1.Association of ultrasound morphological features with serum β subunit human chorionic gonadotrophin and histopathology among sonologically diagnosed cases of gestational trophoblastic neoplasia in a tertiary hospital
Donnabelle R. Taub‑Hernando ; Melissa D. Amosco
Philippine Journal of Obstetrics and Gynecology 2023;47(3):121-128
Background:
Gestational trophoblastic neoplasia (GTN) presents as vascular mass of varying
morphology on ultrasound and confirmed through quantitative serum β subunit human chorionic
gonadotrophin (β‑hCG). In regions with limited access to β‑hCG, ultrasound plays a crucial role in
the initial diagnosis for timely management.
Objectives:
This study aimed to investigate the associations between ultrasound vascular morphologic features, serum β‑hCG levels, and histopathology in GTN cases.
Methodology:
A cross‑sectional review was conducted on 113 cases with ultrasound impression
of GTN over an 8‑year period. The patient data were extracted from case records, and ultrasound
images were categorized based on the distinct features. Associations with β‑hCG levels and
histopathology were analyzed using the Chi‑square test and Mann–Whitney U‑test. Statistical
significance was set at P < 0.05.
Results:
A significant association was observed between ultrasound category and serum
β‑hCG (P < 0.0001). The compact and diffuse types were more prevalent with β‑hCG levels between
104
to <105 mIU/mL, while the lacunar type was common among patients with ≥105 mIU/mL.
However, there was no significant association between ultrasound categories and mean β‑hCG
levels. Regarding histopathology, the lacunar type was more common in invasive moles, whereas
the compact and diffuse types tended to be seen with choriocarcinoma, although these were not
statistically significant (P = 0.182).
Conclusions
Morphologic types of GTN by gray scale and Doppler ultrasound vary across the
different levels of serum β‑hCG and may suggest the histopathological diagnosis. This study provides
valuable insights into the ultrasonographic characteristics of GTN, which can aid in its diagnosis
and management.
Gestational Trophoblastic Disease
;
Ultrasonography, Doppler