Shaarawy Mohamed, El-Mallah Samira Y, Sheiba Mamdouh
Endocrinology and Maternal Biochemistry Laboratories, Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Clin Chem Lab Med. 2003 Mar;41(3):306-10. doi: 10.1515/CCLM.2003.049.
The aim of this study was to evaluate the diagnostic and prognostic values of serum angiogenin concentration in cases with gestational trophoblastic diseases (GTDs). Seventy-two patients with GTDs and 20 first trimester healthy pregnant women (controls) participated in this study. According to the WHO scoring system, GTDs were subgrouped into 24 hydatiform mole spontaneous regression (HMSR), 18 postmolar gestational trophoblastic tumors of high risk (PMHR), 16 low-risk choriocarcinoma, and 14 high-risk choriocarcinoma. Before treatment, a blood sample from each case was assayed for human chorionic gonadotrophin , subunit (hCGb) by radioimmunoassay and angiogenin by enzyme immunoassay. Follow-up hCGb and angiogenin assays were carried out for 1 year after treatment. Pretreatment of abnormal values of serum angiogenin (> 711 ng/ml, upper 95% confidence interval of controls) was encountered in 100% of PMHR cases compared to no single case of HMSR. Serum angiogenin levels in low- and high-risk cases with choriocarcinoma were significantly higher than in controls. Abnormal high values were encountered in 25% and 86% of cases, respectively. None of the low-risk cases exceeded 920 ng/ml, while 72% of high-risk cases exceeded this value. Serial angiogenin assays were correlated with disease progression and were positively correlated with serum hCGb (r = 0.75, p < 0.01). In conclusion, serum angiogenin may be a valuable marker of differential diagnosis of GTDs and its serial measurements are suggestive of remission and effective therapeutic intervention or disease progression.
本研究旨在评估血清血管生成素浓度在妊娠滋养细胞疾病（GTDs）患者中的诊断和预后价值。72例GTDs患者和20例孕早期健康孕妇（对照组）参与了本研究。根据世界卫生组织评分系统，GTDs被分为24例葡萄胎自然消退（HMSR）、18例高危葡萄胎后妊娠滋养细胞肿瘤（PMHR）、16例低危绒毛膜癌和14例高危绒毛膜癌。治疗前，采用放射免疫法检测各病例血样中的人绒毛膜促性腺激素β亚基（hCGb），采用酶免疫法检测血管生成素。治疗后随访1年，进行hCGb和血管生成素检测。100%的PMHR病例血清血管生成素值异常（>711 ng/ml，对照组95%置信区间上限），而HMSR病例无一例异常。绒毛膜癌低危和高危病例的血清血管生成素水平显著高于对照组。异常高值分别出现在25%和86%的病例中。低危病例均未超过920 ng/ml，而72%的高危病例超过此值。连续血管生成素检测与疾病进展相关，且与血清hCGb呈正相关（r = 0.75，p < 0.01）。总之，血清血管生成素可能是GTDs鉴别诊断的有价值标志物，其连续检测提示缓解、有效治疗干预或疾病进展。
