Analysis Of Factors Influencing Chemotherapy Resistance Of Gestational Trophoblastic Tumors

Objective:Explore the influencing factors of chemotherapy resistance of gestational trophoblastic tumors.Methods:.A retrospective analysis of the data of gestational trophoblastic tumor patients who were hospitalized in the Affiliated Hospital of Youjiang Medical College for Nationalities from January 1,2014 to December 31,2020.The study cases were selected according to the inclusion and exclusion criteria,and were divided into two groups according to whether they were resistant to chemotherapy drugs,namely the sensitive group and the drug-resistant group.The clinical observation data of the two groups of cases collected include:age of onset,number of pregnancy,nature of the previous pregnancy,time from the termination of the previous pregnancy,blood hCG level before initial treatment,tumor diameter,metastasis location and number,pathological type,FIGO/WHO prognosis score,initial treatment plan.The SPSS20.0 software was used to compare and analyze the data results of the two groups,and P<0.05 was defined as the difference was statistically significant.Results:A total of 82 GTN patients were included in the study,60 were chemotherapy sensitive,and 22 developed chemotherapy resistance.The drug resistance rate was 26.8%.According to the FIGO/WHO prognostic score(2000)criteria,GTN patients were divided into low-risk group,high-risk group,and very high-risk group.There were 71 low-risk GTN patients,of which 17 were in the low-risk drug resistance group;high-risk GTN patients had There were 11 cases,including 5 cases in the high-risk resistance group.Taking age,pregnancy times,and tumor diameter as single factors,the data of the two groups were compared,P>0.05,and the differences were not statistically significant.According to the nature of the previous pregnancy,82 patients with GTN were divided into 3 groups:hydatidiform mole(65 cases),miscarriage(13 cases),and term delivery(4 cases).There were12 cases,8 cases,and 2 cases in each group during chemotherapy.The drug resistance rate was 18.5%,61.5%,and 50.0%,respectively.The comparison between the groups was carried out by the x~2test,P=0.003<0.05,the difference was statistically significant.According to the initial blood hCG level before treatment,82 patients with GTN were divided into<10~3m IU/mL(7 cases),10~3～10~4m IU/mL(23 cases),10~4～10~5m IU/mL(40 cases)and>10~5m IU/mL(12 cases))A total of 4 groups,each of 1 case,2 cases,15 cases,and 4 cases developed drug resistance during chemotherapy.The drug resistance rates were 14.3%,8.7%,37.5%,and 33.3%,respectively.Passed the x~2test,P=0.043<0.05,the difference was statistically significant.According to the number of lung metastases,82 patients with GTN were divided into 3 groups:0～4(66 cases),5～8(13 cases),and>8(3 cases),each with 13cases,6 cases,Three cases developed drug resistance during chemotherapy.The drug resistance rates were 19.7%,46.2%,and 100.0%,respectively.The number of metastatic lung lesions was different.By x~2test,P=0.001<0.05,the difference was statistically significant.According to the pathological results,82 patients with GTN were divided into 3 groups:erosive hydatidiform mole(23 cases),choriocarcinoma(12 cases),and no pathological results(47 cases).There were 6 cases,8 cases,and 8 cases in chemotherapy.Drug resistance occurred during the process,and the drug resistance rates were 26.1%,66.7%,and 17.0%respectively.By the x~2test,P=0.002<0.05,the difference was statistically significant.According to the FIGO/WHO prognostic score,82 GTN patients were divided into low-risk0～2 group(15 cases),low-risk 3～4 group(41 cases),low-risk 5-6 group(15 cases),and high-risk group(11 Cases)and very high-risk group(0 cases),a total of 5 groups,a total of 71low-risk GTN patients,a total of 11 high-risk GTN patients,this study did not collect very high-risk GTN patients,2 cases,9 cases,6 cases each 5 cases developed drug resistance during chemotherapy,and the drug resistance rates were 13.3%,21.9%,40.0%,and 45.5%,respectively.By x~2test,P=0.028<0.05,the difference was statistically significant.According to the different initial treatment regimens of 82 GTN patients,the chemotherapy resistance rate of MTX single-agent chemotherapy regimen was 35.3%(17/48),and the chemotherapy resistance rate of combination regimen was 13.9%(5/34).Through the x~2test,P=0.037<0.05,the difference was statistically significant.Conclusion:(1)This study shows that age,pregnancy times,and tumor size have little effect on the chemotherapy resistance of gestational trophoblastic tumors.(2)This study shows that the nature of the previous pregnancy,the time from the termination of the previous pregnancy to the initial treatment,the blood hCG level before the initial treatment,the number of lung metastases,the pathological type,the FIGO/WHO prognostic score,and the MTX single-agent chemotherapy are all GTN Influencing factors of chemotherapy resistance in patients.