| Background: based on the improvement of chemotherapy regimens and the height of the tumor markers of blood HCG sensitivity,pregnancy sertoli cell tumor cure rate is as high as 90% above,but there are still about 25% of the patients with GTN resistance after initial chemotherapy,a handful of patients relapse after clinical cure,drug resistance and relapse in patients with poor prognosis,eventually leading to about 0.5% ～ 5% of patients die in multiple drug resistance.Therefore,it is of positive clinical significance to discuss the risk factors of GTN resistance and recurrence.Methods: a retrospective analysis in nearly six years of low risk and high risk patients with GTN clinical medical records,and other domestic hospital treatment of patients with GTN in ni,recurrence rate,and prognosis of comparison,statistics and analysis the influencing factors of drug resistance and relapse,evaluation of treatment the curative effect and prognosis of different treatment methods,as well as for patients,the influence of reproductive function for better clinical evaluation and treatment of patients with GTN to provide the reference value.SPSS 23.0 statistical software was used for descriptive analysis,normal test and analysis of variance.Chi-square test was used for qualitative data,Fisher’s exact probability method was used,and t-test was used for quantitative data.The test level was =0.05,and P < 0.05 was considered statistically significant.Results: As of February 2020,the serological complete response rate of 103 GTN patients was 98.1%,including 2 patients with recurrence time over 1 year,1 invasive mole patient with recurrence time of 2 and a half years,and 1 choriocarcinoma patient with recurrence time of 17 months and recurrence rate of 1.9%.There were no deaths and the mortality rate is 0%.There were 13 cases of drug resistance,with a drug resistance rate of 12.6%,including 12 cases of invasive mole resistance and 1case of choriocarcinoma resistance.In the single-drug chemotherapy regimen,the prognosis score was 3.659 in the T-test of the drug-resistant group and the non-drug-resistant group,P = 0.002 < 0.05,and the difference was statistically significant.The overall mean score of the drug-resistant group was higher than that of the non-drug-resistant group.However,there were no statistically significant differences between the two groups in age,presence or absence of pulmonary and external pulmonary metastasis,course of consolidation,nature of previous pregnancy,onset time interval,serum HCG level before treatment,operation,maximum tumor diameter,and number of metastatic lesions(P > 0.05).Of the 76 patients who did not receive surgical treatment,the majority had regular menstrual history,68(89.4%)had menopause during chemotherapy,73(96%)had menstruation within three months after chemotherapy,2(2.6%)did not have menstruation due to intrauterine adhesion,and 1(1.3%)had menstruation after menstruation for six months.Thirty-seven patients(48.7%)gave birth after the end of chemotherapy.All newborns developed normally,and the mean time from the end of chemotherapy was 1.5 years.Conclusion: GTN chemotherapeutic resistance is mainly related to FIGO prognosis score and non-standard treatment.Combination chemotherapy is recommended for low-risk type GTN with high scores.The menstrual effects of chemotherapy on GTN patients were brief and reversible,and no adverse effects of chemotherapy on ovarian function and fertility were found in GTN patients. |
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