Kitajima T, Mochizuki M, Nishimura R
Department of Obstetrics and Gynecology, Kobe University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1991 Mar;43(3):297-303.
In addition to whole hCG, hCG beta-related molecular species are also present in the serum and urine of patients with trophoblastic diseases. We simultaneously measured whole hCG, free hCG beta and beta-core fragment in the serum and urine of patients with hydatidiform mole and choriocarcinoma by the highly specific and sensitive sandwich enzyme-immunoassay (EIA) systems using two kinds of antibodies. During the clinical courses of patients, although the whole hCG levels in serum and urine were closely correlated, the concentrations in the serum were almost twice as high as those in the urine. The free hCG beta levels were also closely correlated in serum and urine, but the concentrations of free hCG beta were extremely low as compared with those of whole hCG. Furthermore, free hCG beta/whole hCG ratios were significantly higher in choriocarcinoma patients than in hydatidiform mole patients. While whole hCG and free hCG beta were contained in both serum and urine, the beta-core fragment could be detected only in the urine of the patients. The relative contribution of the beta-core fragment to the total urinary hCG beta-immunoactivity accounted for about 40% in hydatidiform mole and about 70% in choriocarcinoma. We conclude that whole hCG should be measured in the serum rather than in the urine as a tumor marker for trophoblastic diseases, and suggest that the ratios of whole hCG, free hCG beta and beta-core fragment to each other may be useful indices to employ in the differential diagnosis of trophoblastic diseases.
除了完整的人绒毛膜促性腺激素（hCG）外，hCGβ相关分子形式也存在于滋养细胞疾病患者的血清和尿液中。我们使用两种抗体，通过高度特异性和灵敏的夹心酶免疫测定（EIA）系统，同时检测了葡萄胎和绒毛膜癌患者血清和尿液中的完整hCG、游离hCGβ和β核心片段。在患者的临床病程中，虽然血清和尿液中的完整hCG水平密切相关，但血清中的浓度几乎是尿液中的两倍。血清和尿液中的游离hCGβ水平也密切相关，但与完整hCG相比，游离hCGβ的浓度极低。此外，绒毛膜癌患者的游离hCGβ/完整hCG比值显著高于葡萄胎患者。虽然血清和尿液中都含有完整hCG和游离hCGβ，但β核心片段仅在患者尿液中检测到。β核心片段对总尿hCGβ免疫活性的相对贡献在葡萄胎中约占40%，在绒毛膜癌中约占70%。我们得出结论，作为滋养细胞疾病的肿瘤标志物，应检测血清而非尿液中的完整hCG，并建议完整hCG、游离hCGβ和β核心片段之间的比值可能是用于滋养细胞疾病鉴别诊断的有用指标。
