| 中文摘要 |
本文報告一例因胎盤滋養層細胞異常增生而導致的妊娠滋養細胞疾病(gestational trophoblastic disease, GTD)病例。患者主訴嘔吐、腹痛及陰道出血，檢測發現其β-人類絨毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)指數高達334,600mIU/mL，經診斷為完全性葡萄胎(complete hydatidiform mole, CHM)，屬GTD之良性病變。初期採用低風險治療策略，以methotrexate (MTX)作為一線治療。惟因病情進展，遂轉為高風險治療模式，改以EMA-CO多重化療方案進行治療，最終成功將β-hCG指數降至低於1.2mIU/mL。本案例為本院首例成功從低風險單一藥物治療轉換至高風險多藥聯合治療的GTD個案，具重要臨床參考價值與研究價值，為未來相似病例的治療策略提供了寶貴經驗。 |
| 英文摘要 |
This article presents a case of gestational trophoblastic disease (GTD) caused by abnormal proliferation of placental trophoblastic cells. The patient initially presented with vomiting, abdominal pain, and vaginal bleeding. Laboratory tests revealed a markedly elevatedβ-human chorionic gonadotropin (β-hCG) level of 334,600 mIU/mL, leading to a diagnosis of complete hydatidiform mole (CHM), a benign form of GTD. Initial management with a low-risk methotrexate (MTX) therapy proved insufficient due to disease progression, necessitating escalation to high-risk EMA-CO multi-agent chemotherapy. This successfully reducedβ-hCG to below 1.2 mIU/mL. This successfully reducedβ-hCG to below 1.2 mIU/mL. This case represents our hospital’s first successful transition from single-agent to multi-agent therapy in GTD, offering valuable clinical and research insights for optimizing future treatment strategies. |
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