Schutter E M, Mijatovic V, Kok A, Van Kamp G J, Verstraeten R, Verheijen R H
Department of Oncologic Gynaecology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Anticancer Res. 1999 Nov-Dec;19(6C):5551-7.
Beta human chorionic gonadotropin (beta-hCG) is expressed in human fetal tissue and cancer cells of various histologic types. It is degraded to the beta-core fragment (beta cf-hCG) which is concentrated in urine, and is known as urinary gonadotropin peptide (UGP). The objective of this study was to assess 1) the value of urinary gonadotropin peptide (UGP) as a single test and the combination of UGP with CA 125 as a diagnostic test in predicting the benign or malignant origin of gynecologic disease, 2) the influence of surgical removal of the tumor on the levels of UGP and CA 125, 3) the influence of the urinary concentration on the UGP levels in relation to the test results. PATIENTS, MATERIALS, METHODS AND STATISTICS: Serum and urine were collected from 31 gynecological patients with malignant and non-malignant disease, preoperatively, and 1 week and 6 weeks after surgery. Optimal cut-off levels were determined by Receiver Operating Characteristic-curves (ROC). Sensitivity (SENS), specificity (SPEC), positive (PPV) and negative predictive value (NPV) and overall test accuracy (ACC) for their ability to discriminate benign from malignant masses were calculated. Logistic regression analysis was performed to calculate the contribution of CA 125, UGP and UGP/creatinine (UGP/creat) to a model predicting malignancy.
The optimal cut-off level for UGP was found 1 fmol/l, for UGP/creat 1.33 fmol/mg creatinine and for CA 125 100 kU/L. The distribution of the urinary creatinine values varied considerably (median = 8.3 mmol/l, range 0.6-25.8 mmol/l). The correlation coefficient (r) between log UGP and log CA 125 was 0.44 (p = 0.001) and between log UGP/creat and log CA 125 0.53 (p < 0.0001).
UGP may be used as a tumor maker in gynecological disease. However, CA 125 as single test discriminates malignant from benign disease better than UGP or UGP/creat. In a logistic model the combination of CA 125 with UGP and UGP/creat predicts the benign or malignant character in 89% of the study population. Significant changes in UGP and UGP/creat levels were seen after removal of benign tumors, however, this was not found in ovarian cancer patients. Correction of the UGP values for the urinary concentration improved the results slightly.
β-人绒毛膜促性腺激素（β-hCG）在人类胎儿组织及各种组织学类型的癌细胞中均有表达。它会降解为β-核心片段（β cf-hCG），该片段在尿液中浓缩，即尿促性腺激素肽（UGP）。本研究的目的是评估：1）尿促性腺激素肽（UGP）作为单一检测指标以及UGP与CA 125联合检测在预测妇科疾病良性或恶性起源方面的诊断价值；2）手术切除肿瘤对UGP和CA 125水平的影响；3）尿液浓度对UGP水平及检测结果的影响。
患者、材料、方法与统计学分析：收集31例患有恶性和非恶性疾病的妇科患者术前、术后1周及术后6周的血清和尿液。通过受试者工作特征曲线（ROC）确定最佳截断值。计算其区分良性与恶性肿块能力的灵敏度（SENS）、特异性（SPEC）、阳性预测值（PPV）、阴性预测值（NPV）及总体检测准确性（ACC）。进行逻辑回归分析以计算CA 125、UGP及UGP/肌酐（UGP/creat）对预测恶性肿瘤模型的贡献。
发现UGP的最佳截断值为1 fmol/l，UGP/creat为1.33 fmol/mg肌酐，CA 125为100 kU/L。尿肌酐值的分布差异很大（中位数 = 8.3 mmol/l，范围0.6 - 25.8 mmol/l）。log UGP与log CA 125之间的相关系数（r）为0.44（p = 0.001），log UGP/creat与log CA 125之间的相关系数为0.53（p < 0.0001）。
UGP可作为妇科疾病的肿瘤标志物。然而，作为单一检测指标，CA 125区分恶性与良性疾病的能力优于UGP或UGP/creat。在逻辑模型中，CA 125与UGP及UGP/creat联合可预测89%研究人群的良性或恶性特征。切除良性肿瘤后，UGP和UGP/creat水平有显著变化，但卵巢癌患者未发现此情况。对尿液浓度进行校正后，UGP值的检测结果略有改善。
