scholarly journals Post-molar Choriocarcinoma Prevention with MTX Treatment of Persistent Trophoblastic Disease

2019 ◽  
Vol 2 (4) ◽  
pp. 96-97
Author(s):  
Maeda Kazuo ◽  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Pregnancy Test ◽  
Trophoblastic Disease ◽  
Case Number

Aim: Prevention of post molar choriocarcinoma. Methods: 70 mg Methotrexate (MTX) was administered all post molar cases, whose urinary pregnancy test was negative, while 200-300 mg MTX was administered to two persistent trophoblastic disease, whose pregnancy test was positive by human chorionic gonadotropin (hCG). Control was 37 post molar cases, who received no MTX. Post molar examination were repeated in both groups. Results: No choriocarcinoma developed in 107 MTX group, while 3 cases developed choriocarcinoma in 37 nonMTX group. Choriocarcinoma case number was significantly less in MTX groups.

scholarly journals Lung neoplasm mimicking as ectopic pregnancy due to paraneoplastic secretion of human chorionic gonadotropin: a case report and literature review

2021 ◽  
Author(s):  
Jin Peng ◽  
Shangge lv ◽  
Lin Liu ◽  
Shuai Feng ◽  
Naidong Xing
Keyword(s):  
Systematic Review ◽  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Lung Neoplasm ◽  
High Serum ◽  
Pregnancy Test ◽  
Positive Pregnancy Test ◽  
Β Hcg ◽  
Present Systematic Review

Abstract Purpose The present systematic review aimed to examine the relationship between lung neoplasm and human chorionic gonadotropin (HCG). Especially, women with lung neoplasm mimicking as ectopic pregnancy were explored. Methods A rare case of lung neoplasm with high serum β-HCG, which was initially thought to be ectopic pregnancy, was reported. A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2020. Results Studies assessed lung neoplasm patients with positive HCG were included. Twenty studies, including 24 patients, were included. These cases illustrate the importance of considering the possibility of paraneoplastic secretion of β-HCG in patients who have a positive pregnancy test. This may prevent a delay in the diagnosis and treatment of malignancy in young women. Of the 24 cases, only 7 (29.17%) were managed surgically; others were managed conservatively or with chemotherapy or radiation. Conclusion The present systematic review shows the need to re-awaken awareness and high index of suspicion to lung neoplasm diagnosis in patients with positive pregnancy test.

Quantitative automated human chorionic gonadotropin measurement in urine using the Modular Analytics E170 module (Roche)

2005 ◽  
Vol 43 (1) ◽  
Author(s):  
Nasser E. Ajubi ◽  
Nine Nijholt ◽  
Albert Wolthuis
Keyword(s):  
Pregnant Woman ◽  
Detection Limit ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Storage Period ◽  
Manual Labor ◽  
Pregnancy Test ◽  
Automated Methods ◽  
Inter Assay Variation ◽  
Analytical Detection

AbstractOngoing demands on laboratory performance require optimization of processes. An obvious way to achieve this is to reduce manual labor in favor of automated methods. We describe the validation of an automated quantitative urine human chorionic gonadotropin (hCG) analysis on the Roche Modular E170 analyzer to replace the manual qualitative pregnancy test in urine. At urine hCG concentrations of 476, 45 and 11U/L, we found inter-assay variation of 4.3%, 4.3% and 6.8% and average intra-assay variation of 3.0%, 2.6% and 3.0%, respectively. The analytical detection limit was 0.7U/L. We did not detect any loss (due to degradation or adsorption) during a storage period of 5days at 4°C or at −20°C. Recoveries of hCG in urine of a pregnant woman diluted with urine of a pre-menopausal non-pregnant woman (concentration range between 6 and 800mU/L) were between 93% and 112% (y=0.997x−3.843, r

Clinical Utility of Hyperglycosylated hCG in Serum Taken before Hydatidiform Mole Evacuation to Predict Persistent Trophoblastic Disease

2006 ◽  
Vol 21 (1) ◽  
pp. 45-49 ◽  
Author(s):  
H. Ngo Duc ◽  
N.E. van Trommel ◽  
F.C.G.J. Sweep ◽  
L.F.A.G. Massuger ◽  
C.M.G. Thomas
Keyword(s):  
Diagnostic Accuracy ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Hydatidiform Mole ◽  
Subsequent Development ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Trophoblastic Disease ◽  
Central Registry ◽  
Hydatidiform Moles

Objective Human chorionic gonadotropin (hCG) is widely used in the management of hydatidiform mole and persistent trophoblastic disease (PTD). Studies on hyperglycosylated human chorionic gonadotropin (invasive trophoblast antigen, ITA) in PTD are limited. In serum samples taken before evacuation of molar pregnancies we measured the concentrations of free hCG β-subunit (free hCGβ), “total” hCG (hCG+hCGβ) and ITA, and determined whether ITA, the two other hCG analytes, or the calculated ratios of hCGβ/hCG+hCGβ, hCGβ/ITA and hCG+hCGβ/ITA could predict the later development of PTD. Design A retrospective study based on blood specimens collected in the Dutch Central Registry for Hydatidiform Moles. The study group comprised 97 patients with hydatidiform moles who did not develop PTD after mole evacuation and 33 patients who did develop PTD. Methods Serum samples from 130 patients with hydatidiform mole with or without PTD were assayed using specific (radio)immunoassays for free hCGβ, total hCG, and ITA. From these analytes we also calculated the ratios hCGβ/hCG+hCGβ, hCGβ/ITA, and hCG+hCGβ/ITA. To predict the development of PTD from these analytes and parameters we performed receiver-operating characteristic (ROC) curve analysis, resulting in areas under the curve (AUCs) that represented the diagnostic accuracy which was rated in a range from excellent (AUC >0.9 or <0.1) to poor (AUC 0.4–0.6). Results The diagnostic accuracy of ITA was moderate (0.618) and not different from that of free hCGβ (0.610) and hCG+hCGβ (0.622). Conclusions ITA as well as the other analytes and parameters in serum taken prior to evacuation from patients with molar pregnancies cannot be used to predict the subsequent development of persistent trophoblastic disease.

