Urinary gonadotropin fragment, a new tumor marker. III. Use in cervical and vulvar cancers.

The efficacy of urinary gonadotropin fragment (UGF) and squamous cell carcinoma antigen (SCC) measurements was examined in the management of cervical and vulvar cancers. Of women with benign gynecologic disease (n = 89) 7%, of women with cervical or vulvar intraepithelial neoplasia (n = 25) 8%, and of those with cervical or vulvar malignancies (n = 60) 47% had elevated UGF levels (greater than 3 fmol/ml). SCC at a cutoff of 2.5 ng/ml had a similar sensitivity, 43%, for the same group of cervical and vulvar malignancies. The populations recognized by SCC and UGF, however, only partially overlapped, so that together UGF and SCC were elevated in 62% of women with malignancies. The sensitivity of both markers was stage dependent, so that UGF and SCC detected 26 and 22%, respectively, of early (stage I or II), and 67 and 40%, respectively, of advanced (stage II or IV) cancers. We monitored the progress of 21 women undergoing therapy for cancer with UGF and SCC measurements. Of the 21, 13 (62%) had true-positive UGF levels and 11 (52%) had true-positive SCC levels when cancer was initially detected. The levels of UGF accurately reflected changing clinical observations in 11 of 21 (52%); those of SCC, in 6 of 21 (29%); and levels of either, in 14 of 21 (67%) cases. Recurrences occurred in 7 of the 21 cases. Rising SCC levels predicted (at an earlier clinic visit) the recurrence in 4 of the 7, and rising UGF levels in 5 of the 7 (includes the 4 detected by SCC) patients. While these numbers for UGF and SCC sensitivity are not ideal, until other markers become available, they are seemingly the best achievable. It is suggested that both UGF and SCC be used to monitor therapy and to detect recurrences of cervical and vulvar cancers.