Marcillac I, Troalen F, Bidart J M, Ghillani P, Ribrag V, Escudier B, Malassagne B, Droz J P, Lhommé C, Rougier P
Department of Molecular Immunology, Institut G. Roussy, Villejuif, France.
Cancer Res. 1992 Jul 15;52(14):3901-7.
The diagnostic value of elevated human chorionic gonadotropin (hCG) and its free alpha (hCG alpha) and beta (hCG beta) subunit serum levels as specific tumor markers for nongonadal malignancies is controversial. In the present report, different monoclonal based immunoradiometric assays specific for hCG and its free hCG alpha and hCG beta subunits have been used to reevaluate the presence of these molecules in the serum of patients with a wide variety of tumors. Serum samples from patients with newly diagnosed, persistent, or recurrent malignancies of either known (n = 717) or unknown (n = 32) primary site, healthy blood donors (n = 309), and nonmalignant disease controls (n = 86) were studied using four highly specific and sensitive monoclonal based immunoradiometric assays to hCG and its free subunits. Low level hCG elevations (less than 1000 pg/ml) were found to be common in cancer patients, normal subjects, and disease controls. However, serum levels greater than 1000 pg/ml were highly diagnostic of gonadal tumors and specifically identified nonseminomatous testicular tumors. Significant serum elevations of free hCG alpha subunit (as high as 3000 pg/ml) were found in approximately 96% of cancer patients, normal individuals, and disease controls. In contrast, free hCG beta subunit levels (greater than or equal to 100 pg/ml) were detected in 70 and 50% of patients with nonseminomatous and seminomatous testicular cancers, respectively, and in 47% of bladder, 32% of pancreatic, and 30% of cervical carcinomas. All normal subjects and disease controls had free hCG beta levels less than 100 pg/ml. Thus, the detection of the free hCG beta subunit in serum of nonpregnant subjects was highly diagnostic of malignancy in general and specifically defines a subgroup of aggressive nongonadal malignancies.
人绒毛膜促性腺激素（hCG）及其游离α亚基（hCGα）和β亚基（hCGβ）血清水平升高作为非性腺恶性肿瘤的特异性肿瘤标志物，其诊断价值存在争议。在本报告中，使用了针对hCG及其游离hCGα和hCGβ亚基的不同基于单克隆抗体的免疫放射分析方法，重新评估这些分子在患有多种肿瘤的患者血清中的存在情况。使用四种针对hCG及其游离亚基的高度特异性和敏感性基于单克隆抗体的免疫放射分析方法，对来自已知（n = 717）或未知（n = 32）原发部位的新诊断、持续性或复发性恶性肿瘤患者、健康献血者（n = 309）以及非恶性疾病对照者（n = 86）的血清样本进行了研究。发现癌症患者、正常受试者和疾病对照者中低水平的hCG升高（低于1000 pg/ml）很常见。然而，血清水平高于(1000 pg/ml)对性腺肿瘤具有高度诊断价值，并且特别能识别非精原细胞瘤性睾丸肿瘤。在大约96%的癌症患者、正常个体和疾病对照者中发现游离hCGα亚基血清水平显著升高（高达3000 pg/ml）。相比之下，分别在70%的非精原细胞瘤性睾丸癌患者和50%的精原细胞瘤性睾丸癌患者中检测到游离hCGβ亚基水平（大于或等于100 pg/ml），在47%的膀胱癌患者、32%的胰腺癌患者和30%的宫颈癌患者中也检测到了该水平。所有正常受试者和疾病对照者的游离hCGβ水平均低于100 pg/ml。因此，在非妊娠受试者血清中检测到游离hCGβ亚基通常对恶性肿瘤具有高度诊断价值，并且特别能定义一组侵袭性非性腺恶性肿瘤。
