Cellular immune response levels in gestational trophoblastic tumor patients after hydatidiform mole

Objective: This study looked for an association of natural (innate) cellular immune responses with the development of gestational trophoblastic tumors (GTT) after hydatidiform moles (HM). Method: An observational prospective cohort study (73 patients) was carried out to measure the serum level of Natural Killer (NK) cells, Monocytes (Mo) and a Bio-Merieux skin test was performed on the day of HM evacuation and 4 weeks afterwards. The diagnosis of GTT were after Soper and Hammond (1998) and followed up for at least 6 months after evacuation. Patients' characteristics and cellular immune responses among patients who developed GTT were analysed by multiple logistic regression (SPSS version 5). Results: The results showed that a low NK cell percentage was associated (P = 0.020) with the development of GTT, also a low Mo (P = 0.034) on day 0. While on day 28 a low NK cell percentage (P = 0.008) and Mo cell count (P = 0.043) were associated with the development of GTT. The cut-off point between the sensitivity (60%) and specificity of NK cell percentage on day 0 was 16, and also showed a negative predictive value of 83%. Meanwhile on day 28, the cut-off point between the sensitivity and specificity (80%) was 17, and showed a negative predictive value of NK cell percentage (85%). Conclusion: These figures indicated that HM-lowered NK cell serum percentages were associated with the development of GTT. (C) 1999 International Federation of Gynecology and Obstetrics.