Clinical Analysis Of 47 Cases Of Invasive Mole And Choriocarcinoma

OBJECTIVE: To analyze the clinical trends of invasive mole and choriocarcinoma (IHM & CC)at the Department of Obstetrics and Gynecology, the First Hospital of Ji Lin University.METHODS: A medical record review was performed of epidemiologic, clinical and diagnostic features of 47 cases of invasive mole and choriocarcinoma at the First Hospital of Ji Lin University from 2000 to 2007.RESULTS: In this research, the ages of patients were between 18 and 50 years.The mean age was 28.4 years. The middle age was 27 years. The ages distributed like normal school. The pinnacle was 20 to 25 years. 82.4% ages were between 20 and 25 years. Team of younger than 20 years and team of older than 40 years were the most proportions in rates of case load and their total numbers of pregnancies in hospital. There were 30 cases having history of abortion in IHM & CC, occupied 63.8%.The average was 1.62 times. The most was 6 times. The comparation of IHM & CC in abortion history had no statistics significance(p﹥0.05). 93.9% IHM happened in 6 months afer post hydatidiform mole. 81.8% IHM happened in 3 months. In the antecedence pregnancies of CC, hydatidiform mole ,term delivery and abortion had nealy same rates, and could be taken bad at any time. CC of posthydatidiform mole after 1 year occupied 60%. The comparation of IHM & CC in time of antecedence pregnancies had statistics significance(p﹤0.05). The most common symptom was vaginal bleeding,39 cases, occupied 83.0%. The shortest bleeding time was 1day. The longest bleeding time was 1 year. The average was 2.6 monthes. The comparation of IHM & CC in vaginal bleeding had no statistics significance(p﹥0.05).The symptom of abdominal discomfort was 21 cases, occupied 42%, thereinto abdominal pain occupied 6%. The comparation of IHM & CC in abdominal discomfort had no statistics significance(p﹤0.05). The metastasis rate of IHM was 60.6%. The GTN metastasis rate of CC was 71.4%. The comparation of IHM & CC in metastasisrate had no statistics significance(p﹥0.05).The lung metastasis rate of IHM was 33.3%. The GTN metastasis rate of CC was 64.3%. The comparation of IHM & CC in lung metastasis rate had statistics significance(p﹤0.05). The miss diagnose rate of IHM & CC was 22%. There were 34 cases in 5-FU and KSM chemotherapy. All of them had digestive system reaction in different extentions, thereinto 13 cases influencing taking food, 2 cases of severe buccal ulcer and diarrhea, 7 cases of slight myelosuppression and slight live disfunction. Except 1 death case, other cases were all treated by heteropathy. There were 11 cases having operation therapy, 5 cases in IHM, 6 cases in CC. The comparation of IHM & CC in operation had statistics significance(p﹥0.05). In this data, the efficiency of treatment was 92.9%,and the recent cure rate was 78.6%. The recent cure rate of IHM & CC inⅠ,Ⅱstage nearly reached 100%. The average time ofβHCG turning negative in IHM was 11.4091 weeks, S=4.6050. The average time ofβHCG turning negative in CC was 16.6250 weeks, S=6.2778. The comparation of IHM & CC in had statistics significance(p﹤0.05).βHCG turning negative time of 68.2% IHM was between 9 and 12 weeks.CONCLUSION: The most ages in IHM & CC are between 20 and 35 years, but women who were younger than 20 years and older then 35 years more easily got IHM & CC,and the latter had more fatalness. IHM & CC all had high rate abortion history, shows that abortion may have relationship with IHM & CC. 3 months after hydatidiform mole is the risk time for IHM. The time after hydatidiform mole have some relationship with IHM & CC. menopause is more common in CC than IHM. Vaginal bleeding is the most common symptom in IHM & CC. The abdominal discomfort in CC is more than in IHM, IHM & CC all have a cute abdomen rate. IHM & CC all have rather high matestasis rate, CC higher than IHM. The miss diagnose is quite high in IHM & CC, untypical symptom such as vaginal bleeding, cough, hemoptysis, anemia, nerve system symptom, et al. if the above symptoms come on and pathogeny is not very clear, IHM & CC should be taken into account. Heteropathy is important in chemotherapy. Most patients can be cured bychemotherapy, if necessary operation also can be used. Afer chemotherapyβHCG turning negative time in CC are longer than in IHM.