Cellular immune response levels in gestational trophoblastic tumor patients after hydatidiform mole.
OBJECTIVE
This study looked for an association of natural (innate) cellular immune responses with the development of gestational trophoblastic tumors (GTT) after hydatidiform moles (HM).


METHODS
An observational prospective cohort study (73 patients) was carried out to measure the serum level of Natural Killer (NK) cells, Monocytes (Mo) and a Bio-Merieux skin test was performed on the day of HM evacuation and 4 weeks afterwards. The diagnosis of GTT were after Soper and Hammond (1998) and followed up for at least 6 months after evacuation. Patients' characteristics and cellular immune responses among patients who developed GTT were analysed by multiple logistic regression (SPSS version 5).


RESULTS
The results showed that a low NK cell percentage was associated (P = 0.020) with the development of GTT, also a low Mo (P = 0.034) on day 0. While on day 28 a low NK cell percentage (P = 0.008) and Mo cell count (P = 0.043) were associated with the development of GTT. The cut-off point between the sensitivity (60%) and specificity of NK cell percentage on day 0 was 16, and also showed a negative predictive value of 83%. Meanwhile on day 28, the cut-off point between the sensitivity and specificity (80%) was 17, and showed a negative predictive value of NK cell percentage (85%).


CONCLUSIONS
These figures indicated that HM-lowered NK cell serum percentages were associated with the development of GTT.
Sutoto
M T
MT
Department of Obstetrics and Gynecology, Diponegoro University, Semarang, Indonesia.
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000276:immunology*; D007111:Immunity, Cellular; D007694:Killer Cells, Natural / Q000276:immunology*; D016015:Logistic Models; D009364:Neoplasm Recurrence, Local / Q000276:immunology; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014594:Uterine Neoplasms / Q000276:immunology*