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ORIGINAL ARTICLE
Year : 2020  |  Volume : 11  |  Issue : 1  |  Page : 187

Early detection of gestational trophoblastic neoplasia based on serial measurement of human chorionic gonadotrophin hormone in women with molar pregnancy


1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2 Student Research Committee, Department of Biostatistics and Epidemiology, School of Public Health Mashhad University of Medical Sciences, Mashhad, Iran
3 Non-Communicable Diseases Research Center, School of Medicine; Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Correspondence Address:
Abbas Rahimiforoushani
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpvm.IJPVM_288_19

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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.


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