Analysis Of The Factors Related To The Metastasis Of Invasive Hydatidiform Mole And The Treatment Effect

Objective : To discuss the factors related to the metastasis of invasive hydatidiform mole(IHM)and its treatment effect.Methods : 50 cases of IHM admitted in our hospital from June 2012 to March 2018 was involved in the retrospective study.Twenty-four patients with pulmonary(22/24)and vaginal(2/24)metastasis were assigned to the metastasis group.26 patients with no definite signs of metastasis were divided into the no metastasis group(observation group).The clinical characteristics of the two groups were analyzed by Logistic regression analysis.The treatment duration,clinical efficacy and the prognosis were compared.Results:(1)The Logistic regression analysis showed that longer interval between menopause and first uterine curettage and complication with ovarian luteinized cyst were both independent risk factors of the IHM metastasis(OR>1,P<0.05).Pseudo pregnant symptom was a protective factor(OR<1,P<0.05).(2)The treatment time before the blood HCG converted to normal was longer in the metastasis group of the metastasis group(70.00±21.07d)compared with that in the observation group(57.27±16.75d).The difference was significant(P<0.05).However,there was no statistically significant difference(P>0.05)in the number ofchemotherapy,total hysterectomy,recent cure,recent improvement,second pregnancy and recurrence rate between the two groups.There were nine cases without recent cure in both groups due to missed chemotherapy.Conclusions: Once,the uterine curettage should be performed as early as the diagnosis of hydatidiform mole considered to reduce the incidence of the metastasis of IHM.Patients with IHM accompanied with ovarian luteinized cyst should be alert for metastasis.During the course of treatment,the level of blood HCG should be closely monitored.Satisfactory curative effect could also be achieved in IHM with metastasis after standard treatment.