Title: Cellular Atypia as a Risk Factor for Persistant Trophoblastic Disease: Prospective Cohort Study
Authors: Dr Uma Thankam, Dr Nandini Vamadevan Retnamma, Dr Simi Jameela, Dr Nirmala Chellamma
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.153
Abstract
Introduction: Gestational trophoblastic tumours have varying behavior from being locally invasive to metastatic. It would be useful if there is an effective prognosticating method especially in low resource settings. This study was an attempt to identify such a prognosticator.
Aim: To look for the presence of atypical cells in the histopathology of vesicular mole, the βhCG level four week after evacuation and look for any association with persistent trophoblastic disease (PTD)
Material and Methods: It was hospital based prospective cohort study conducted in a tertiary care hospital. 95 cases of vesicular mole were studied .The patients had a pre evacuation βhCG done and underwent suction curettage. The products were sent for histopathologic examination and apart from identifying the grade of proliferation they were specifically examined for presence of atypical cells. The βhCG levels four weeks after evacuation was checked.
Results: On looking at the distribution of atypical cells with βhCG four weeks after evacuation, it is seen that of the 90.6% of the patients with cellular atypia had abnormal levels of status four weeks βhCG levels. With regards to the distribution of atypical cells with the time needed to reach baseline βhCG ,out of the 32 patients with atypical cells 23 (71.9%) had an abnormal βhCG fall.
Conclusion: Looking for the presence of atypical cells in the histopathology of vesicular mole can prognosticate the nature of regression of the tumor and help in classifying it as high risk and low risk.
Keywords: cellular atypia, persistent trophoblastic disease.
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