Apakah Kadar β-hCG Praevakuasi dan Gambaran Proliferasi Sel Trofoblas secara Mikroskopik dapat digunakan untuk Prediksi Transformasi Keganasan pada Mola Hidatidosa?

Kemala Isnainiasih Mantilidewi,(1*) Zulvayanti Zulvayanti,(2) Wiryawan Permadi,(3)

(1) 
(2) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran Hasan Sadikin General Hospital Bandung
(3) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran Hasan Sadikin General Hospital Bandung
(*) Corresponding Author

Abstract


Abstrak
Tujuan: Meneliti perbedaan karakteristik umur, paritas, besar uterus, kadar β-hCG, dan hiperproliferasi pada mola hidatidosa (MH) dengan regresi spontan dan pada MH dengan transformasi keganasan di RS Dr.Hasan Sadikin Bandung.
Metode: Penelitian cross sectional deskriptif restrospektif mengambil data umur, paritas, besar uterus, kadar β-hCG pre-evakuasi, dan hiperproliferasi dari rekam medis pasien MH periode 2007-2016. Data diolah menggunakan program SPSS versi 20.0 for Windows. Nilai p<0,05 dianggap signifikan.
Hasil: Dari 400 rekam medis yang dianalisis, 233 dengan data lengkap dapat dianalisis. Mayoritas pasien usia reproduktif 20-35(53,6%) tahun, paritas 1-2 (n=90, 38,6%), dan besar uterus rata-rata 19,12±4,633 (~minggu kehamilan). Kadar β-hCG <100000 mIU/mL sebanyak 78(33,5%), ≥100000 mIU/mL sebanyak 155(66,5%). Pasien dengan hiperproliferasi sebanyak 83(35,6%) sedangkan pasien tanpa hiperproliferasi sebanyak 150(64,4%). Terdapat 219(94,0%) dengan komplit MH, dan 14(6,0%) HM parsial (tidak dipublikasi). Pasien kemudian dikategorikan menjadi kelompok transformasi keganasan dan kelompok remisi spontan. Tidak terdapat perbedaan umur, paritas, dan besar uterus diantara dua kelompok (p>0,05). Perbedaan kadar βhCG (mIU/mL) dan tingkat proliferasi menunjukkan hasil signifikan (p<0.05).
Kesimpulan: Kadar β-hCG preevakuasi dan status hiperproliferasi dapat digunakan sebagai prediktor transformasi keganasan pasien MH.

Can Preevacuation Level β-hCG and Microscopic Trophoblast Proliferation Predict Malignant Transformation in Hydatidiform Mole?

Abstract
Objective: To describe differences among age, parity, size of uterus, level of β-hCG, and hyperproliferation state in HM with spontaneous remission and in that with malignancy transformation at dr.Hasan Sadikin General Hospital Bandung.
Methods: This a cross sectional descriptive restrospective study of HM cases analyzing data on age, parity, size of uterus, pre-evacuation level of β-hCG, and hyperproliferation state taken from medical record of HM patients between 2007-2016. Data were statistically analyzed using SPSS version 20.0 for Windows. Result p<0.05 was considered significant.  
Results: Out of 400 cases, 233 cases were selected. Those with incomplete data were not included in the analysis. Majority of patients were in reproductive age 20-35(53.6%) years old, has parity 1-2(n=90, 38.6%), and the size of uterus has mean 19.12±4.633 (~week of pregnancy). The level of β-hCG <100000 mIU/mL was 78(33.5%), ≥100000 mIU/mL was 155(66.5%). Patients with hyperproliferation were 83(35.6%) while without hyperproliferation were 150(64.4%). There were 219(94.0%) with complete HM, and 14(6.0%) partial HM (unpublished data). There were no significant differences in age, parity, size of uterus between the two groups (p>0.05). Differences on level of βhCG (mIU/mL) and proliferation state showed significant result (p<0.05).
Conclusion: Preevacuation level of β-hCG and histopatology (proliferation state) may predict malignancy transformation in HM.

Keywords: Hydatidiform mole, risk factors, remission, malignancy transformation


Keywords


hydatidiform mole, risk factors, remission, malignancy transformation

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References


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DOI: http://dx.doi.org/10.24198/obgynia.v1n1.1

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