Valuation Of Ultrasound On Response To Sngle Methotrexate In Primary Chemotherapy Of Patients With Low-risk Gestational Trophoblastic Neoplasia

Objective To evaluate the value of ultrasonic parameters in assessing response to single methotrexate in initial chemotherapy of patients with low-risk gestational trophoblastic neoplasia.Methods Human chorionic gonadotropin(β-hCG)in serum of patients with low-risk gestational trophoblastic neoplasia were detected before chemotherapy, and Color Doppler Ultrasound examination was run to get RI,PI values of both lesion areas and uterine artery.All patients were treated with single methotrexate(MTX) for initial chemotherapy. β-hCG concentration in serum were collected twice a week after chemotherapy. All patients were divided into MTX-sensitive group and MTX-insensitive group according to the drop degree of β-hCG level.The ultrasonic parameters in two groups were compared.Results The ultrasonic parameters in two groups were statistically significant.For predicting MTX-insensitivity,the optimum cutoff values are lesion RI≤0.335,lesion PI≤1.215,uterine artery RI≤0.445, uterine artery PI≤1.45and the uterine vloume≥149ml according to the receiver operating characteristics.The odds ratio for the risk of MTX-insensitivity in patients with a lesion RI<0.335compared with those with a lesion RI>0.335was9.5,and it was11.6of lesion PI≤1.215,6.01of a uterine artery RI≤0.445,2.3of a uterine artery PI≤1.45,and3.8of the uterine volume≥149ml.Conclusion For patients on low-risk gestational trophoblastic neoplasia who are treated with single methotrexate(MTX)chemotherapy initially,ultrasonic parameters can provide a reference in assessing responses to MTX.