Clinical Analysis Of233Cases With Gestational Trophoblastic Disease Patients Of Different Ages

Objective: The purpose of this study is, through analyzing retrospectively the clinicaldata of the GTD patients with different age, to understand GTD incidence trend, incidencerate and malignant rate of the GTD patients with different age, relevant factors, clinicalfeatures, misdiagnosis and the treatment method, so as to avoid risk factors and search forearly remedy of diagnosis and treatment, to reduce the rate of misdiagnosis and thus toimprove the patients survival rate and prolong patients’ life.Method: Collect233cases patients with gestational trophoblastic disease from thegynecology of our hospital from1999and2012, and the same period of6231cases lying-inwoman, adopt the method of retrospective, descriptive comparison analysis,use the EXCELsoftware to establish the database and to chart and statistical analysis of the clinical data of233patients with GTD.Contents:(1) Incidence trends of GTD patients during14years(2) Incidence rate changes of GTD patients with different ages(3) Malignant proportion GTD patients with different ages(4) Comparison between GTD patients and the number of births during the same period(5) Incidence relevant factors of GTD patients with different ages(6) Comparison of clinical features of GTD patients with different ages(7) The rate of clinical misdiagnosis of GTD patients with different ages(8) Treatment choice of GTD patients with different agesResults:1. The study data displayed that the number of GTD patients was in anupward trend during the14years,which rised up to by5.8times, the number of hydatidiformmole patients rised up to by6.1times, the number of GTN patients rised up to by4.5times2,70%GTD occurred in childbearing age as21~40years old,the proportion of hydatidiformmole was up to26.71%between21~25years old women and GTN was up to33.33%.3,Malignant rate of GTD patients who were41years old or more was the highest,as for as 40.00%.4,Relative to the number of births for the same period, the incidence rate of GTDwas the highest,as for as28.30%, secondly for aged20or less years old woman. Therefore,perimenopausal women had the highest incidence of GTD during pregnancy.5, Womenaged20or less had a higher chance for the occurrence of hydatidiform mole duringpregnancy for the first time. GTD patients of perimenopausal occurred in the women whopregnance more than four times. Therefore,the number of pregnancy had obviousrelationship with GTD disease of different ages.6, GTD patients distributed mainly in therural areas, the proportion of hydatidiform mole patient distributed in rural was69.57%, theproportion of GTN patient distributed in rural was72.22%;7, The occurrence of GTD had acertain relationship with profession, which all tended to occur among farmers.8, Mainclinical symptoms of hydatidiform mole patients with different ages were menopause andvaginal bleeding, which respectively accounted for86.76%and60.29%, but the proportionof different age groups was different,35years old or less young patients ware given priorityto menopause, the proportion of vaginal bleeding in perimenopausal patients was higher thanthe younger.9, The proportion of GTN patients with a history of hydatidiform mole was70.83%, the ratio of patients with history of hydatidiform mole was higher among the youngGTN patients, for perimenopausal women GTN patients more secondary to full production,abortion, etc; GTN patients of different ages had obvious differences of vaginal bleeding.10,The rate of GTN patients occurred pulmonary metastasis was40.28%, the followed wasvaginal and brain, so lung metastasis was easily occurred in the GTN patients.11, Themisdiagnosis rate of GTD patients was11.16%,the misdiagnosis rate of perimenopausalwomen was higher than the younger women.12,The complete curettage of uterine cavityproportion of hydatidiform mole patient was96.88%, so the mainly treatment ofhydatidiform mole was complete curettage of uterine cavity. GTN patients is given priorityto with chemotherapy and cure rate was high,52cases of patients with low-risk patientschemotherapy alone accounted for78.85%;20cases of patients with high-risk chemotherapyalone accounted for40.00%, surgery plus chemotherapy combined treatment accounted for60.00%, patients with perimenopausal who had no fertility requirement could take theoperation of panhysterectomy, and the position of surgery in patients with GTD over40 years old was important.Conclusion:1, The incidence trend of gestational trophoblastic disease is on the rise,whichdistributed mainly in the rural areas and is given priority to with farmers.2,The incidence of perimenopausal gestational trophoblastic disease relative to thenumber of births for the same period is significantly higher than all other all ages, themalignant rate is also higher.3, The clinical misdiagnosis rate of perimenopausal gestational trophoblastic diseasepatients is higher than all other years old patients.4, The initial symptom of36years old or more and20years old or less gestationaltrophoblastic neoplasia is vaginal bleeding,but many35years old or less gestationaltrophoblastic neoplasia patients has a history of hydatidiform mole;5, Adolescence women has a higher chance for the occurrence of hydatidiform moleduring pregnancy for the first time,gestational trophoblastic disease of perimenopausaloccurs in pregnancy more than four times.