, and hCG ratios. Methods: 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. Results: 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. Conclusions: 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.