Trophoblastic cells expressing human chorionic gonadotropin genes in peripheral blood of patients with trophoblastic disease

Life Sciences ◽  
2000 ◽  
Vol 66 (17) ◽  
pp. 1593-1601 ◽  
Author(s):  
Rika Taniguchi ◽  
Tamio Koizumi ◽  
Hiranmoy Das ◽  
Sanjoy Chakraborty ◽  
Takeshi Sugimoto ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Peripheral Blood ◽  
Trophoblastic Disease ◽  
Trophoblastic Cells

Is normal β-hCG regression curve helpful in the diagnosis of persistent trophoblastic disease?

2004 ◽  
Vol 14 (5) ◽  
pp. 980-983
Author(s):  
N. Behtash ◽  
F. Ghaemmaghami ◽  
H. Honar ◽  
K. Riazi ◽  
A. Nori ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Confidence Limits ◽  
Regression Curve ◽  
Normal Range ◽  
Trophoblastic Disease ◽  
Normal Regression ◽  
Β Hcg ◽  
Hydatidiform Moles

ObjectiveThe aim of this study was to evaluate the probable usefulness of normal β-human chorionic gonadotropin (β-hCG) regression curve in the diagnosis of persistent trophoblastic disease (PTD).MethodsA log-value regression curve was developed from the means and 95% confidence limits of serial weekly serum β-hCG titers of 43 patients with uneventful complete hydatidiform moles and 14 patients, who were previously confirmed as PTD.ResultsAll 14 PTD patients (100%) had abnormal values, beyond normal range, within 4 weeks. β-hCG was in its upper values, compared to normal regression curve at 2.29 ± 0.19 weeks. This was earlier than plateau or rise detection at 4.21 ± 0.33 weeks (P < 0.001). Within 3 weeks of evacuation, 13 of 14 (92.86%) PTD patients' β-hCG values exceeded the normal range, whereas only six of 14 (42%) showed a rise or plateau.ConclusionOur finding indicates that the normal β-hCG regression curve may be useful for quicker detection of PTD than the plateau or rise of level.

Is there uniformity in definitions and treatment of gestational trophoblastic disease in Europe?

2019 ◽  
Vol 29 (1) ◽  
pp. 108-112 ◽  
Author(s):  
Minke M Frijstein ◽  
Christianne A R Lok ◽  
John Coulter ◽  
Nienke E van Trommel ◽  
Marianne J ten Kate – Booij ◽  
...  
Keyword(s):  
High Risk ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Gestational Trophoblastic Disease ◽  
Gestational Trophoblastic Neoplasia ◽  
Clinical Practices ◽  
Trophoblastic Disease ◽  
Consensus Statements ◽  
Definition Of

ObjectivesBecause gestational trophoblastic disease is rare, little evidence is available from randomized controlled trials on optimal treatment and follow-up. Treatment protocols vary within Europe, and even between different centers within countries. One of the goals of the European Organization for Treatment of Trophoblastic Diseases (EOTTD) is to harmonize treatment in Europe. To provide a basis for international standardization of definitions, treatment and follow-up protocols in gestational trophoblastic disease, we evaluated differences and similarities between protocols in EOTTD countries.MethodsMembers from each EOTTD country were asked to complete an online structured questionnaire comprising multiple-choice and multiple-answer questions. The following themes were discussed: incidence of gestational trophoblastic disease and gestational trophoblastic neoplasia, definitions, guidelines, classification system, treatment, recurrence, and follow-up.ResultsForty-four respondents from 17 countries participated in this study. Guidelines were present in 80% of the countries and the FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) staging and risk classification was often used to estimate risks. Agreement about when to start chemotherapy for post-molar gestational trophoblastic neoplasia was present among 66% of the respondents. Preferred first-line treatments in low- and high-risk gestational trophoblastic neoplasia were methotrexate (81%) and EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (93%), respectively. The definition of human chorionic gonadotropin normalization after hydatidiform mole evacuation was two consecutive normal values for nine countries. The FIGO definition of post-molar gestational trophoblastic neoplasia based on human chorionic gonadotropin plateau or rise was agreed on by 69% of respondents, and only 69% and 74% defined low-risk and high-risk disease, respectively, using FIGO criteria. There were major differences in definitions of recurrence, chemotherapy resistance and follow-up protocols among countries, despite EOTTD consensus statements.ConclusionsThis questionnaire provides a good overview of current clinical practices in different countries. Based on the survey results, it is clear that there are several gestationaltrophoblastic disease-related topics that need urgent attention within the EOTTD community to create more uniformity and to aid the development of uniform guidelines in Europe.

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