Objective: Recurrent hydatidiform moles are reportedly biparental complete moles and related to mutated NLRP7 and KHDC3L. This study was designed to identify mutations of gene NLRP7 and KHDC3L in biparental complete moles. Methods: In this study, we have screened NLRP7 and KHDC3L mutations in five patients with recurrent moles and five with sporadic moles. Molar tissues and blood samples were collected from patients and their partners. Genotypes of the molar tissues were determined based on short tandem repeat polymorphism. The coding exons of NLRP7 and KHDC3L were sequenced. Results: Two patients with recurrent moles had biparental complete moles, while all other patients had androgenetic complete moles. Three non-synonymous variants in NLRP7 (c.955 G>A, c.1280 T>C and c.1441 G>A) and one in KHDC3L (c.602 C>G) were identified in patients with recurrent moles. NLRP7 c.1441 G>A and c.1280 T>C were mutations found in the Chinese population, while c.1441 G>A was only detected in patients with biparental complete moles in this study. Conclusions: Genotyping can be used to differentiate biparental complete moles from androgenetic moles and to predict the risk of recurrent moles in future pregnancies. NLRP7 c.1441 G>A may associate with biparental complete moles. Biparental complete moles exhibit genetic heterogeneity.

To analyze the clinicopathological characteristics of subsequent pelvic masses after hysterectomy for benign diseases, and to compare the masses following hysterectomy with or without simultaneous bilateral salpingectomy. This study retrospectively analyzed patients undergone reoperation for pelvic mass subsequently to previous hysterectomy for benign disease from January 2012 to December 2016 in Peking Union Medical College Hospital. A total of 247 patients were enrolled in this study, of which 80.16% (n = 198) received simple hysterectomy, and 5.67% (n = 14) underwent hysterectomy with bilateral salpingectomy. The clinicopathological data of patients undergone simple hysterectomy or simultaneous bilateral salpingectomy was compared. In the former group, we found that 68.18% (n = 135) of the pelvic massed were benign, and the remaining 31.82% (n = 63) were malignant. In latter group, 57.10% (n = 8) were benign (8%) and 42.90% (n = 6) were malignant. Univariate analysis showed that the age of surgery for pelvic masses in patients undergoing hysterectomy with simultaneous bilateral salpingectomy was significantly younger than that in patients without salpingectomy (median, 44.5 vs 50 years, P < 0.0001), and the time interval between hysterectomy and onset of pelvic masses was also significantly shorter (median, 2 vs 5 years, P < 0.0001). And the probability of pelvic encapsulated effusion was significantly higher for the salpingectomy group. Multivariate analysis showed that there was no significant difference of the age of resection of pelvic mass, the time interval hysterectomy and pelvic mass onset, and the probability of pelvic encapsulated effusion between the two groups. The results showed that the incidence of secondary benign pelvic masses may be reduced when hysterectomy was performed with simultaneous bilateral salpingectomy. However, there was no statistical difference in the clinical characteristics and pathological types of pelvic masses between patients received hysterectomy with or without salpingectomy.

Background/Objectives: To determine treatment-free probability after persistent low-level human chorionic gonadotropin (hCG) elevation following complete remission from gestational trophoblastic neoplasia (GTN) and examine its association with the early hCG course. Methods: This single-center retrospective study included patients treated in 2015–2022 for gestational choriocarcinoma or invasive mole who developed ≥3 post-remission hCG results >5 and ≤1000 U/L over ≥14 days. The primary endpoint was retreatment for GTN recurrence. Kaplan–Meier analysis estimated treatment-free probability from the first low-level hCG elevation. Exploratory landmark analyses at 60, 90, and 180 days stratified patients still under observation by pre-landmark peak hCG (≤20 versus >20 U/L). Results: Forty-six patients contributed 595 hCG measurements. Thirty-five developed recurrence requiring retreatment; 11 remained recurrence-free. All patients whose first low-level hCG exceeded 20 U/L (n = 11) developed recurrence. Treatment-free probability was 30.4% at 1 year and 24.2% at 2 years. At the 60-, 90-, and 180-day landmarks, 365-day treatment-free probability was higher with pre-landmark peak hCG ≤ 20 U/L than >20 U/L: 68.4% versus 9.1%, 70.6% versus 22.2%, and 92.3% versus 14.3%, respectively. All 35 retreated patients achieved hCG ≤ 5 U/L after treatment. Conclusions: Most patients with persistent low-level hCG after remission from GTN developed recurrence. For patients still under observation at 60, 90, or 180 days, a peak hCG of 20 U/L or lower before the landmark was associated with higher treatment-free probability over the following year. Continued surveillance after clinical and imaging assessment is reasonable in this subgroup.