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标题：Early Detection of Gestational Trophoblastic Neoplasia Based on Serial Measurement of Human Chorionic Gonadotrophin Hormone in Women with Molar Pregnancy
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作者：Roya Riahi ; Abbas Rahimiforoushani ; Keramat Nourijelyani 等
期刊名称：INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE
印刷版ISSN：2008-7802
出版年度：2020
卷号：11
DOI：10.4103/ijpvm.IJPVM_288_19
语种：English
出版社：ISFAHAN UNIVERSITY OF MEDICAL SCIENCES
摘要：Background: The majority of studies which investigate the predicted power of Human chorionic gonadotropin (hCG) levels to the occurrence of Gestational trophoblastic neoplasia (GTN) considered the effect of a single measurement of hCG or used classical statistical methods without considering the endogenous marker. The aim of this study is to investigate the association between weekly measurements of β-hCG with time to GTN occurring, using a robust Bayesian joint modeling. Methods: Data of 201 women with a molar pregnancy were considered for this retrospective cohort study. After the first measurement of β-hCG in 48 hours post evacuation of mole, the other titration was performed on a weekly basis until three consecutive normal titers. The association between serial measurements of β-hCG and risk of GTN occurring were assessed by the classic and Bayesian joint modeling and in separate analysis the mixed linear effect and Cox-PH model were used. Results: The mean age (SD) of participants was 26.6 (6.55) year. The GTN was occurred among 14.9% of patients. The association parameter using Bayesian approach was estimated as 1.30 (95% CI: 0.44 to 2.20) which showed one unit increase in the log β-hCG corresponds to the 2.80-times increase in the hazard for the occurrence of GTN (Hazard Ratio: 2.80, 95% CI: 1.55 to 8.98). Conclusions: Findings of this study revealed that weekly measurements of β-hCG are an important and reliable biomarker to early detection of developing of molar pregnancy to persistent GTN.