Screening of persistent trophoblastic disease with various serum markers

Eighty percent of the patients with molar pregnancy go into spontaneous rem ission and do not require any therapy. Serial hCG determinations can identi fy the 20% who will develop malignant sequelae. It does not seem appropriat e to treat all patients. This study was designed to assess several serum ma rkers, including free beta-hCG, total beta-hCG, and CA-125 in order to iden tify persistent trophoblastic disease. The study was performed at Doctor Zekai Tahir Burak Women's Hospital, Depar tment of Oncology. Forty-seven patients with complete hydatidiform mole wer e included in the study. In the spontaneous remission group (Group I), tota l beta hCG, CA-125 and free beta hCG values were 27988.7+/-18491.6 mlU/ml, 51.7+/-74.7 U/ml and 42.35+/-28.4 mlU/ml, respectively. Patients in whom pe rsistent trophoblastic disease had developed (Group II) the mean serum CA-1 25 and mean total beta hCG values were lower than in group I, whereas the m ean free beta hCG value was higher but not significant. The mean value of f ree beta hCG per total beta hCG was found to be significantly higher in gro up 2. The free beta hCG per total beta hCG ratio seems to be a sensitive predicto r of persistency of trophoblastic disease. Further prospective studies with a larger series of patients may warrant the exact predictive value of free beta hCG per total hCG ratios.