[Significance of serum/cerebrospinal fluid human chorionic gonadotropin ratio and prophylactic intrathecal therapy in patients with brain metastases of gestational trophoblast tumor].
OBJECTIVE
To evaluate the effect of serum/cerebrospinal fluid (CSF) ratio of human chorionic gonadotropin (hCG) in detecting brain metastases of gestational trophoblast tumor and the significance of prophylactic intrathecal therapy.


METHODS
Clinical information of 44 patients with brain metastases (stage IV) and 29 patients with lung metastases (stage III) of gestational trophoblast tumor who were admitted to our hospital between 1986 to 2001 were retrospectively analyzed by case control study. The variability of the ratio and the relationship between brain metastases was investigated, together with the effect of prophylactic intrathecal therapy.


RESULTS
Serum/CSF hCG ratio in patients with brain metastases declined with time. The ratio before chemotherapy was in relevant with the size of the lesion which were less than 60 in advanced stages and more than 60 in early stages. Patients of stage III with prophylactic intrathecal therapy did not progress to stage IV.


CONCLUSIONS
Serum/CSF hCG ratio before chemotherapy could reflect the encephalic tumor load which had reference value in diagnosis and prognosis and prophylactic intrathecal therapy played an important role in preventing brain metastasis.
Shi
Hong-hui
HH
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Yang
Xiu-yu
XY
Xiang
Yang
Y
Wan
Xi-run
XR
Luo
Li-bing
LB
Li
Ling
L
Liu
Ming-rui
MR
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D008727:Methotrexate / Q000627:therapeutic use; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology
D000964:Antimetabolites, Antineoplastic; D006063:Chorionic Gonadotropin; D008727:Methotrexate