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El coriocarcinoma y los lunares hidatidiformes parciales
M J Seckl1, R A Fisher, G Salerno
1Department of Medical Oncology, Imperial College, London, UK. m.seckl@ic.ac.uk
Lancet (London, England)
|July 13, 2000
Resumen
Los lunares parciales hidatidiformes (PMs) pueden transformarse en coriocarcinoma, una forma rara pero agresiva de la enfermedad trofoblástica gestacional. Este estudio confirma la transformación y hace hincapié en la necesidad de seguimiento de gonadotropina coriónica humana (hCG) para casos sospechosos de PM.
Área de la Ciencia:
- La Medicina Reproductiva es una de ellas.
- Oncología Ginecológica Oncología Ginecológica.
- Genética La genética.
Sus antecedentes:
- Los lunares parciales hidatidiformes (PMs) rara vez se asocian con la quimioterapia y su transformación en coriocarcinoma no se ha establecido previamente.
- La posibilidad de que las PM progresen hacia el coriocarcinoma plantea dudas sobre la necesidad de monitorear la gonadotropina coriónica humana (hCG).
Objetivo del estudio:
- Para investigar la posibilidad de que los lunares parciales hidatidiformes (PMs) se transformen en coriocarcinoma.
- Para establecer el vínculo entre las PMs y el posterior desarrollo del coriocarcinoma.
Principales métodos:
- Pacientes identificados con PM que desarrollaron coriocarcinoma a partir de una base de datos de enfermedad trofoblástica gestacional (GTD).
- Revisó la histología, verificó el estado triploide a través de citometría de flujo y comparó el ADN utilizando polimorfismos microsatélites para confirmar el origen del coriocarcinoma de PM.
Principales resultados:
- Tres de cada 3000 pacientes con PM desarrollaron coriocarcinoma que requirió quimioterapia.
- El análisis genético confirmó que el coriocarcinoma se originó en el PM, mostrando alelos maternos idénticos y dos alelos paternos.
- Confirmado PM triploidia en los tres casos.
Conclusiones:
- Los lunares parciales hidatidiformes (PM) pueden transformarse en coriocarcinoma.
- La revisión central de los PMs sospechosos es crucial.
- Los casos confirmados de PM requieren seguimiento de gonadotropina coriónica humana (hCG) para detectar la transformación maligna.
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