Vascular patterns of gestational trophoblastic tumors by color doppler ultrasound

Fon‐Jou ‐J Hsieh, Chih‐Cheng ‐C Wu, Chien‐Nan ‐N Lee, Tzer‐Ming ‐M Chen, Chi‐An ‐A Chen, Fu‐Chin ‐C Chen, Chang‐Yao ‐Y Hsieh, Chi‐Long ‐L Chen

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Abstract

Background. Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. Methods. Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta‐human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two‐tailed Student's t‐test and Fisher's exact test were used for statistical analysis. Results. The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta‐hCG level at diagnosis in diffuse type lesions (6608 ± 6320 mIU/mL) was significantly lower than in the lacunar type (40462 ± 39735 mIU/mL; P = 0.04) and compact type (212114 ± 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 ± 0.13) than diffuse type (0.66 ± 0.10; P = 0.03) or compact type lesions (0.70 ± 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. Conclusion. Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta‐hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.

Original languageEnglish
Pages (from-to)2361-2365
Number of pages5
JournalCancer
Volume74
Issue number8
DOIs
Publication statusPublished - 1994
Externally publishedYes

Fingerprint

Trophoblastic Neoplasms
Doppler Ultrasonography
Blood Vessels
Color
Uterine Artery
Drug Therapy
Invasive Hydatidiform Mole
Choriocarcinoma
Chorionic Gonadotropin
Serum
Uterus
Hemodynamics
Students

Keywords

  • chemotherapy
  • color Doppler ultrasound
  • gestational trophoblastic tumors
  • histopathology

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Vascular patterns of gestational trophoblastic tumors by color doppler ultrasound. / Hsieh, Fon‐Jou ‐J; Wu, Chih‐Cheng ‐C; Lee, Chien‐Nan ‐N; Chen, Tzer‐Ming ‐M; Chen, Chi‐An ‐A; Chen, Fu‐Chin ‐C; Hsieh, Chang‐Yao ‐Y; Chen, Chi‐Long ‐L.

In: Cancer, Vol. 74, No. 8, 1994, p. 2361-2365.

Research output: Contribution to journalArticle

Hsieh, Fon‐Jou ‐J ; Wu, Chih‐Cheng ‐C ; Lee, Chien‐Nan ‐N ; Chen, Tzer‐Ming ‐M ; Chen, Chi‐An ‐A ; Chen, Fu‐Chin ‐C ; Hsieh, Chang‐Yao ‐Y ; Chen, Chi‐Long ‐L. / Vascular patterns of gestational trophoblastic tumors by color doppler ultrasound. In: Cancer. 1994 ; Vol. 74, No. 8. pp. 2361-2365.
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abstract = "Background. Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. Methods. Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta‐human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two‐tailed Student's t‐test and Fisher's exact test were used for statistical analysis. Results. The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta‐hCG level at diagnosis in diffuse type lesions (6608 ± 6320 mIU/mL) was significantly lower than in the lacunar type (40462 ± 39735 mIU/mL; P = 0.04) and compact type (212114 ± 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 ± 0.13) than diffuse type (0.66 ± 0.10; P = 0.03) or compact type lesions (0.70 ± 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. Conclusion. Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta‐hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.",
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N2 - Background. Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. Methods. Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta‐human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two‐tailed Student's t‐test and Fisher's exact test were used for statistical analysis. Results. The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta‐hCG level at diagnosis in diffuse type lesions (6608 ± 6320 mIU/mL) was significantly lower than in the lacunar type (40462 ± 39735 mIU/mL; P = 0.04) and compact type (212114 ± 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 ± 0.13) than diffuse type (0.66 ± 0.10; P = 0.03) or compact type lesions (0.70 ± 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. Conclusion. Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta‐hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.

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