GTN Diagnosis and Staging.

Majority of gestational trophoblastic neoplasia (GTN) follows molar pregnancies where diagnosis is mostly based on persistent or rising serum human chorionic gonadotrophin (hCG). Diagnosis of GTN could be based on clinical presentation, serum hCG measurement, imaging, histology, and genotyping. A high index of suspicion in women of reproductive age presenting with abnormal vaginal bleeding or unusual systematic presentation is important. An accurate staging and classification system for GTN is crucial to evaluate the risk and the prognosis of patients, and to optimize treatment. GTN is staged using the International Federation of Gynecology and Obstetrics 2000 staging and the modified World Health Organization prognostic scoring system.

Ngu SF ，Ngan HYS 《-》

Serum hCG level and rising world health organization score at second-line chemotherapy (pulse dactinomycin): poor prognostic factors for methotrexate-failed low-risk gestational trophoblastic neoplasia.

Kang WD ，Kim CH ，Cho MK ，Kim JW ，Cho HY ，Kim YH ，Choi HS ，Kim SM ... -  《-》

Linear regression of postevacuation serum human chorionic gonadotropin concentrations predicts postmolar gestational trophoblastic neoplasia.

Lybol C ，Sweep FC ，Ottevanger PB ，Massuger LF ，Thomas CM ... -  《-》

Postmolar gestational trophoblastic neoplasia: beyond the traditional risk factors.

To investigate the slope of linear regression of postevacuation serum hCG as an independent risk factor for postmolar gestational trophoblastic neoplasia (GTN). Multicenter retrospective cohort study. Academic referral health care centers. All subjects with confirmed hydatidiform mole and at least four measurements of β-hCG titer. None. Type and magnitude of the relationship between the slope of linear regression of β-hCG as a new risk factor and GTN using Bayesian logistic regression with penalized log-likelihood estimation. Among the high-risk and low-risk molar pregnancy cases, 11 (18.6%) and 19 cases (13.3%) had GTN, respectively. No significant relationship was found between the components of a high-risk pregnancy and GTN. The β-hCG return slope was higher in the spontaneous cure group. However, the initial level of this hormone in the first measurement was higher in the GTN group compared with in the spontaneous recovery group. The average time for diagnosing GTN in the high-risk molar pregnancy group was 2 weeks less than that of the low-risk molar pregnancy group. In addition to slope of linear regression of β-hCG (odds ratio [OR], 12.74, confidence interval [CI], 5.42-29.2), abortion history (OR, 2.53; 95% CI, 1.27-5.04) and large uterine height for gestational age (OR, 1.26; CI, 1.04-1.54) had the maximum effects on GTN outcome, respectively. The slope of linear regression of β-hCG was introduced as an independent risk factor, which could be used for clinical decision making based on records of β-hCG titer and subsequent prevention program.

Bakhtiyari M ，Mirzamoradi M ，Kimyaiee P ，Aghaie A ，Mansournia MA ，Ashrafi-Vand S ，Sarfjoo FS ... -  《-》

Women with a partial mole during their first pregnancy and diagnosed earlier in gestation are at increased risk of developing gestational trophoblastic neoplasia.

Worley MJ Jr ，Joseph NT ，Berkowitz RS ，Goldstein DP ... -  《-》