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Objective To investigate the correlation of pre-treatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), D-dimer level and other clinical factors with the time to serum human chorionic gonadotropin (hCG) remission in patients with gestational trophoblastic neoplasia (GTN). Methods A total of 97 patients (mean age: 34 years) with GTN admitted to our hospital from February 2011 to December 2020 were enrolled and their clinical data were retrospectively analyzed. Univariate and multivariate analyses were performed to investigate the correlation between hCG remission time with factors such as age, antecedent pregnancy, interval time from previous pregnancy, tumor stage, FIGO score, chemotherapy regimen, serum hCG level, NLR, PLR and D-dimer before treatment. Results Among the included patients, the median time to hCG remission was 64 d. The antecedent pregnancy, interval time from previous pregnancy, FIGO score, chemotherapy regimen, pre-treatment hCG level, NLR, PLR and D-dimer were all proved to be correlated with hCG remission time (P < 0.05). Multivariate analysis confirmed that high-risk FIGO score (HR=12.368), extremely high-risk FIGO score (HR=4.205), hCG level ≥10 000 IU/L (HR=2.582), NLR≥2.29 (HR=1.675), chemotherapy with EMA-CO regimen (HR=6.183) and changing MTX regimen to EMA-CO regimen (HR=4.472) were independent risk factors for extended time to hCG remission. Subgroup analysis on the patients with initial EMA-CO regimen revealed that high-risk FIGO score (HR=7.759), extremely high-risk FIGO score (HR=3.633), pre-treatment hCG≥10 000 IU/L (HR=2.535) and NLR≥2.29 (HR=2.29) were also the independent risk factors for extended hCG remission time in this group. Conclusion NLR is related to the remission time for hCG in GTN patients. The higher pre-treatment hCG is, the longer hCG remission time. |
