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

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