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02 July 2022, Volume 38 Issue 7 Previous Issue    Next Issue

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Research status of histopathology and molecular pathology of gestational trophoblastic disease.   TAO Xiang, CHEN Ting-ting, ZHOU Xian-rong 2022, 38(7): 676-680.  DOI: 10.19538/j.fk2022070102 Abstract ( )   Gestational trophoblastic diseases include non-neoplastic hydatidiform mole（HM）and neoplastic lesions，including choriocarcinoma，placental site trophoblastic tumor and epithelioid trophoblastic tumor. With the development of researches in this field，some new disease subtypes have been discovered，such as familial recurrent HM and complete HM in a twin gestation. Some molecular diagnostic methods have also been developed，such as p57 immunohistochemical staining and short tandom repeat（STR）genotyping，making the pathological diagnosis more accurate than the previous morphology-based diagnosis，and more reflective of the process of carcinogenesis. In this review，based on the latest articles and WHO Classification of Female Genital Tumors，we summarized the pathological features and the molecular diagnostic methods of such diseases.

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Imaging features and significance of gestational trophoblastic disease.  PENG Mei-lian, LIN Kai-wu, WENG Zong-jie, WU Qi-bin, SUN Peng-ming. 2022, 38(7): 680-684.  DOI: 10.19538/j.fk2022070103 Abstract ( )   Gestational trophoblastic disease（GTD）is a group of heterogeneous diseases characterized by abnormal proliferation of trophoblastic tissue，which is a rare disease，including both benign and malignant forms，and the latter are collectively referred to as gestational trophoblastic tumors（gestational trophoblastic neoplasia，GTN）. Imaging examinations are essential in the early diagnosis of GTD，especially in the identification of benign or malignant GTD，tumor staging and risk assessment，which play a crucial role in the localization and estimation of lesions in GTD patients，as well as in the choice of treatment.  It provides an evidence for judging prognosis，and can dynamically observe the effect of chemotherapy and recurrence，which has high clinical application value for the diagnosis of trophoblastic diseases.Transabdominal and transvaginal ultrasonography with duplex Doppler assessment are often appropriate adjuncts in any of these settings and in post-treatment monitoring. The use of broader imaging techniques depends on the diagnosis of GTN and other factors.

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Standardized management of hydatidiform mole. CHENG Guang-yan, QU Peng-peng. 2022, 38(7): 684-687.  DOI: 10.19538/j.fk2022070104 Abstract ( )   The hydatidiform mole is the most common gestational trophoblastic disease，and according to heredity，histopathological features and clinical manifestations：hydatidiform mole can be divided into two types，complete hydatidiform mole and partial hydatidiform mole. In addition, there are three special types：recurrent hydatidiform mole, familial hydatidiform mole，and one complete hydatidiform mole in a twin gestation. This article will introduce the etiology，clinical diagnosis，treatment，follow-up and special types of hydatidiform mole in order to improve the standardized diagnosis and treatment of this disease.

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Treatment for low-risk gestational trophoblastic neoplasia.  LIU Xiao-mei, LI Xiu-qin. 2022, 38(7): 687-691.  DOI: 10.19538/j.fk2022070105 Abstract ( )   The treatment of low-risk gestational trophoblastic neoplasia，based on the chemotherapy recommended by FIGO guidelines，should be stratified again，and actinomycin D（Act-D）or methotrexate（MTX） single-agent chemotherapy should be selected for those of 0-4 points. According to some research reports，the efficacy of Act-D is better than that of MTX，and the side effects are lower；single-agent chemotherapy is recommended for those with a score of 5-6，but the indications for combined chemotherapy can be broadened. The curative effect should be closely monitored during chemotherapy，and if the single-agent chemotherapy is resistant，another single-agent or combination regimen can be used individually.

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Treatment for high-risk gestational trophoblastic neoplasia. LI Ke-min, YIN Ru-tie 2022, 38(7): 691-693.  DOI: 10.19538/j.fk2022070106 Abstract ( )   The treatment principle of high-risk gestational trophoblastic neoplasia is mainly the combined chemotherapy，supplemented by comprehensive treatment such as surgery，radiotherapy，targeted and immune therapy. In general，the prognosis is good，but there are still patients who die due to tumor recurrence and drug resistance. This article summarizes the recent progress in the treatment of high-risk gestational trophoblastic neoplasia and provides a reference for clinical treatment.

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Immunotherapy for gestational trophoblastic neoplasia.  CHENG Hong-yan, XIANG Yang. 2022, 38(7): 693-696.  DOI: 10.19538/j.fk2022070107 Abstract ( )   Gestational trophoblastic neoplasia （GTN） is a subsequent disease to pregnancy. Although it is highly sensitive to chemotherapy，some patients still died of drug resistance and relapse. Since the disease origin is closely related to immunity，immunotherapy has shown initial success in refractory GTN. With the deepening of the research on emerging immune targets，immunotherapy has gradually become the focus of GTN salvage therapy in recent years. This review will focus on the research progress about immunotherapy for GTN.

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Treatment for special pathological types of gestational trophoblastic neoplasia.  WANG Fen-fen, BAO Ke-chun, CHENG Xiao-dong 2022, 38(7): 696-701.  DOI: 10.19538/j.fk2022070108 Abstract ( )   Special pathological types of gestational trophoblastic neoplasia mainly include placental site trophoblastic tumour（PSTT）and epithelioid trophoblastic tumour（ETT），which belong to intermediate-type trophoblastic tumors. The diagnosis is relatively difficult because of the lack of specific clinical manifestations and sensitive tumor markers. Surgery is the mainly primary treatment；hysterectomy is performed for localized disease in uterus and surgical resection can be carried out for resectable lesions if there is extra-uterine invasion or metastasis. The adjuvant chemotherapy plan is made according to the factors of poor prognosis. Most patients are young and have the desire of fertility preservation，the treatment of retaining reproductive function can be implemented for suitable patients with lesion limited to uterus. Due to poor sensitivity of PSTT and ETT to chemotherapy，drug resistance is a most important factor of  poor prognosis. There is still a lack of randomized controlled trials to guide clinical treatment because of the low incidence，and new treatments such as targeted therapy amd immunotherapy are also constantly explored.

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Fertility preservation in gestational trophoblastic neoplasia.  XI Ling, SUN Yue. 2022, 38(7): 701-704.  DOI: 10.19538/j.fk2022070109 Abstract ( )   Gestational trophoblastic neoplasia（GTN）usually occurs in young women of childbearing age. It is generally required to protect ovarian function and preserve fertility. Therefore，it is particularly important to choose the treatment scheme that has the least impact on fertility but has no effect on the cure rate or related prognosis. This article describes the fertility preserving treatment of GTN and the subsequent pregnancy outcome.